Supply-Demand Mismatch Transients in Susceptible Peri-infarct Hot Zones Explain the Origins of Spreading Injury Depolarizations
Supply-Demand Mismatch Transients in Susceptible Peri-infarct Hot Zones Explain the Origins of Spreading Injury Depolarizations
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易受影响的梗塞周围热区的供需失配瞬变解释了损伤去极化蔓延的根源
DOI：
10.1016/j.neuron.2015.02.007
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发表时间：
2015
期刊：
影响因子：
16.2
通讯作者：
Ayata C
中科院分区：
文献类型：
--
作者：
von Bornstädt D;Houben T;Seidel JL;Zheng Y;Dilekoz E;Sandow N;Kura S;Eikermann-Haerter K;Endres M;Boas DA;Moskowitz MA;Dreier JP;Woitzik J;Sakadžić S;Ayata C
梗死周围去极化（PID）似乎是自发的扩散性抑郁样波，对实验性和人类卒中的组织结局产生负面影响。触发PID的因素未知。在这里，我们表明，当激活的皮层在缺血的临界范围内时，梗死周围皮层的体感激活触发PID。我们表明，该机制涉及增加激活皮层内的氧利用率，恶化供需不匹配。我们支持的概念，临床数据显示，不匹配的中风患者易患PID以及。相反，发作性低氧血症或低血压引起的不匹配的短暂恶化也可重复触发PID。因此，PID是在由于需求增加或供应减少而导致的亚稳态梗塞周围热区中的供需不匹配瞬变时触发的。基于这些数据，我们建议在中风和脑损伤中尽量减少感觉刺激和缺氧或脑水肿瞬变，将减少PID的发生率及其对结果的不利影响。视频摘要
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
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影响因子：
37.8
作者：
Eikermann-Haerter K;Lee JH;Yuzawa I;Liu CH;Zhou Z;Shin HK;Zheng Y;Qin T;Kurth T;Waeber C;Ferrari MD;van den Maagdenberg AM;Moskowitz MA;Ayata C
通讯作者：
Ayata C
影响因子：
9.9
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影响因子：
8.8
作者：
Y. Kayama;K. Iwama
通讯作者：
K. Iwama
影响因子：
5.7
作者：
Ullmann, Jeremy F. P.;Watson, Charles;Reutens, David C.
通讯作者：
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