Temporo-parietal theta activity correlates with misery perfusion in arterial occlusive disease.
OBJECTIVE
Temporo-parietal theta activity (TPTA), often detected in hemispheres with internal carotid (ICA) or middle cerebral artery (MCA) occlusive lesions, is more clearly separated from occipital alpha activity by magnetoencephalography (MEG) than electroencephalography. The present study investigated whether TPTA is correlated with misery perfusion, a surgically correctable type of hemodynamic impairment.


METHODS
Awake MEG was measured in 56 patients with ICA or MCA occlusive lesions. Regional cerebral blood flow (rCBF) and regional cerebrovascular reactivity (rCVR) to acetazolamide were measured in the MCA territory by xenon-133 single-photon emission computed tomography. MEG was repeated in 10 patients after vascular reconstruction surgery.


RESULTS
Fourteen patients showed TPTA in the lesion hemisphere (n=13) or bilaterally (n=1). The presence of TPTA was significantly correlated with both reduced rCBF and reduced rCVR (P=0.0009). After surgery, TPTA disappeared in 7 of the 10 studied patients.


CONCLUSIONS
The presence of TPTA suggests misery perfusion, which is characterized by reduced rCBF and reduced rCVR.


CONCLUSIONS
MEG can detect the presence of reversible and surgically remediable cerebral ischemia before the development of complete infarction.
Ohtomo
Satoru
S
Department of Neurosurgery, Kohnan Hospital, Sendai, Japan.
Nakasato
Nobukazu
N
Shimizu
Hiroaki
H
Seki
Shintarou
S
Kanno
Akitake
A
Kumabe
Toshihiro
T
Tominaga
Teiji
T
D000328:Adult; D000368:Aged; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000378:metabolism* / Q000503:physiopathology* / Q000601:surgery; D002545:Brain Ischemia / Q000378:metabolism / Q000503:physiopathology; D001931:Brain Mapping; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D015225:Magnetoencephalography; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D010100:Oxygen / Q000378:metabolism*; D010296:Parietal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology*; D049268:Positron-Emission Tomography; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013702:Temporal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013826:Theta Rhythm; D015899:Tomography, Emission-Computed, Single-Photon; D014656:Vascular Surgical Procedures
D010100:Oxygen