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[Dynamics of cerebral circulation in patients with chronic cerebrovascular disease--analysis with multi-channel near infra-red spectroscopic topography plus hand grasp as the exercise task].

We used multi-channel near infra-red spectroscopic topography to evaluate the dynamics of cerebral circulation of patients with cerebrovascular disease (CVD). The subjects included 17 patients with chronic CVD, while 11 physically unimpaired persons served as controls. We used a spectroscopic topography device (Hitachi, ETG -100) to determine the topographic values of oxy-Hb, deoxy-Hb, and total-Hb in the right and left cerebral hemispheres. Hand grasp for 30 or 60 second duration was used as the exercise task, and each task was tried twice. In the control group, the oxy-Hb values of the left cerebral hemisphere were elevated by bilateral hand grasp, while those of the right cerebral hemisphere were elevated by left hand grasp. In patients with a lesion in the left cerebral hemisphere, oxy-Hb values of the left hemisphere were elevated by the bilateral hand grasp, while those of the right hemisphere were elevated only by the healthy left hand grasp. When the 30- and 60-second-duration grasp exercises were compared, it was found that the oxy-Hb values in the control group corresponded to the loading time. In patients with either right or left cerebral lesion, the oxy-Hb peak values were lower than those of the control group, while the peak values did not show any difference between the 30-and 60-seconds hand grip durations themselves. The latency from the start of the grasp to the maximum peak of the oxy-Hb value was significantly prolonged in CVD patients as compared with that in the control group. As for the relation between the degree of hemiparesis and the oxy-Hb values, the value of the oxy-Hb in the left cerebral hemisphere during right hand grasp decreases depending on the severity of paralysis induced by the left cerebral lesion. The determination of cerebral oxy-Hb values by near infra-red spectroscopic topography using exercise test appeared to be useful for the evaluation of the dynamic of cerebral circulation in stroke patients. Furthermore, the possibility of inducing recovery by the rehabilitation of stroke patients, who were in the chronic stage, should be studied.