Executive (dys)function after stroke: special considerations for behavioral pharmacology.
Executive (dys)function after stroke: special considerations for behavioral pharmacology.
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DOI：
10.1097/fbp.0000000000000432
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发表时间：
2018-10
影响因子：
1.6
通讯作者：
Engler-Chiurazzi EB
中科院分区：
文献类型：
--
作者：
Povroznik JM;Ozga JE;Vonder Haar C;Engler-Chiurazzi EB
中风是世界范围内导致死亡和长期残疾的主要原因，并发的次要后果主要包括情绪功能障碍以及感觉、运动和认知缺陷。本文综述了人类、非人灵长类动物和其他动物模型中与脑卒中相关的特定执行功能障碍（包括决策、工作记忆和认知灵活性）的认知缺陷。此外，我们回顾了中风后执行功能障碍的各个组成部分及其神经解剖学基础的一些细胞和分子基础，重点是生物源性单胺神经传递过程中发生的变化。我们主要集中在儿茶酚胺能（多巴胺能和去甲肾上腺素能）和多巴胺能系统的神经递质的合成，分布，再摄取和降解水平的变化。我们还讨论了潜在的继发性卒中相关行为缺陷（特别是卒中后抑郁以及药物滥用潜力和成瘾）及其与卒中诱导的执行功能缺陷的关系，考虑到人类卒中人群的平均年龄正在下降，这是一个特别重要的考虑因素。在最后一节中，我们讨论了治疗缺血和随后的功能障碍的药理学考虑，以及目前在中风和执行功能研究领域的局限性。
Stroke is a world-wide leading cause of death and long-term disability with concurrent secondary consequences that are largely comprised of mood dysfunction, as well as sensory, motor, and cognitive deficits. This review focuses on the cognitive deficits associated with stroke specific to executive dysfunction (including decision making, working memory, and cognitive flexibility) in humans, non-human primates, and additional animal models. Further, we review some of the cellular and molecular underpinnings of the individual components of executive dysfunction and their neuroanatomical substrates after stroke, with an emphasis on the changes that occur during biogenic monoamine neurotransmission. We concentrate primarily on changes in the catecholaminergic (dopaminergic and noradrenergic) and serotonergic systems at the levels of neurotransmitter synthesis, distribution, re-uptake, and degradation. We also discuss potential secondary stroke-related behavioral deficits (specifically, post-stroke depression as well as drug-abuse potential and addiction) and their relationship with stroke-induced deficits in executive function, an especially important consideration given that the average age of the human stroke population is decreasing. In the final sections, we address pharmacological considerations for the treatment of ischemia and the subsequent functional impairment, as well as current limitations in the field of stroke and executive function research.