Time is brain - Quantified
Time is brain - Quantified
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DOI：
10.1161/01.str.0000196957.55928.ab
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发表时间：
2006-01-01
期刊：
影响因子：
8.3
通讯作者：
Saver, JL
中科院分区：
文献类型：
--
作者：
Saver, JL
背景和目的——“时间就是大脑”这句话强调，随着中风的进展，人类神经组织会迅速丧失，需要紧急评估和治疗。定量神经立体学和中风神经影像学的最新进展允许计算急性缺血性中风中每单位时间损失的大脑数量。方法 - 系统文献综述确定了对人类前脑中神经元、突触和有髓纤维数量的共识估计；大血管体积、幕上缺血性中风；以及大血管、幕上缺血性中风从发作到完成的时间间隔。结果-大血管、幕上缺血性中风的典型最终体积为54 mL（敏感性分析中从19到100 mL不等）。非腔隙性中风演变的平均持续时间为10小时（范围为6至18小时），人类前脑中的神经元平均数量为220亿个。在经历典型大血管急性缺血性中风的患者中，每小时会损失 1.2 亿个神经元、8,300 亿个突触和 714 公里（447 英里）的有髓纤维。每分钟，190 万个神经元、140 亿个突触和 12 公里（7.5 英里）的有髓纤维被破坏。与大脑衰老过程中神经元损失的正常速度相比，如果不进行治疗，缺血性大脑每小时就会衰老3.6岁。改变敏感性分析中的单个输入变量对估计点值有一定影响，但不影响数量级。结论 - 对人类缺血性中风神经回路损失速度的定量估计强调了中风护理的时间紧迫性。如果中风得不到治疗，典型的患者每分钟就会失去 190 万个神经元。
Background and Purpose - The phrase "time is brain" emphasizes that human nervous tissue is rapidly lost as stroke progresses and emergent evaluation and therapy are required. Recent advances in quantitative neurostereology and stroke neuroimaging permit calculation of just how much brain is lost per unit time in acute ischemic stroke.Methods - Systematic literature-review identified consensus estimates of number of neurons, synapses, and myelinated fibers in the human forebrain; volume of large vessel, supratentorial ischemic stroke; and interval from onset to completion of large vessel, supratentorial ischemic stroke.Results - The typical final volume of large vessel, supratentorial ischemic stroke is 54 mL (varied in sensitivity analysis from 19 to 100 mL). The average duration of nonlacunar stroke evolution is 10 hours (range 6 to 18 hours), and the average number of neurons in the human forebrain is 22 billion. In patients experiencing a typical large vessel acute ischemic stroke, 120 million neurons, 830 billion synapses, and 714 km (447 miles) of myelinated fibers are lost each hour. In each minute, 1.9 million neurons, 14 billion synapses, and 12 km (7.5 miles) of myelinated fibers are destroyed. Compared with the normal rate of neuron loss in brain aging, the ischemic brain ages 3.6 years each hour without treatment. Altering single input variables in sensitivity analyses modestly affected the estimated point values but not order of magnitude.Conclusions - Quantitative estimates of the pace of neural circuitry loss in human ischemic stroke emphasize the time urgency of stroke care. The typical patient loses 1.9 million neurons each minute in which stroke is untreated.