Highly Purified Eicosapentaenoic Acid Improves Cerebral Vasomotor－reactivity in Patients with Chronic Cerebral Ischemia

Background：Eicosapentaenoic acid（EPA）was reported to significantly reduce therecurrence of stroke in a cohort of hypercholesterolemic Japanese patients receiving lowdosestatin therapy. We measured the cerebral blood flow to assess how EPA contributes todecreasing the incidence of recurrent stroke in patients with chronic cerebral ischemia.Methods：Eight patients（mean age 64±10.3 years）with chronic cerebral ischemiawere administrated 1800 mg of EPA daily. At entry into the study and 3 months later wemeasured the patients’ serum level of fatty acids, assessed their depressive state using theJapan Stroke Scale－Depression Scale（JSS－D）, and determined the cerebral blood flow（CBF）at rest and after acetazolamide challenge. Lastly, we calculated cerebral vasomotorreactivity（CVR）.Results：After 3 months of EPA administration serum EPA and the EPA／arachidonicacid ratio were significantly increased（p＝0.002 and p＝0.003, respectively）. Comparisonof the pre－ and post－administration JSS－D showed that depression tended to beameliorated. At 3 months CVR（％）was significantly increased in the left occipital－（p＝0.004）and right temporo－parietal cortex（p＝0.043）. Comparison of the EPA concentrationand CVR（％）at entry and after 3－month treatment revealed a positive correlation in theleft occipital－（r＝0.512, p＝0.043）and right temporo－parietal cortex（r＝0.552, p＝0.02）.Conclusion：In patients treated with EPA, the significant increase in CVR（％）in theleft occipital－ and right temporo－parietal cortex correlated with the increase in the plasmaEPA level and depression amelioration. Our findings suggest that EPA contributes toamelioration of cerebral artery remodeling in patients with chronic cerebral ischemia andinhibits its recurrence.