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(Stroke. 2002;33:1294.)
© 2002 American Heart Association, Inc.

Original Contributions

Changes in Blood Flow and Oxygen Metabolism During Visual Stimulation in Carotid Artery Disease

Effect of Baseline Perfusion and Oxygen Metabolism

Hiroshi Yamauchi, MD, PhD; Hidehiko Okazawa, MD, PhD; Yoshihiko Kishibe; Kanji Sugimoto, MS Masaaki Takahashi

From the Research Institute, Shiga Medical Center, Moriyama, Japan.

Reprint requests to Dr Hiroshi Yamauchi, Research Institute, Shiga Medical Center, 5-4-30 Moriyama, Moriyama-City, Shiga 524-8524, Japan. E-mail yamauchi{at}shigamed.moriyama.shiga.jp

Background and Purpose— Severe atherosclerotic disease of the carotid arteries may affect perfusion in the posterior circulation according to the degree of collateral supply. The purpose of this study was to determine whether the responses of regional cerebral blood flow (rCBF) and regional cerebral metabolic rate of oxygen (rCMRO₂) during neural stimulation are affected by the baseline perfusion or oxygen metabolism.

Methods— We used PET to measure rCBF, rCMRO₂, and regional oxygen extraction fraction (rOEF) in 13 patients with carotid artery steno-occlusive lesions at baseline and during visual stimulation. We examined whether the changes in CBF, CMRO₂, and OEF during visual stimulation were correlated with the baseline values of these parameters in the visual cortex.

Results— With visual stimulation, rCBF increased in all patients, whereas rCMRO₂ showed variable changes. The baseline rCMRO₂ value showed a positive relationship with the degree of rCBF increase and a negative relationship to the degree of rCMRO₂ increase. rCMRO₂ decreased in patients with relatively high baseline rCMRO₂ values, resulting in dissociation of the rCMRO₂ response from the rCBF response. The rCBF increase was large in the region with an increased baseline rOEF value. These variable changes in rCBF and rCMRO₂ resulted in a significant correlation between the values of rCBF and rCMRO₂ during visual stimulation in contrast to the lack of such a correlation at baseline.

Conclusions— In patients with cerebrovascular disease, neural stimulation may induce variable changes in rCBF and rCMRO₂ according to the baseline perfusion and oxygen metabolism.

Key Words: carotid artery diseases • cerebral blood flow • oxygen • tomography, emission-computed

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