摘自：FRONTIERS
作者：Xiuyun Liu, Yuehua Pu, Dan Wu1, Zhe Zhang, Xiao Hu and Liping Liu

背景：
神經(jīng)血管耦合能夠快速適應(yīng)腦血流（CBF）以支持神經(jīng)元活動(dòng)。 這種機(jī)制在缺血性卒中后的急性期是否受損仍然未知。 在這項(xiàng)研究中，我們應(yīng)用相位-幅度交叉頻率耦合（PAC）算法來研究包括腦血流速度（CBFV）和腦電圖（EEG）的多模神經(jīng)信號(hào)。

方法：
選取入住首都醫(yī)科大學(xué)天壇醫(yī)院神經(jīng)重癥監(jiān)護(hù)室的急性缺血性卒中患者，持續(xù)監(jiān)測(cè)8導(dǎo)聯(lián)腦電圖（F3-C3，T3-P3，P3-O1，F(xiàn)4-C4，T4-P4，P4-O2），無創(chuàng)動(dòng)脈血壓（ABP）、雙側(cè)大腦中動(dòng)脈（MCA）或大腦后動(dòng)脈（PCA）的血流速度，并進(jìn)行回顧性分析。使用頻帶為0-0.05Hz和0.05-0.15Hz的CBFV相位，與5個(gè)頻帶（δ, θ, α, β, γ）的EEG振幅來計(jì)算PAC。全局的PAC則由每個(gè)患者6個(gè)EEG通道中的5個(gè)EEG頻帶的所有PAC的總和。交叉頻率耦合（CFC）的半球不對(duì)稱性通過左右PAC之間的差異進(jìn)行計(jì)算。

結(jié)果：
16名患者（3名男性）符合標(biāo)準(zhǔn)并納入本研究，年齡為60.9±7.9歲，平均ABP、平均左側(cè)CBFV、平均右側(cè)CBFV分別為90.2±31.2mmHg、57.3±20.6cm/s、68.4±20.9cm /s。CBFV和EEG之間的PAC在β和γ波段明顯高于其他三個(gè)頻段。枕部區(qū)域（P3-O1和P4-O2通道）顯示出比其他區(qū)域更強(qiáng)的PAC。死亡組的全局PAC往往小于生存組（受試者工作特征曲線[AUROC]下的面積為0.81，p=0.57）。不利結(jié)果組的全局PAC較有利結(jié)果組更小（AUROC=0.65，p=0.23）。兩個(gè)腦半球之間的PAC不對(duì)稱性與中風(fēng)患者的狹窄程度相關(guān)（p=0.01）。

結(jié)論：
我們發(fā)現(xiàn)，CVBF與β和γ頻帶的EEG通過相位振幅CFC關(guān)系相互作用，且在枕區(qū)PAC最強(qiáng)，并且CFC的半球不對(duì)稱程度與狹窄程度相關(guān)。

Cross-Frequency Coupling Between Cerebral Blood Flow Velocity and EEG in Ischemic Stroke Patients With Large Vessel Occlusion
  Xiuyun Liu, Yuehua Pu, Dan Wu1, Zhe Zhang, Xiao Hu， and Liping Liu
Background: Neurovascular coupling enables a rapid adaptation of cerebral blood flow(CBF) to support neuronal activities. Whether this mechanism is compromised during the acute phase after ischemic stroke remains unknown. In this study, we applied a phase-amplitude cross-frequency coupling (PAC) algorithm to investigate multimodal neuro signals including CBF velocity (CBFV), and electroencephalography (EEG).
Methods: Acute ischemic stroke patients admitted to the Neurointensive Care Unit,
Tiantan Hospital, Capital Medical University (Beijing, China) with continuous monitoring of 8-lead EEG (F3-C3, T3-P3, P3-O1, F4-C4, T4-P4, P4-O2), non-invasive arterial blood pressure (ABP), and bilateral CBFV of the middle cerebral arteries or posterior cerebral arteries were retrospectively analyzed. PAC was calculated between the phase of CBFV in frequency bands (0–0.05 and 0.05–0.15Hz) and the EEG amplitude in five bands (d, ", a, b, g). The global PAC was calculated as the sum of all PACs across the six EEG channels and five EEG bands for each patient. The hemispherical asymmetry of cross-frequency coupling (CFC) was calculated as the difference between left and right PAC.
Results: Sixteen patients (3 males) met our inclusion criteria. Their age was 60.9 ± 7.9 years old. The mean ABP, mean left CBFV, and mean right CBFV were 90.2 ± 31.2 mmHg, 57.3 ± 20.6 cm/s, and 68.4 ± 20.9 cm/s, respectively. The PAC
between CBFV and EEG was significantly higher in b and g bands than in the other three bands. Occipital region (P3-O1 and P4-O2 channels) showed stronger PAC than the other regions. The deceased group tended to have smaller global PAC than the
survival group (the area under the receiver operating characteristic curve [AUROC] was 0.81, p = 0.57). The unfavorable outcome group showed smaller global PAC than the favorable group (AUROC = 0.65, p = 0.23). The PAC asymmetry between the two brain hemispheres correlates with the degree of stenosis in stroke patients (p = 0.01). Conclusion: We showed that CBFV interacts with EEG in b and g bands through a phase-amplitude CFC relationship, with the strongest PAC found in the occipital region and that the degree of hemispherical asymmetry of CFC correlates with the degree of stenosis.
Keywords: cerebral blood flow, EEG, cross frequency coupling, stroke, neurovascular coupling
fneur-10-00194.pdf