Cerebrovascular hemodynamic changes in multiple sclerosis patients during head-up tilt table test: Effect of high-dose intravenous steroid treatment

Zsolt Mezei, Laszlo Olah, Laszlo Kardos, Reka Katalin Kovacs, Laszlo Csiba, Tunde Csepany

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Demyelination in multiple sclerosis (MS) may cause damage to the vegetative nervous system. Our objective was to examine cerebral autoregulation assessed via blood pressure and cerebral blood flow velocity fluctuations during head-up tilt table testing. We also investigated the effects of high-dose intravenous corticosteroid treatment. Transcranial Doppler registration of middle cerebral artery blood flow velocity and continuous blood pressure and heart rate monitoring were performed at rest and during tilt table testing in 30 MS patients. Ten age-matched healthy subjects were also examined as controls. Correlations between mean arterial blood pressure (MBP) and cerebral blood flow velocity (CBF) fluctuations were averaged, yielding the correlation coefficient index Mx. For a subgroup of 11 patients with acute exacerbations, results were also evaluated before and after methylprednisolone treatment (1 g/day intravenously for 5 days). No significant differences in the autoregulatory indices were seen between patients and controls, or between pre- and post-steroid results. Modeling CBF velocity changes associated with a 1-mmHg increase in MBP, significant differences (p < 0.05) were detected in patients vs. controls, and also after vs. before steroid administration. We conclude that cerebrovascular autoregulation impairments are detectable in early phase MS. Corticosteroid treatment has a significant effect on hemodynamic changes in acute exacerbations.

Original languageEnglish
Pages (from-to)2335-2342
Number of pages8
JournalJournal of Neurology
Volume260
Issue number9
DOIs
Publication statusPublished - Sep 1 2013

Keywords

  • Blood flow velocity
  • Cerebral autoregulation
  • Corticosteroid
  • Multiple sclerosis
  • Transcranial Doppler

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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