Document Detail

Lateralization in autonomic dysfunction in ischemic stroke involving the insular cortex.
MedLine Citation:
PMID:  15076768     Owner:  NLM     Status:  MEDLINE    
Autonomic nervous system dysfunction is a common complication of ischemic stroke. Clinical and experimental data indicate hemispheric lateralization in the control of autonomic activity. The insular cortex has also been shown to play a crucial role in the central autonomic network. The aim of this study was to assess cardio-autonomic dysfunction in patients with ischemic insular versus non-insular cortex infarction, and to demonstrate a possible lateralization in autonomic activity mediated by the insular cortex. Sympathetic function was prospectively assessed by determining plasma norepinephrine and epinephrine in 15 patients with left-hemisphere (LH; four insular infarction), and 14 with right-hemisphere (RH) middle cerebral artery (MCA) stroke (five insular infarction). Systolic and diastolic blood pressure and heart rate were recorded during the first 5 days after stroke. Sympathetic activity was significantly higher in insular than in non-insular infarction (p < 0.05) with concomitantly elevated cardiovascular parameters in insular stroke patients. The pathological activation of the sympathetic nervous system was most excessive in RH-stroke involving the insular cortex (p < 0.05). Our data indicate a hemispheric lateralization in autonomic activity which is mediated by the right-sided insular cortex. Patients with RH stroke involving the insular cortex are most susceptible to develop cardio-autonomic dysfunction.
S Meyer; M Strittmatter; C Fischer; T Georg; B Schmitz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neuroreport     Volume:  15     ISSN:  0959-4965     ISO Abbreviation:  Neuroreport     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-04-12     Completed Date:  2004-06-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9100935     Medline TA:  Neuroreport     Country:  England    
Other Details:
Languages:  eng     Pagination:  357-61     Citation Subset:  IM    
Department of Neurology and Pediatrics, University of the Saarland, Germany.
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MeSH Terms
Autonomic Nervous System Diseases / etiology,  pathology,  physiopathology*
Blood Pressure / physiology
Brain Ischemia / complications*
Cerebral Cortex / pathology,  physiopathology*
Cerebral Infarction / blood,  pathology,  physiopathology
Epinephrine / blood
Functional Laterality / physiology*
Heart Rate / physiology
Infarction, Middle Cerebral Artery / complications
Middle Aged
Nordefrin / blood
Prospective Studies
Stroke / complications*
Reg. No./Substance:
51-43-4/Epinephrine; 6539-57-7/Nordefrin

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