title: Altered cerebral vasoregulation predicts the outcome of patients with partial anterior circulation stroke.
abstract: OBJECTIVE
  The aim of this study was to investigate the correlation between cerebral hemodynamic changes and the evolution of neurological deficit after stroke.
  
  
  METHODS
  We included 65 patients with non-lacunar stroke admitted to a rehabilitation hospital within 4 weeks from the event. An evaluation of cerebrovascular reactivity to hypercapnia was performed with transcranial Doppler ultrasonography using the breath-holding index (BHI). Activities of daily living status was measured by the Barthel Index (BI) and impairment of mobility was assessed by means of the Rivermead Mobility Index (RMI). Multivariate analyses were performed using effectiveness of treatment, evaluated on BI and RMI as dependent variables. Independent variables were BHI values, age, sex, length of stay, hypertension, smoking habit, presence of aphasia and neglect, poststroke depression, and the degree of severity of stroke.
  
  
  RESULTS
  The effectiveness on BI was associated positively with normal BHI values and with neurological severity at admission, measured by the Canadian Neurological Scale. The regression coefficients for effectiveness on RMI showed that the most relevant predictor was ipsilateral BHI (the slope resulted equal to 5.8), followed by age (a 10-year age difference is expected to diminish the effectiveness by about 4.3%) and by depression (depressed patients have almost 11% less effectiveness than non-depressed patients).
  
  
  CONCLUSIONS
  These findings suggest that a satisfactory recovery from neurologic deficits requires a preserved cerebrovascular reactivity in the lesioned hemisphere despite the presence of an anatomic lesion.
authors.affiliation: S. Lucia Foundation, IRCCS Rome, Rome, Italy. e.troisi @ hsantalucia.it
authors.forename: Elio
authors.initials: E
authors.lastname: Troisi
authors.forename: Maria
authors.initials: M
authors.lastname: Matteis
authors.forename: Mauro
authors.initials: M
authors.lastname: Silvestrini
authors.forename: Stefano
authors.initials: S
authors.lastname: Paolucci
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Grasso
authors.forename: Patrizio
authors.initials: P
authors.lastname: Pasqualetti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Vernieri
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001783:Blood Flow Velocity; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods