Postural changes in optic nerve and optic nerve sheath diameters in postural orthostatic tachycardia syndrome and spontaneous intracranial hypotension: A cohort study


Autoři: Debora Cipriani aff001;  Belén Rodriguez aff001;  Levin Häni aff001;  Raya Zimmermann aff001;  Jens Fichtner aff001;  Christian T. Ulrich aff001;  Andreas Raabe aff001;  Jürgen Beck aff002;  Werner J. Z‘Graggen aff001
Působiště autorů: Department of Neurosurgery, Inselspital, Bern University Hospital, Bern, Switzerland aff001;  Department of Neurosurgery, Medical Center University of Freiburg, Freiburg, Germany aff002;  Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223484

Souhrn

Background

Postural orthostatic tachycardia syndrome is a disorder of the autonomic nervous system. Approximately 30% of patients experience orthostatic headaches. Orthostatic headaches also are a hallmark symptom in spontaneous intracranial hypotension. While the cause of orthostatic headaches in spontaneous intracranial hypotension can be linked to the cerebrospinal fluid loss at the spinal level and consecutively reduced intracranial pressure in the upright position, the cause of orthostatic headaches in postural orthostatic tachycardia syndrome still remains unknown. The present study examined orthostatic changes of intracranial pressure using dynamic ultrasound of the optic nerve and optic nerve sheath diameter in postural orthostatic tachycardia syndrome, spontaneous intracranial hypotension and healthy subjects.

Methods

Data was obtained from postural orthostatic tachycardia syndrome patients with (n = 7) and without orthostatic headaches (n = 7), spontaneous intracranial hypotension patients (n = 5) and healthy subjects (n = 8). All participants underwent high-resolution transorbital ultrasound in the supine and upright position to assess optic nerve and optic nerve sheath diameter.

Results

Group differences were found in percentage deviations when changing position of optic nerve sheath diameter (p < 0.01), but not regarding the optic nerve diameter. Pairwise comparisons indicated differences in optic nerve sheath diameter only between spontaneous intracranial hypotension and the other groups. No differences were found between postural orthostatic tachycardia syndrome patients with and without orthostatic headaches.

Conclusion

This study shows that the size of the optic nerve sheath diameter dynamically decreases during orthostatic stress in spontaneous intracranial hypotension, but not in postural orthostatic tachycardia syndrome with or without orthostatic headaches, which indicates different underlying causes.

Klíčová slova:

Analysis of variance – Cerebrospinal fluid – Headaches – Magnetic resonance imaging – Optic nerve – Ultrasound imaging – Hypotension – Tachycardia


Zdroje

1. Lambert E., & Lambert G. W., Sympathetic dysfunction in vasovagal syncope and the postural orthostatic tachycardia syndrome. Frontiers in physiology, 2014. 5, 280. doi: 10.3389/fphys.2014.00280 25120493

2. Freeman R., Wieling W., Axelrod F. B., Benditt D. G., Benarroch E., Biaggioni I., et al., Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Auton Neurosci, 2011. 161(1–2): p. 46–8. doi: 10.1016/j.autneu.2011.02.004 21393070

3. Freeman R., Wieling W., Axelrod F. B., Benditt D. G., Benarroch E., Biaggioni I., et al., Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res, 2011. 21(2): p. 69–72. doi: 10.1007/s10286-011-0119-5 21431947

4. Low P.A., Sandroni P., Joyner M., & Shen W.K., Postural tachycardia syndrome (POTS). J Cardiovasc Electrophysiol, 2009. 20(3): p. 352–8. doi: 10.1111/j.1540-8167.2008.01407.x 19207771

5. Schondorf R., Benoit J., Wein T., & Phaneuf D., Orthostatic intolerance in the chronic fatigue syndrome. J Auton Nerv Syst, 1999. 75(2–3): p. 192–201. doi: 10.1016/s0165-1838(98)00177-5 10189122

6. Benarroch E.E., Postural tachycardia syndrome: a heterogeneous and multifactorial disorder. Mayo Clin Proc, 2012. 87(12): p. 1214–25. doi: 10.1016/j.mayocp.2012.08.013 23122672

7. Garland E.M., Celedonio J.E., & Raj S.R., Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance. Curr Neurol Neurosci Rep, 2015. 15(9): p. 60. doi: 10.1007/s11910-015-0583-8 26198889

8. Raj S.R., Postural tachycardia syndrome (POTS). Circulation, 2013. 127(23): p. 2336–42. doi: 10.1161/CIRCULATIONAHA.112.144501 23753844

9. Deb, A., Morgenshtern, K., Culbertson, C. J., Wang, L. B., & Hohler, A. D., A survey-based analysis of symptoms in patients with postural orthostatic tachycardia syndrome. In Baylor University Medical Center Proceedings, 2014. (Vol. 28, No. 2, pp. 157–159). Taylor & Francis.

10. Graf, N., Fernandes Santos, A. M., Ulrich, C. T., Fung, C., Raabe, A., Beck, J., et al., Clinical symptoms and results of autonomic function testing overlap in spontaneous intracranial hypotension and postural tachycardia syndrome. Cephalalgia, 2018.

11. Khurana R.K., & Eisenberg L., Orthostatic and non-orthostatic headache in postural tachycardia syndrome. Cephalalgia, 2011. 31(4), 409–415. doi: 10.1177/0333102410382792 20819844

12. Mokri B. & Low P.A., Orthostatic headaches without CSF leak in postural tachycardia syndrome. Neurology, 2003. 61(7): p. 980–2. doi: 10.1212/01.wnl.0000085868.37963.7d 14557573

13. Fichtner J., Ulrich C. T., Fung C., Knüppel C., Veitweber M., Jilch A.,et al., Management of spontaneous intracranial hypotension—Transorbital ultrasound as discriminator. J Neurol Neurosurg Psychiatry, 2016. 87(6): p. 650–5. doi: 10.1136/jnnp-2015-310853 26285586

14. Schievink W.I. & Atkinson J.L., Spontaneous intracranial hypotension. J Neurosurg, 1996. 84(1): p. 151–2. 8613830

15. Schievink W.I., Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA, 2006. 295(19): p. 2286–96. doi: 10.1001/jama.295.19.2286 16705110

16. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 2018. 38(1): p. 1–211.

17. Spears R. C., Low-pressure/spinal fluid leak headache. Current pain and headache reports, 2014. 18(6), 425. doi: 10.1007/s11916-014-0425-4 24760494

18. Ertl M., Barinka F., Torka E., Altmann M., Pfister K., Helbig H., et al., Ocular color-coded sonography–a promising tool for neurologists and intensive care physicians. Ultraschall Med, 2014. 35(05), 422–431. doi: 10.1055/s-0034-1366113 24647767

19. Takeuchi N., Horikoshi T., Kinouchi H., Watanabe A., Yagi T., Mitsuka K., et al., Diagnostic value of the optic nerve sheath subarachnoid space in patients with intracranial hypotension syndrome. J Neurosurg, 2012. 117(2): p. 372–7. doi: 10.3171/2012.5.JNS1271 22680244

20. Watanabe A., Horikoshi T., Uchida M., Ishigame K., & Kinouchi H., Decreased diameter of the optic nerve sheath associated with CSF hypovolemia. AJNR Am J Neuroradiol, 2008. 29(5): p. 863–4. doi: 10.3174/ajnr.A1027 18310231

21. Beck J., Ulrich C. T., Fung C., Fichtner J., Seidel K., Fiechter M., et al., Diskogenic microspurs as a major cause of intractable spontaneous intracranial hypotension. Neurology, 2016. 87(20): 1220–1226. doi: 10.1212/WNL.0000000000003122 27566748

22. Dubost C., Le Gouez A., Zetlaoui P. J., Benhamou D., Mercier F. J., & Geeraerts T., Increase in optic nerve sheath diameter induced by epidural blood patch: a preliminary report. Br J Anaesth, 2011. 107(4): p. 627–30. doi: 10.1093/bja/aer186 21693468

23. Fichtner J., Ulrich C. T., Fung C., Cipriani D., Gralla J., Piechowiak E. I., et al., Sonography of the optic nerve sheath diameter before and after microsurgical closure of a dural CSF fistula in patients with spontaneous intracranial hypotension–a consecutive cohort study. Cephalalgia, 2018. 0333102418793640. doi: 10.1177/0333102418793640 30099952

24. Erdfelder E., Faul F., & Buchner A. (1996). GPOWER: A general power analysis program. Behavior research methods, instruments, & computers, 28(1), 1–11.

25. Candeliere Merlicco A., Gabaldón Torres L., Villaverde González R., Fernández Romero I., Aparicio Castro E., & Lastres Arias M. C., Transorbital ultrasonography for measuring optic nerve atrophy in multiple sclerosis. Acta Neurologica Scandinavica, 2018. 138(5), 388–393. doi: 10.1111/ane.12976 29963693

26. Lochner P., Coppo L., Cantello R., Nardone R., Naldi A., Leone M. A., et al., Intra-and interobserver reliability of transorbital sonographic assessment of the optic nerve sheath diameter and optic nerve diameter in healthy adults. Journal of ultrasound, 2016. 19(1), 41–45. doi: 10.1007/s40477-014-0144-z 26941872

27. Ertl M., Aigner R., Krost M., Karnasová Z., Müller K., Naumann M., et al., Measuring changes in the optic nerve sheath diameter in patients with idiopathic normal pressure hydrocephalus: a useful diagnostic supplement to spinal tap tests. European journal of neurology, 2017. 24(3), 461–467. doi: 10.1111/ene.13225 27981690

28. Lochner P., Fassbender K., Knodel S., Andrejewski A., Lesmeister M., Wagenpfeil G.,et al., B-Mode Transorbital Ultrasonography for the Diagnosis of Idiopathic Intracranial Hypertension: A Systematic Review and Meta-Analysis. Ultraschall in der Medizin-European Journal of Ultrasound, 2018. doi: 10.1055/a-0719-4903 30347420

29. Lochner P., Brigo F., Zedde M. L., Sanguigni S., Coppo L., Nardone R.,et al., Feasibility and usefulness of ultrasonography in idiopathic intracranial hypertension or secondary intracranial hypertension. BMC neurology, 2016. 16(1), 85.

30. Bäuerle J., Lochner P., Kaps M., & Nedelmann M., Intra- and Inter-and interobserver reliability of sonographic assessment of the optic nerve sheath diameter in healthy adults. J Neuroimaging, 2012. 22:42–5. doi: 10.1111/j.1552-6569.2010.00546.x 21121998

31. Steinborn M., Friedmann M., Hahn H., Hapfelmeier A., Macdonald E., Warncke K., et al., Normal values for transbulbar sonography and magnetic resonance imaging of the optic nerve sheath diameter (ONSD) in children and adolescents. Ultraschall Med, 2015. 36:54–8. doi: 10.1055/s-0034-1385012 25140497

32. Diaz J. H. (2001). Epidemiology and outcome of postural headache management in spontaneous intracranial hypotension. Regional anesthesia and pain medicine, 26(6), 582–587. doi: 10.1053/rapm.2001.28275 11707800

33. Mathias C. J., Low D. A., Iodice V., Owens A. P., Kirbis M., & Grahame R. (2012). Postural tachycardia syndrome—current experience and concepts. Nature Reviews Neurology, 8(1), 22.


Článek vyšel v časopise

PLOS One


2019 Číslo 10

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

Léčba bolesti v ordinaci praktického lékaře
nový kurz
Autoři: MUDr. PhDr. Zdeňka Nováková, Ph.D.

Revmatoidní artritida: včas a k cíli
Autoři: MUDr. Heřman Mann

Jistoty a nástrahy antikoagulační léčby aneb kardiolog - neurolog - farmakolog - nefrolog - právník diskutují
Autoři: doc. MUDr. Štěpán Havránek, Ph.D., prof. MUDr. Roman Herzig, Ph.D., doc. MUDr. Karel Urbánek, Ph.D., prim. MUDr. Jan Vachek, MUDr. et Mgr. Jolana Těšínová, Ph.D.

Léčba akutní pooperační bolesti
Autoři: doc. MUDr. Jiří Málek, CSc.

Nové antipsychotikum kariprazin v léčbě schizofrenie
Autoři: prof. MUDr. Cyril Höschl, DrSc., FRCPsych.

Všechny kurzy
Kurzy Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se