Chronic intermittent hypoxia worsens brain damage and sensorimotor behavioral abnormalities after ischemic stroke: Effect on autonomic nervous activity and sleep patterns

Chi-Wei Lin; Jia-Yi Li; Terry B J Kuo; Chang-Wei Huang; Shiang-Suo Huang; Cheryl C H Yang

doi:10.1016/j.brainres.2022.148159

Chronic intermittent hypoxia worsens brain damage and sensorimotor behavioral abnormalities after ischemic stroke: Effect on autonomic nervous activity and sleep patterns

Brain Res. 2023 Jan 1:1798:148159. doi: 10.1016/j.brainres.2022.148159. Epub 2022 Nov 9.

Authors

Chi-Wei Lin¹, Jia-Yi Li², Terry B J Kuo³, Chang-Wei Huang¹, Shiang-Suo Huang⁴, Cheryl C H Yang⁵

Affiliations

¹ Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
² Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan.
³ Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.
⁴ Department of Pharmacology and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan. Electronic address: sshuang@csmu.edu.tw.
⁵ Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: cchyang@ym.edu.tw.

PMID: 36370768
DOI: 10.1016/j.brainres.2022.148159

Abstract

Objective: Sleep apnea (SA) is characterized by intermittent hypoxia (IH), which increases sympathetic activity and sleep fragmentation, thus increasing the risk of stroke. SA is a highly prevalent disease and can worsen prognosis in patients with stroke. However, the correlation of changes in the cardiac autonomic nervous system and sleep patterns under IH with sensorimotor behavior and cerebral infarction after stroke remains unclear. We hypothesized that dysregulated autonomic activity and unstable sleep patterns induced by IH and correlated with cerebral infarction and abnormal sensorimotor behavior after middle cerebral artery occlusion (MCAO).

Methods: Wistar-Kyoto rats (WKY) were divided into IH (hypoxia: 5 % O_2, 8 h/day) and RA group (room air) for 2 weeks and both groups were subjected to MCAO. After MCAO, the IH group was continuously exposed to IH for 1 week. The 24-h physiological signals, blood pressure, and sensorimotor behavior were recorded at baseline (Bas), the first and second weeks during IH (RA/IH1W and RA/IH2W, respectively), and poststroke.

Results: Before MCAO, IH caused sympathetic activity during sleep and parasympathetic activity of active waking (AW) to increase. Moreover, IH reduced the accumulated time and duration of paradoxical sleep (PS) and increased the interruption during sleep. After MCAO, IH increased blood pressure, more severe brain damage, and poor sensorimotor performance. Moreover, IH reduced autonomic activity after MCAO and decreased sympathetic activity was associated with poor sensorimotor performance.

Conclusion: Autonomic activity and sleep patterns affected by IH were correlated with increased cerebral infarction and poor sensorimotor behavior after MCAO.

Keywords: Heart rate variability (HRV); Intermittent hypoxia (IH); Middle cerebral artery occlusion (MCAO).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Animals
Brain
Brain Injuries* / complications
Hypoxia / complications
Infarction, Middle Cerebral Artery / complications
Ischemic Stroke*
Rats
Rats, Inbred WKY
Sleep / physiology
Stroke* / complications