Cerebral hemodynamic abnormalities of patients with ischemic stroke who are opium addicted: A study by transcranial doppler ultrasonography

  • Yaser Moadabi Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran Department of Neurology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Alia Saberi Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran Department of Neurology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Sajjad Hoseini Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran Department of Neurology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Ashkan Karimi Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran
  • Shahrokh Yousefzadeh-Chabok Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran
Keywords: Opium, Doppler Transcranial Ultrasonography, Stroke, Blood Flow Velocity

Abstract

Background: Ischemic stroke as the major cause of mortality and morbidity worldwide has different risk factors. One of its modifiable risk factors is opium addiction whose role is not clear yet. This study aimed at assessing the hemodynamic parameters in ischemic stroke patients addicted to opium using transcranial Doppler (TCD) ultrasonography and comparing them with non-addicted patients. Methods: This comparative cross-sectional study was conducted in an academic hospital in the north of Iran in 2016. All the patients diagnosed as ischemic stroke underwent cerebrovascular ultrasound in the first 4 days of symptoms onset. Frequency of hemodynamic abnormalities confirmed by pulsatility index (PI) and mean flow velocity (MFV) were determined and compared between the two groups. The data were analyzed by chi-square test, t-test, and multiple logistic regression models using SPSS software. Results: A total of 353 patients with ischemic stroke (92 addicted and 261 non-addicted patients) were enrolled in the study. Univariate analysis indicated that the PI and MFV differences were statistically significant between two groups of addicted and non-addicted patients (P = 0.0001). By multivariate logistic regression model, the age [odds ratio (OR) = 1.143], diabetes mellitus (DM) (OR = 3.875), hypertension (HTN) (OR = 2.557), and opium usage (OR = 6.993) had influence on PI and only opium usage (OR = 3.246) had influence on MFV. Conclusion: Opium usage affects the cerebral hemodynamic parameters and increases the chance of having abnormal PI as seven-fold and abnormal MFV as three-fold.

References

1. Ashrafi F, Rokni A, Asaadi S, Pakdaman H, Yourdkhani F. Effects of high-frequency repetitive transcranial magnetic stimulation on motor functions in patients with subcortical stroke. Caspian J Intern Med 2015; 1(1): 1-6.
2. Ghanei AM, Saadatnia M, Haghjooy Javanmard S. Effects of opium addiction on vascular endothelium. J Isfahan Med Sch 2013; 30(216): 2084-90. [In Persian].
3. Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J, Manolio T, et al. Heart disease and stroke statistics--2006 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2006; 113(6): e85-151.
4. Biller J, Love BB. Vascular diseases of the nervous system. In: Bradley WG, editor. Neurology in clinical practice: The neurological disorders. 4th ed. Philadelphia, PA: Butterworth-Heinemann; 2004. p. 1197-326.
5. Saberi A, Javadpoor M, Farahmand N, Kazem-Nezhad E. The serum level of estrogen and progesterone and their ratio in patients with ischemic stroke: A comparative study. Caspian J Intern Med 2015; 1(1): 35-42.
6. Hosseininezhad M, Hatamian H, Bakhshayesh-Eghbali B, Moaddabi Y. A survey about the temporal pattern of stroke occurrence. Caspian J Intern Med 2015; 1(2): 15-9.
7. Roudbary SA, Alizadeh A, Ghayeghran A, Roshan F. Serum uric acid as a potential concomitant with carotid atherosclerosis. Caspian J Intern Med 2016; 2(6): 33-8.
8. Majidi Shad M, Saberi A, Shakiba M, Rezamasouleh S. Evaluating the duration of hospitalization and its related factors among stroke patients. Caspian J Intern Med 2018; 4(15): 169-77.
9. Hamzei Moqaddam A, Ahmadi Musavi SM, Khademizadeh K. Relationship of opium dependency and stroke. Addict Health 2009; 1(1): 6-10.
10. Lv XY. Correlation between middle cerebral arterial hemodynamic parameters assessed by transcranial doppler sonography and neural functional recovery after stroke. J Hainan Med Univ 2016; 22(16): 138-41.
11. Tegeler CH, Crutchfield K, Katsnelson M, Kim J, Tang R, Passmore GL, et al. Transcranial Doppler velocities in a large, healthy population. J Neuroimaging 2013; 23(3): 466-72.
12. Demirkaya S, Uluc K, Bek S, Vural O. Normal blood flow velocities of basal cerebral arteries decrease with advancing age: A transcranial Doppler sonography study. Tohoku J Exp Med 2008; 214(2): 145-9.
13. Lee KY, Sohn YH, Baik JS, Kim GW, Kim JS. Arterial pulsatility as an index of cerebral microangiopathy in diabetes. Stroke 2000; 31(5): 1111-5.
14. Rezvani MR, Ghandehari K. Is opium addiction a risk factor for ischemic heart disease and ischemic stroke? J Res Med Sci 2012; 17(10): 958-61.
15. Ghayeghran A, Janeshin S, Saberi A, Sohrabnezhad R, Kazemnezhad E. The relationship between opium addiction and ischemic stroke. J Guilan Univ Med Sci 2016; 24(96): 42-9. [In Persian].
16. Hashemi M, Talaei P, Basiratnia R, Motaghi P. Comparison of endothelial dependent and independent dilatation in cigarette smokers and opium addicts. J Isfahan Med Sch 2006; 24(80-81): 19-24. [In Persian].
Published
2019-06-11
How to Cite
1.
Moadabi Y, Saberi A, Hoseini S, Karimi A, Yousefzadeh-Chabok S. Cerebral hemodynamic abnormalities of patients with ischemic stroke who are opium addicted: A study by transcranial doppler ultrasonography. Iran J Neurol. 18(2).
Section
Original Article(s)