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Changes in autonomic tone during delirium in acute stroke patients assessed by pupillometry and skin conductance

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@article{41468c25d3e8414d8f95343d118fbaf3,
title = "Changes in autonomic tone during delirium in acute stroke patients assessed by pupillometry and skin conductance",
abstract = "Delirium is a common complication in acute ischemic stroke, possibly caused by alterations in the regulation of the sympathetic autonomic nervous system. We investigated whether such an association could be demonstrated with two easy-to-use measurement techniques: Measurement of palmar skin conductance level (SCL) and pupillometry measuring the dilation velocity in the pupillary light reflex (PLRdil.vel.). The cohort study included 64 patients admitted with acute ischemic stroke. During the study period (median 4.1 days, interquartile range 2.1 days) patients were assessed for delirium once daily as well as with measurements of SCL and PLRdil.vel up to twice daily. SCL and PLRdil.vel. during delirium were lower than without delirium present. For SCL the unadjusted difference was -40.8% (95% CI (-55.1 to -22.0), P value <.001) and for PLRdil.vel the unadjusted difference was -0.22 mm/s (95% CI (-0.42 to -0.01), P value = .041). The results demonstrate changes in sympathetic autonomic nervous system regulation during delirium in acute stroke patients.",
keywords = "Autonomic Nervous System, Brain Ischemia, Cohort Studies, Delirium/diagnosis, Humans, Reflex, Pupillary, Stroke/complications",
author = "Jannik Stokholm and Birkmose, {Lars Kristian Hebsgaard} and Ahmed, {Abd Al Bari Omar} and Claudio Csillag and Kj{\ae}r, {Troels Wesenberg} and Thomas Christensen",
note = "Copyright {\textcopyright} 2021 Elsevier B.V. All rights reserved.",
year = "2021",
month = sep,
day = "15",
doi = "10.1016/j.jns.2021.117582",
language = "English",
volume = "428",
pages = "117582",
journal = "Journal of the Neurological Sciences",
issn = "0022-510X",
publisher = "Elsevier BV",

}

RIS

TY - JOUR

T1 - Changes in autonomic tone during delirium in acute stroke patients assessed by pupillometry and skin conductance

AU - Stokholm, Jannik

AU - Birkmose, Lars Kristian Hebsgaard

AU - Ahmed, Abd Al Bari Omar

AU - Csillag, Claudio

AU - Kjær, Troels Wesenberg

AU - Christensen, Thomas

N1 - Copyright © 2021 Elsevier B.V. All rights reserved.

PY - 2021/9/15

Y1 - 2021/9/15

N2 - Delirium is a common complication in acute ischemic stroke, possibly caused by alterations in the regulation of the sympathetic autonomic nervous system. We investigated whether such an association could be demonstrated with two easy-to-use measurement techniques: Measurement of palmar skin conductance level (SCL) and pupillometry measuring the dilation velocity in the pupillary light reflex (PLRdil.vel.). The cohort study included 64 patients admitted with acute ischemic stroke. During the study period (median 4.1 days, interquartile range 2.1 days) patients were assessed for delirium once daily as well as with measurements of SCL and PLRdil.vel up to twice daily. SCL and PLRdil.vel. during delirium were lower than without delirium present. For SCL the unadjusted difference was -40.8% (95% CI (-55.1 to -22.0), P value <.001) and for PLRdil.vel the unadjusted difference was -0.22 mm/s (95% CI (-0.42 to -0.01), P value = .041). The results demonstrate changes in sympathetic autonomic nervous system regulation during delirium in acute stroke patients.

AB - Delirium is a common complication in acute ischemic stroke, possibly caused by alterations in the regulation of the sympathetic autonomic nervous system. We investigated whether such an association could be demonstrated with two easy-to-use measurement techniques: Measurement of palmar skin conductance level (SCL) and pupillometry measuring the dilation velocity in the pupillary light reflex (PLRdil.vel.). The cohort study included 64 patients admitted with acute ischemic stroke. During the study period (median 4.1 days, interquartile range 2.1 days) patients were assessed for delirium once daily as well as with measurements of SCL and PLRdil.vel up to twice daily. SCL and PLRdil.vel. during delirium were lower than without delirium present. For SCL the unadjusted difference was -40.8% (95% CI (-55.1 to -22.0), P value <.001) and for PLRdil.vel the unadjusted difference was -0.22 mm/s (95% CI (-0.42 to -0.01), P value = .041). The results demonstrate changes in sympathetic autonomic nervous system regulation during delirium in acute stroke patients.

KW - Autonomic Nervous System

KW - Brain Ischemia

KW - Cohort Studies

KW - Delirium/diagnosis

KW - Humans

KW - Reflex, Pupillary

KW - Stroke/complications

UR - http://www.scopus.com/inward/record.url?scp=85110333993&partnerID=8YFLogxK

U2 - 10.1016/j.jns.2021.117582

DO - 10.1016/j.jns.2021.117582

M3 - Journal article

C2 - 34284172

VL - 428

SP - 117582

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

SN - 0022-510X

M1 - 117582

ER -

ID: 68047625