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Abstract Details

Ischemic Stroke Strikes Autonomic Nervous System
Cerebrovascular Disease and Interventional Neurology
P15 - Poster Session 15 (12:00 PM-1:00 PM)
4-012

1) To assess autonomic dysfunction in ischemic stroke patients compared to healthy controls.

2) To identify any association of dysautonomia with stroke severity, sub-types, the outcome at 3 months.

Disturbances of the autonomic nervous system are common in patients with various cerebrovascular diseases. Reliable recognition of autonomic dysfunction using quantitative analysis is important because these disturbances are subjectively disabling & may also cause unfavorable prognosis. There has not been much work done on prevalence of autonomic disturbances in stroke patients, especially concerning stroke sub-types and severity.

Hence we aimed to study autonomic dysfunction among ischemic stroke patients attending our stroke clinic comprising predominantly South Indian population.
A case-control study comparing ischemic stroke with control subjects matched for age, gender, and status of diabetes and hypertension was conducted. Ischemic stroke patients were evaluated using conventional bedside tests and sophisticated automated computerized tests using beat to beat blood pressure recording and Heart Rate Variability (HRV) analysis in the first month post-stroke phase.
HRV time and frequency domains revealed significant dysautonomia in ischemic stroke patients. Dysautonomia expressed in HRV parameters- HF power, RMSSD and pRR50 reflecting parasympathetic modulation had a significant association with baseline stroke severity (NIHSS) after controlling for baseline confounders like Systolic BP, Diastolic BP (DBP), and heart rate. Conventional autonomic function tests like deep breathing Expiratory: Inspiratory ratio, Valsalva ratio, standing 30:15 ratio, DBP rise with the isometric handgrip, cold pressor, and mental arithmetic also showed significant impairment in ischemic stroke patients on univariate analysis. However, on controlling baseline confounders, there was no distinction between ischemic stroke and controls for these.
Ischemic stroke is associated with significant dysautonomia in post-stroke first-month duration and dysautonomia is associated with the baseline stroke severity (NIHSS). Limitation of the study could be an absence of Total Anterior Circulation Stroke cases.
Authors/Disclosures

PRESENTER
No disclosure on file