Relation of cerebral blood flow to motor and cognitive functions in chronic stroke patients.
- 1 February 1994
- journal article
- research article
- Published by Wolters Kluwer Health in Stroke
- Vol. 25 (2) , 309-317
- https://doi.org/10.1161/01.str.25.2.309
Abstract
The aim of this study was to examine the levels of cerebral blood flow in relation to motor and cognitive functions in 300 chronic unilateral stroke patients (age, 64 +/- 12 years; mean +/- SD). Cerebral blood flow was measured by the 133Xe inhalation method, adjusted for age, sex, and PCO2 level. Motor function was scored according to Brunnstrom hemiplegic staging and cognitive function according to the Hasegawa dementia rating scale tested in Japanese. Asymmetries of blood flow between affected and nonaffected hemispheres increased with lesion size and were highest in 11 embolic strokes (20 +/- 9%) and higher in 80 nonembolic cortical infarctions (11 +/- 11%) and 76 hemorrhages (9 +/- 7%) than in the group of 133 subcortical infarctions (2 +/- 6%) or 16 control subjects (1 +/- 2%). Severity of hemiparesis correlated with decreased cerebral blood flow in the affected hemisphere (P < .01) and increased hemispheric asymmetries of blood flow (P < 001). Cognitive impairments, after adjusting for age, correlated with decreased cerebral blood flow in the nonaffected hemisphere (P < .0001), left hemispheric lesions (P < .0005), and embolic stroke (P < .005) but not with asymmetries of blood flow. Among 67 patients having bilateral reductions of cerebral blood flow, 25 patients with left hemispheric lesions showed more severe cognitive impairments than among 42 patients with right hemispheric lesions (P < .05). We confirmed that severity of hemiparesis correlated with the degree of asymmetries of cerebral blood flow, reflecting the extent and location of the lesions. Bilateral reductions of cerebral blood flow in patients with left hemispheric lesions may in part contribute to cognitive impairments, indicating reductions of global neuronal activities in the contralateral hemisphere or diffuse cerebrovascular changes. Further studies of cerebral metabolism and follow-up of cerebral circulation are required to reveal the pathophysiology and clinical consequences.Keywords
This publication has 25 references indexed in Scilit:
- Effect of Long-Term Antihypertensive Treatment on the Cerebral Blood Flow in Patients with Brain InfarctionCerebrovascular Diseases, 1993
- Problems in cerebral blood flow calculation using xenon-133 in patients with pulmonary diseases.Stroke, 1990
- Effects of capsular or thalamic stroke on metabolism in the cortex and cerebellum: a positron tomography study.Stroke, 1990
- Changes of blood flow in the cerebral cortex after subcortical ischemic infarction.Stroke, 1989
- Regional cerebral blood flow in chronic stroke patients with dementia.Japanese Journal of Medicine, 1988
- Cerebral blood flow in the patient with putaminal hemorrhage - Comparison between surgical and conservtive treatment.Japanese Journal of Stroke, 1988
- Regional cerebral blood flow in essential hypertension: data evaluation by a mapping system.Stroke, 1987
- The profile of recovery from stroke and factors influencing outcome.Stroke, 1984
- Focal cerebral ischemia measured by the intra-arterial 133xenon method. Limitations of 2-dimensional blood flow measurements.Stroke, 1981
- Cerebral hemodynamic response to mental activation in normo- and hypercapnia.Stroke, 1980