Document Detail


Postural neurocognitive and neuronal activated cerebral blood flow deficits in young chronic fatigue syndrome patients with postural tachycardia syndrome.
MedLine Citation:
PMID:  22180650     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neurocognition is impaired in chronic fatigue syndrome (CFS). We propose that the impairment relates to postural cerebral hemodynamics. Twenty-five CFS subjects and twenty control subjects underwent incremental upright tilt at 0, 15, 30, 45, 60, and 75° with continuous measurement of arterial blood pressure and cerebral blood flow velocity (CBFV). We used an n-back task with n ranging from 0 to 4 (increased n = increased task difficulty) to test working memory and information processing. We measured n-back outcomes by the number of correct answers and by reaction time. We measured CBFV, critical closing pressure (CCP), and CBFV altered by neuronal activity (activated CBFV) during each n value and every tilt angle using transcranial Doppler ultrasound. N-back outcome in control subjects decreased with n valve but was independent of tilt angle. N-back outcome in CFS subjects decreased with n value but deteriorated as orthostasis progressed. Absolute mean CBFV was slightly less than in control subjects in CFS subject at each angle. Activated CBFV in control subjects was independent of tilt angle and increased with n value. In contrast, activated CBFV averaged 0 in CFS subjects, decreased with angle, and was less than in control subjects. CCP was increased in CFS subjects, suggesting increased vasomotor tone and decreased metabolic control of CBFV. CCP did not change with orthostasis in CFS subjects but decreased monotonically in control subjects, consistent with vasodilation as compensation for the orthostatic reduction of cerebral perfusion pressure. Increasing orthostatic stress impairs neurocognition in CFS subjects. CBFV activation, normally tightly linked to cognitive neuronal activity, is unrelated to cognitive performance in CFS subjects; the increased CCP and vasomotor tone may indicate an uncoupling of the neurovascular unit during orthostasis.
Authors:
Julian M Stewart; Marvin S Medow; Zachary R Messer; Ila L Baugham; Courtney Terilli; Anthony J Ocon
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-12-16
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  302     ISSN:  1522-1539     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-24     Completed Date:  2012-04-19     Revised Date:  2012-05-28    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H1185-94     Citation Subset:  IM    
Affiliation:
Departments of Physiology, New York Medical College, Valhalla, New York. USA. julian_stewart@nymc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Flow Velocity / physiology
Blood Pressure / physiology
Cerebrovascular Circulation / physiology*
Cerebrum / blood supply*,  physiopathology
Cognition Disorders / physiopathology*
Fatigue Syndrome, Chronic / physiopathology*
Female
Heart Rate / physiology
Humans
Male
Memory, Short-Term / physiology
Postural Orthostatic Tachycardia Syndrome / physiopathology*
Posture / physiology*
Reaction Time / physiology
Tilt-Table Test
Ultrasonography, Doppler, Transcranial / methods
Young Adult
Grant Support
ID/Acronym/Agency:
1-F30-HL-097380/HL/NHLBI NIH HHS; 1-RO1-HL-074873/HL/NHLBI NIH HHS; 1-RO1-HL-087803/HL/NHLBI NIH HHS; R01 HL074873/HL/NHLBI NIH HHS; R01 HL074873-08/HL/NHLBI NIH HHS; R01 HL087803/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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