Neuroelectrophysiological Changes In Posterior Circulation TIA Patients With Vertebral Artery Stenosis

Objective:This study observed the neurophysiological changes in patients with transient ischemic attacks(TIA)with vertebral artery stenosis,and the effect of vertebral artery stenosis on neurophysiological changes.Methodology:Thirty patients with clinically diagnosed posterior circulation TIA complicated with vertebral basilar artery stenosis in Jiangsu Subei People's Hospital from December 2017 to March 2019 underwent Blink Reflex(BR)and Trigeminal cervical reflex(TCR)check.The latency of each component of R1,R2 and R2c on both sides of BR,R1 amplitude,R2 R2c area and The P19 and N31 latency of TCR were observed.The results of 30 patients with results of 20 healthy people without vertebral artery stenosis were compared and analyzed;the neuroelectrophysiological results of medorate patients with posterior circulation TIA with vertebral artery stenosis and those of severe patients were compared.Results:1.Thirty patients with posterior circulation TIA with vertebral artery stenosis,there is 1 normal BR and 29 abnormal BR results.The abnormal rates are as high as 97%.The results showed that R1 abnormalities were 8 cases,accounting for 27%,of which 2 cases were right side abnormalities(1 case of right R1 latency extension,1 case of right R1 deletion).There were 4 cases of abnormality on the left side(2 cases showed a decrease in the left R1 latency and a decrease in amplitude,1 case showed a decrease in R1 amplitude,and the remaining 1 case was an extension of the left R1 latency).The remaining 2 cases were delayed in bilateral R1 latency.There were 29 cases with abnormal R2,and the abnormal rate was 97%.Among them,14 patients with simple bilateral R2 and R2c latency were extended;the remaining 15 patients showed different degrees of R2 and R2c changes as well as the prolongation of latency.Compared with the control group,the difference in latency between the bilateral R1 and the bilateral R2 and R2c in the stenosis group was significant(left R1 P=0.028522,left R2 P=0.000001,left R2c P0.000001,right R1 P=0.011205,right R2 P<0.000001,right R2c P<0.000001),and there was no statistical difference between the bilateral R1 amplitude and the R2 R2c area.Compared among three groups,The difference in latency between the bilateral R1 and the bilateral R2 and R2c was significant(left R1,P=0.004594,left R2 P=0.000003,left R2c P=0.000115,right R1 P?0.0043471,right R2 P ?0.000001,right R2c P?0.000002).There was no statistical difference between the moderate group and severe group,and the P values in the two stenosis group(moderate group and severe group)compared with the control group were less than 0.05.There was no significant difference in the area of bilateral R1 amplitude and bilateral R2 and R2c.2.Thirty patients with posterior circulation TIA with vertebral artery stenosis,there are 3 noraml TCR and 27 abnormal TCR results.The abnormal rate is 90%.26 patients had abnormal latency and 5 patients had abnormal A values.Compared with the control group,the latency of all evoked waves compared with the control group was less than 0.05(left P19 P=0.00014,left N31 P<0.000001,left P19c P<0.000001,left N31c P=0.000011,right P19 P=0.000003,right N31 P=0.001868,right P19c P-0.0.000001 left N31c P=0.000021),there was a significant difference,and the bilateral A value,Ac value and the control group P value were greater than 0.05 no statistical difference.Compared among three groups,the difference in latency between the two sides of P19,N31,P19c and N31c is significant(Left R1,P=0.004594,left R2 P=0.000003,left R2c P?0.000115,right R1 P=0.0043471,right R2 P?0.000001,right R2c P=0.000002).There was no statistical difference between the moderate group and the severe group,and the P values obtained by comparing the two stenosis groups with the control group were less than 0.05.There was no statistical difference in the bilateral A and Ac values.In patients with posterior circulation TIA with vertebral artery stenosis,the combined abnormal rate of BR and TCR is 100%.Conclusion:1.The abnormal rate of BR in patients with posterior circulation TIA complicated with vertebral artery stenosis was 97%,mainly due to the prolongation of the latency of each wave and the change of the amplitude of each wave was not obvious.The abnormal rate of TCR is 90%,which is mainly due to the prolongation of the latency of the reaction wave and the change of the A value is not obvious.The combined abnormal rate of the two tests was 100%.2.There was no significant difference in the latency and response range between the mild to moderate stenosis and the severe stenosis.However,the two groups showed significant changes in latency and significant changes in non-reactive amplitude compared with the normal control group.3,patients with posterior circulation TIA with vertebral artery stenosis are prone to neurophysiological changes in the BR and TCR reflex pathways,and there is no significant correlation with the degree of vascular stenosis.