Biomedical subjects
Kyösti Sotaniemi
Publications and source records attributed to Kyösti Sotaniemi.
Nocturnal cardiac autonomic regulation in Parkinson's disease.
Diminished heart rate (HR) variability has been reported in patients with early phase Parkinson's disease (PD) using standardized cardiovascular reflex tests. However, limited data exist on HR variability during sleep; thus the present study was performed to investigate the characteristics of HR variability during different sleep stages. The HR variability of 21 newly diagnosed and untreated PD patients and of 22 control subjects was evaluated by using time domain, frequency domain and non-linear methods and by analyzing HR reactions to body movements during the different sleep stages (non-REM stages S1-4 and the REM stage). The nocturnal cardiac autonomic control was disturbed in PD patients compared to controls both during sleep and waking. HR reactions to body movements were decreased especially during REM sleep referring to defective sympathetic cardiovascular control. High frequency spectral power of HR variability was attenuated in the patients in waking and during non-REM sleep but not during REM sleep suggesting that parasympathetic cardiovascular control is also affected in early PD. However, the variance of R-R intervals during non-REM sleep was significantly increased in PD patients. Especially during this sleep stage the patients also moved more than the controls. HR variability is decreased not only in waking but also during sleep in PD patients. However, the increased variance of HR during non-REM sleep refers that in early phase of PD cardiovascular system is still able to react to changing body circumstances. Furthermore, our findings suggest that the indicators measuring the dominant sympathetic or parasympathetic activity of each given sleep stage are the most sensitive measures in revealing disturbed nocturnal ANS function.
Pulsatile tinnitus as a symptom of cervicocephalic arterial dissection.
The aim of this study was to investigate pulsatile tinnitus as a presenting symptom in cervicocephalic arterial dissection (CCAD). Of the 136 consecutive patients with confirmed CCAD, 16 presented with pulsatile tinnitus. On admission 10 patients presented with subjective tinnitus and five with objective tinnitus, tinnitus being the only presenting symptom in one case. In one further case with bilateral ICA dissection (ICAD) subjective tinnitus appeared three months after the initial symptoms of arterial dissection, despite a contralateral cervical bruit being evident on admission. Thirteen patients presented with headache or neck pain. Ischaemic symptoms were detected in six and Horner's syndrome in four patients. Vertigo and dysgeusia were reported in two patients each. Arterial dissection involved unilateral ICA in 11, bilateral ICA in two, unilateral vertebral artery (VA) in two and bilateral ICA and bilateral VA in one patient. In angiography the most common finding was irregular stenosis, and the majority of these abnormalities normalized during follow-up. To avoid delay in diagnosis a high index of suspicion and early angiography (digital subtraction or magnetic resonance angiography) are warranted.
[Treatment of cerebrovascular stroke in a specialized stroke unit].
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