Combined transcranial doppler and EEG recording in vasovagal syncope

E. Vicenzini, S. Pro, S. Strano, P. Pulitano, M. Altieri, V. Di Piero, G. L. Lenzi, N. Accornero, O. Mecarelli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In neurally mediated syncope a 'typical' EEG pattern during hyperventilation (HV) may be observed. This study aimed to investigate transcranial Doppler (TCD) and EEG variations in response to hyper- and hypocapnia using simultaneous recording. Methods: Syncope patients with a typical EEG pattern during HV (SEEG+, n = 15) and those without abnormalities (SEEG-, n = 16) were compared with healthy controls (n = 20). Simultaneous TCD and EEG recordings were performed at rest (baseline), during 2 apnea tests and during HV. Cerebrovascular vasoreactivity, index for hypocapnia, total vasomotor reserve and time to flow velocity normalization after HV (t-norm) were recorded. Results: With TCD, a reduction in Vasomotor reserve was observed in SEEG+ compared with the other 2 groups (control: 67 ± 8%; SEEG-: 67 ± 10%; SEEG+: 57 ± 8%; p <0.0001). t-norm was longer in all syncopal patients and in particular in SEEG+ (control: 20.2 ± 3 s; SEEG-: 40 ± 7 s; SEEG+: 123 ± 45s; p <0.0001). Quantitative EEG showed an increase in slow bands in all subjects during HV, small and nonsignificant in controls and SEEG-, higher and significant in SEEG+, related with flow reduction. Conclusions: Changes in the sympathetic modulation of cerebral vasoconstriction may explain both the pathophysiology of vasovagal syncope and the typical paroxysmal EEG findings.

Original languageEnglish
Pages (from-to)258-263
Number of pages6
JournalEuropean Neurology
Volume60
Issue number5
DOIs
Publication statusPublished - Oct 2008

Keywords

  • Cerebral vasoreactivity
  • Quantitative EEG
  • Syncope
  • Transcranial Doppler

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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