Effect of cerebrospinal fluid removal on cerebral blood flow and metabolism in patients with Alzheimer's disease versus recent stroke.

Meyer, John Stirling; Miyakawa, Yuichi; Ishihara, Naoki; Itoh, Yoshifumi; Mathew, Ninan T.; Welch, K. M. A.; Deshmukh, Vinod D.; Ericksson, A D

doi:10.1161/01.str.8.1.44

Cited by 11 publications

(5 citation statements)

References 36 publications

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“…The increase in overall rCBF values after prolonged methylphenidate treatment of patients with narcolepsy is consonant with pharmacological studies [3,6,71. Experiments reported by Carlsson et al [4] showed significant increases in cerebral blood flow and oxidative metabolism after amphetamine administration in animals.…”

Section: Methodssupporting

confidence: 63%

Sleep apnea, narcolepsy, and dreaming: Regional cerebral hemodynamics

Meyer

Sakai

Karacan

et al. 1980

Annals of Neurology

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Regional cerebral flow after inhalation of xenon 133 as well as polysomnography were recorded during daytime sleep and the awake state in patients with narcolepsy and sleep apnea. Brainstem-cerebellar (BSC) gray matter blood flow (Fg) values in the awake state were reduced below normal (p less than 0.05) in both narcolepsy and sleep apnea; in sleep apnea, bihemispheric Fg values were also reduced in the awake state. After sleep onset, Fg paradoxically increased in narcolepsy but decreased further in sleep apnea. Maximal regional Fg changes occurred in BSC regions in both groups of patients. Oral administration of methylphenidate hydrochloride (Ritalin) increased resting Fg values in awake narcoleptics, particularly in BSC regions, but attentuated Fg increases during sleep onset. Regional Fg values during visual dreaming or hypnagogic hallucinations in narcoleptics were maximally increased in right parietooccipital regions. In narcoleptics, impaired control of sleep-wake and REM mechanisms is attentuated by methylphenidate. In patients with sleep apnea, brainstem functional activity is low in the awake state but becomes critically reduced during sleep, culminating in apnea-stimulated arousal followed by repetitive cycles as sleep recurs.

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Section: Methodssupporting

confidence: 63%

Sleep apnea, narcolepsy, and dreaming: Regional cerebral hemodynamics

Meyer

Sakai

Karacan

et al. 1980

Annals of Neurology

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“…13 " 15 Removal of CSF from patients with NPH resulted in increased CBF but had no effect on or decreased CBF in patients with an identical clinical picture due to cerebral atrophy. 1 *" 16 Grubb et al 17 and Kushner et al 18 did not confirm these observations. The accurate diagnosis of NPH is important because complications arising from CSF shunts (hemorrhage, infection) may be fatal in old and fragile patients.…”

mentioning

confidence: 90%

Cerebral blood flow in normal pressure hydrocephalus.

Mamo

Méric

Ponsin

et al. 1987

Stroke

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A xenon-133 method was used to measure cerebral blood flow (CBF) before and after cerebrospinal fluid (CSF) removal in patients with normal pressure hydrocephalus (NPH). Preliminary results suggested that shunting should be performed on patients whose CBF increased after CSF removal. There was a significant increase in CBF in patients with NPH, which was confirmed by the favorable outcome of 88% of patients shunted. The majority of patients with senile and presenile dementia showed a decrease or no change in CBF after CSF removal. It is suggested that although changes in CBF and clinical symptoms of NPH may have the same cause, i.e., changes in the cerebral intraparenchymal pressure, there is no simple direct relation between these two events. The mechanism underlying the loss of autoregulation observed in NPH is also discussed. (Stroke 1987;18:1074-1080)

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“…18 The first clinicaf study on the effects of lowering CSFP on CBF was reported by Shenkin et al" They showed that reduction of increased intracranial pressure by removal of CSF in patients with brain tumor caused no change in CBF. More recently, it was reported from this laboratory that lowering CSFP by removal of CSF in patients with benign intracranial hypertension" or stroke 1 did not alter CBF.…”

Section: Discussionmentioning

confidence: 96%

“…1 Since it is relatively easily detected polarographically it would appear to be ideal for measurement of blood flow in very discrete regions.…”

Section: Use Of Hydrogen Formentioning

confidence: 99%

“…1 In that study after CSF removal cerebral blood flow (CBF) decreased in patients with Alzheimer's disease but showed no significant change in patients with stroke. It was postulated that a neurogenic reflex induced by alterations in cerebral venous pressure may vary vasomotor tone of the cerebral arterial system (venoarterial reflex), and this reflex might provide part of a cerebrospinal fluid pressure-cerebral blood flow (CSFP-CBF) autoregulatory mechanism.…”

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confidence: 92%

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