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KMID : 1101420160480020144
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Korean Journal of Clinical Laboratory Science
2016 Volume.48 No. 2 p.144 ~ p.152
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Cerebral-perfusion Reserve after Carotid-artery Stenting: Relationship with Power Spectrum of Electroencephalography
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Jeong Da-Hye
Jung Seok-Won
Kwak Byeong-Geun
Kim Young-Soo
Kim Soo-Kyoung
Kwon Oh-Young
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Abstract
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Carotid-artery stenosis may reduce cerebral perfusion, and affect cerebral neuronal activities. We examined the question of whether the recovery of cerebral-perfusion reserve after carotid-artery stenting (CAS) can affect the EEG power-spectrum. Nineteen candidates for CAS were initially recruited. Subtraction imaging of single photon emissary computerized tomography (SPECT) and an electroencephalogram (EEG) were taken twice, before and 1 month after CAS. At each time point, the EEGs were recorded before and after injection of acetazolamide (pre-ACZ EEG and post-ACZ EEG). Finally, 7 patients were enrolled after exclusion of incomplete studies. We obtained the spectral ratio (SR) of each hemisphere. SR was defined as the divided value of the power-spectrum sum of fast activities by that of slow activities. The power-spectrum values between hemispheres were compared using the inter-hemispheric index of spectral ratio (IHISR), and we examined the correlation between the power-spectrum and the cerebral-perfusion reserve. Cerebral-perfusion reserve improved after CAS on the stent side in 6 of 7 patients. In 3 patients with unilateral carotid-artery stenosis, CAS increased SR on the pre-ACZ EEGs, and IHISR on the post-ACZ EEGs. The increases of SR and IHISR were concordant with the increment of cerebral-perfusion reserve. In contrast, the results in the other patients with bilateral stenosis showed complex patterns. The SR of pre-ACZ EEGs and IHISR of post-ACZ EEGs may be useful electrophysiological markers for the blood-flow reserve after CAS in patients with unilateral carotid-artery stenosis, but not in those with bilateral stenosis.
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KEYWORD
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Carotid stenosis, Stents, Electroencephalography, Spectrum analysis
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