The Study Of The Relation Between Dynamic Cerebral Autoregulation And Generalized Anxiety Disorder

Objective:Generalized anxiety disorder(GAD)has long been considered a functional disease,and patients often feel nervous,disturbed,overly worried,or even frightened,dizziness,palpitations,sleep disorders,irritability,increased alertness,etc.Thease symptoms seriously affecting the quality of patients' daily lives.In recent years,a large number of studies have shown that GAD and physical diseases,especially cardiovascular and cerebrovascular diseases,scholars believe that organic changes in patients with GAD may be associated with autonomic dysfunction,endocrine function changes,neuroendocrine abnormalities.In recent years,GAD's cerebral hemodynamics has been paid more and more attention,some studies have shown that cerebral blood flow in anxiety group of patients can change,there are researchers found that CBF changes related to anxiety degree.CBF in patients with anxiety decreased the sensitivity of carbon dioxide partial pressure changes,resulting in damage to cerebral autoregualation.Our earlier study found that brain blood flow velocity decreased,heart rate increased when patients with anxiety from supine to upright position,suggesting that cerebral autoregulation and autonomic nerve were damaged.At present,the study of dynamic cerebral autoregulation in patients with anxiety disorder is rarely reported.It is expected to find a new target for the treatment of anxiety syndrome by further studying the relationship between anxiety and dynamic cerebral autoregulation.Methods:A total of 112 patients with generalized anxiety disorder were enrolled in the study.The patients were diagnosed with neurological outpatients at the First Hospital of Jilin University from March 2016 to March 2017.We measured patients with Hamilton Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD),transcranial Doppler ultrasonography(TCD),and combined with fingertip blood pressure test to obtain cerebral blood flow velocity(CBFV)and arterial blood pressure,and then through the transfer function analysis to getparameters: phase,gain,correlation.At the same time,the basic information of patients was collected and the relationship between generalized anxiety disorder and dynamic cerebral auregulation was obtained by statistical analysis.Results:Phase of bilateral cerebral hemispheres in patients with generalized anxiety disorder is significantly lower than healthy control group,while no significant difference in gain.There is no significant difference in phase and gain between light,moderate and severe generalized anxiety disorder.HAMA score has no significant correlation with phase and gain of bilateral hemisphere in patients with generalized anxiety.There is no significant difference in phase and gain between depression group and anxiety group.The HAMD score has no significant correlation with the parameters of cerebral autoregulation.Conclusion:The dynamic cerebral autoregulation in GAD patients is impaired.The dynamic cerebral autoregulation in GAD patients is independent of the degree of depression.Whether GAD is associated with depression has no significant effect on dynamic autoregulation.