Electrophysiological Characteristics of Autonomic Nervous System Function in Post-Stroke Patients.

, Kim, Do Sung; , Jeong, Ho Joong; , Sim, Young Joo; , Jun, Po Sung; , Lee, Ji Heoung

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2009;33(6):682-686.

Kim, Do Sung , Jeong, Ho Joong , Sim, Young Joo , Jun, Po Sung , Lee, Ji Heoung

¹Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Korea. jhjpmr@yahoo.co.kr
²Department of Physical Medicine and Rehabilitation, Dong-Eui Hospital, Korea.

뇌졸중 환자의 자율신경계 기능의 전기생리학적 특성

김도성, 정호중, 심영주, 전포성¹, 이지형¹

고신대학교 의과대학 재활의학교실, ¹동의병원 재활의학과

Abstract

Objective
To evaluate the autonomic nervous function in post-stroke patients.
Method
A total of 58 subjects, 34 post-stroke patients (mean age of 61.35 years) and 24 healthy subjects (mean age of 34.42 years) were included. The sympathetic skin response (SSR), the R-R interval variation (RRIV) and orthostatic hypotension (OH) were evaluated. Bilateral sympathetic skin responses were recorded on the palm and sole with stimulation of both median and tibial nerves. The obtained SSRs were divided into normal response and abnormal response including no response. The R-R interval variations were estimated during rest, deep breathing and Valsalva maneuver respectively.
Results
In all healthy subjects, obtained SSRs were of normal response. Although the rate of abnormal SSR was 75.4% (205 of 272 waves) in stroke patients, the rate of abnormal SSR on affected side (81.6%, 111 of 136 waves) was significantly higher than unaffected side (69.1%, 94 of 136 waves) (p＜0.05). The rate of abnormal SSR according to OH was not significantly different (with OH 75.0%, without OH 75.6%) (p＞0.05). The RRIV of stroke patients with OH (1.09±0.06) was significantly lower than in control (1.14±0.05) during rest (p＜0.01), and in stroke patients without OH, the RRIV (1.13±0.06) was also significantly lower than in control (1.27±0.22) during Valsalva maneuver (p＜0.01).
Conclusion
Evaluation of SSR and RRIV could be helpful in detecting dysfunction of autonomic nervous system in post-stroke patients. (J Korean Acad Rehab Med 2009; 33: 682-686)

Key Words: Autonomic nervous system, R-R interval variation, Stroke, Sympathetic skin response