Supply-Demand Mismatch Transients in Susceptible Peri-infarct Hot Zones Explain the Origins of Spreading Injury Depolarizations
| Autor: | Yi Zheng, Matthias Endres, Ergin Dilekoz, Thijs Houben, Nora Sandow, David A. Boas, Sreekanth Kura, Daniel von Bornstädt, Michael A. Moskowitz, Jens P. Dreier, Jessica L. Seidel, Cenk Ayata, Eng H. Lo, Sava Sakadžić, Katharina Eikermann-Haerter, Johannes Woitzik, Tao Qin |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty physiology [Cortical Spreading Depression] Neuroscience(all) Apparent oxygen utilisation Ischemia Infarction Somatosensory system metabolism [Cerebral Infarction] Article Hypoxemia Mice Cortex (anatomy) Internal medicine medicine Animals Humans ddc:610 metabolism [Infarction Middle Cerebral Artery] Stroke Aged Sensory stimulation therapy business.industry General Neuroscience Cortical Spreading Depression Infarction Middle Cerebral Artery Cerebral Infarction Somatosensory Cortex Middle Aged pathology [Somatosensory Cortex] medicine.disease pathology [Infarction Middle Cerebral Artery] pathology [Cerebral Infarction] Mice Inbred C57BL medicine.anatomical_structure Cardiology metabolism [Somatosensory Cortex] Female medicine.symptom business |
| Zdroj: | Neuron 85(5), 1117-1131 (2015). doi:10.1016/j.neuron.2015.02.007 |
| ISSN: | 0896-6273 |
| DOI: | 10.1016/j.neuron.2015.02.007 |
| Popis: | Summary Peri-infarct depolarizations (PIDs) are seemingly spontaneous spreading depression-like waves that negatively impact tissue outcome in both experimental and human stroke. Factors triggering PIDs are unknown. Here, we show that somatosensory activation of peri-infarct cortex triggers PIDs when the activated cortex is within a critical range of ischemia. We show that the mechanism involves increased oxygen utilization within the activated cortex, worsening the supply-demand mismatch. We support the concept by clinical data showing that mismatch predisposes stroke patients to PIDs as well. Conversely, transient worsening of mismatch by episodic hypoxemia or hypotension also reproducibly triggers PIDs. Therefore, PIDs are triggered upon supply-demand mismatch transients in metastable peri-infarct hot zones due to increased demand or reduced supply. Based on the data, we propose that minimizing sensory stimulation and hypoxic or hypotensive transients in stroke and brain injury would reduce PID incidence and their adverse impact on outcome. Video Abstract |
| Databáze: | OpenAIRE |
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