Brainstem control of cerebral blood flow and application to acute vasospasm following experimental subarachnoid hemorrhage.
Brainstem control of cerebral blood flow and application to acute vasospasm following experimental subarachnoid hemorrhage.
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DOI：
10.1016/j.neuroscience.2009.06.031
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发表时间：
2009-10-06
期刊：
影响因子：
3.3
通讯作者：
Heinricher, M. M.
中科院分区：
文献类型：
--
作者：
Cetas, J. S.;Lee, D. R.;Alkayed, N. J.;Wang, R.;Iliff, J. J.;Heinricher, M. M.
动脉瘤性蛛网膜下腔出血后的症状性脑缺血很常见，但了解不多，治疗也不充分。脑底主要动脉的严重收缩，称为血管痉挛，传统上被认为是导致这些缺血的近端事件，尽管也有微血管变化的描述。绝大多数旨在了解缺血缺陷和血管痉挛发病机制的研究都集中在血管外渗血的“痉挛原”与动脉的平滑肌和内皮之间的相互作用。这导致了对中枢神经系统对维持大脑灌流的贡献的相对忽视。在本研究中，我们重点研究了在大鼠实验性蛛网膜下腔出血后，延髓头端腹内侧(RVM)在调节脑血流中的作用。用激光多普勒血流仪和三维光学微血管造影术检测脑血流量的变化。局部应用GABAA受体激动剂和拮抗剂分别灭活和激活RVM。我们在这里表明，RVM在静息状态下调节脑血流，进而有助于高度蛛网膜下腔出血后脑血流的恢复。这种脑干代偿机制的失败可能是蛛网膜下腔出血后患者急性血流灌注不足的重要原因。
Symptomatic ischemia following aneurysmal subarachnoid hemorrhage is common but poorly understood and inadequately treated. Severe constriction of the major arteries at the base of the brain, termed vasospasm, traditionally has been thought to be a proximal event underlying these ischemias, although microvascular changes also have been described. The vast majority of studies aimed at understanding the pathogenesis of ischemic deficits and vasospasm have focused on the interaction of the “spasmogen” of the extravasated blood with the smooth muscle and endothelium of the arteries. This has led to a comparative neglect of the contribution of the central nervous system to the maintenance of cerebral perfusion. In the present study, we focused on the role of the rostral ventromedial medulla (RVM) in modulating cerebral perfusion at rest and following an experimental subarachnoid hemorrhage in the rat. Changes in cerebral blood flow (CBF) were measured using laser-Doppler flowmetry and three-dimensional optical microangiography. Focal application of a GABAA receptor agonist and antagonist were used to respectively inactivate and activate the RVM. We show here that the RVM modulates cerebral blood flow under resting conditions, and further, contributes to restoration of cerebral perfusion following a high-grade subarachnoid hemorrhage. Failure of this brainstem compensatory mechanism could be significant for acute perfusion deficits seen in patients following subarachnoid hemorrhage.
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DOI：
10.1152/ajpheart.00857.2007
发表时间：
2007-12-01
影响因子：
4.8
作者：
Ansar, Saema;Vikman, Petter;Edvinsson, Lars
通讯作者：
Edvinsson, Lars
影响因子：
5.3
作者：
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通讯作者：
Heinricher, Mary M.
影响因子：
5.5
作者：
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DOI：
10.1098/rstb.1985.0037
发表时间：
1985-01-01
期刊：
PHILOSOPHICAL TRANSACTIONS OF THE ROYAL SOCIETY OF LONDON SERIES B-BIOLOGICAL SCIENCES
影响因子：
--
作者：
FIELDS, HL;HEINRICHER, MM
通讯作者：
HEINRICHER, MM
影响因子：
6.3
作者：
GOLANOV, EV;REIS, DJ
通讯作者：
REIS, DJ