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ABSTRACT: OBJECTIVE: Cerebral autoregulation (CA) is the mechanism by which constant cerebral blood flow is maintained despite changes in cerebral perfusion pressure. CA can be evaluated by dynamic monitoring of cerebral blood flow velocity (CBFV) with transcranial Doppler sonography (TCD). The present study aimed to explore CA in chronic anxiety. METHODS: Subjects with Hamilton anxiety scale scores ≥14 were enrolled and the dynamic changes of CBFV in response to an orthostatic challenge were investigated using TCD. RESULTS: In both the anxious and the healthy subjects, the mean CBFV was significantly lower in the upright position than when supine. However, the CBFV changes from supine to upright differed between the anxious and the healthy groups. Anxious subjects showed more pronounced decreases in CBFV with abrupt standing. CONCLUSION: Our results indicate that cerebrovascular modulation is compromised in chronic anxiety; anxious subjects have some insufficiency in maintaining cerebral perfusion after postural change. Given the fact that anxiety and impaired CA are associated with cardiovascular disease, early ascertainment of compromised cerebrovascular modulation using TCD might suggest interventional therapies in the anxious population, and improve the primary prevention of cardiovascular disease.
Neuroscience Bulletin 11/2012; · 1.31 Impact Factor
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The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques 05/2012; 39(3):383-4. · 0.97 Impact Factor
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ABSTRACT: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system characterized by episodic and progressive neurologic dysfunction resulting from inflammatory and autoimmune reactions. The underlying pathogenesis of MS remains largely unclear. However, it is currently accepted as a T cell-mediated autoimmune disease. Among other clinical manifestations, sexual dysfunction (SD) is a painful but still underreported and underdiagnosed symptom of the disorder. SD in MS patients may result from a complex set of conditions and may be associated with multiple anatomic, physiologic, biologic, medical and psychological factors. SD arises primarily from lesions affecting the neural pathways involved in physiologic function. In addition, psychological factors, the side effects of medications and physical symptoms such as fatigue, muscular weakness, menstrual changes, pain and concerns about bladder and bowel incontinence may also be involved. Since MS primarily affects young people, SD secondary to MS may have a great impact on quality of life. Thus, maintaining a healthy sexual life with MS is an important priority. The treatment of SD requires multidisciplinary teamwork and cooperation among specialists, individual patients, partners and the society.
Asian Journal of Andrology 03/2012; 14(4):530-5. · 1.52 Impact Factor
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ABSTRACT: To report a case of progressive facial hemiatrophy with unusual features of contralateral brain atrophy and transcranial Doppler ultrasound evidence of autonomic dysfunction.
Case report.
A teaching hospital.
A 63-year-old man who presented with a 10-year history of progressive right-sided facial atrophy and recent facial pain.
Brain magnetic resonance imaging revealed left frontoparietal atrophy. Transcranial Doppler ultrasound demonstrated evidence of autonomic dysfunction ipsilateral to brain atrophy.
This case expands the spectrum of findings in progressive facial hemiatrophy to include contralateral brain atrophy and suggests that sympathetic dysfunction might play a pathogenic role in progressive facial hemiatrophy.
Archives of neurology 09/2011; 68(9):1195-7. · 6.31 Impact Factor
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ABSTRACT: Mycoplasma pneumoniae (M. pneumoniae) is a frequent cause for human infection, and central nervous system disease associated with M. pneumoniae infection is being reported with increasing frequency. We described herein a 60-year-old woman who developed meningitis associated with bilateral optic papillitis following M. pneumoniae infection and discussed the possible mechanisms. To our knowledge, there have been only a few reports that described the meningitis complicated by bilateral optic papillitis in association with M. pneumoniae infection. Our case highlighted the protean neurological manifestations of M. pneumoniae infection.
Neurological Sciences 07/2011; 33(2):355-8. · 1.32 Impact Factor
