Which Spreading Depolarizations Are Deleterious To Brain Tissue?
Which Spreading Depolarizations Are Deleterious To Brain Tissue?
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DOI：
10.1007/s12028-019-00776-7
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发表时间：
2020-02-01
影响因子：
3.5
通讯作者：
Hartings, Jed A.
中科院分区：
文献类型：
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作者：
Shuttleworth, C. William;Andrew, R. David;Hartings, Jed A.
扩散性去极化（sd）是对细胞稳态的严重破坏，它缓慢地通过灰质传播，并对脑组织提出了非凡的代谢挑战。最近的研究表明，SDs通常发生在神经重症监护的人类患者中，并且已经建立了一个令人信服的案例，证明它们在急性脑损伤的病理生理学中的重要性。2018年9月在佛罗里达州博卡拉顿举行的国际扩散去极化会议（iCSD）包括一个讨论会议，重点讨论了“哪些sd对脑组织有害？”iCSD由研究各种动物物种的研究人员参加，包括无脊椎动物、体内和体外制剂、急性脑损伤和偏头痛疾病、计算建模和临床脑损伤等主题。讨论包括对许多关键问题的普遍认同，但也揭示了一些与针对SDs的临床干预设计相关的主题的不同观点。然后，由公务员制度委员会成员组成的一个多学科写作小组根据会议记录编写了一份提出的观点摘要草案。然后对所有讨论者的反馈进行正式整理、审查并纳入最终文件。随着该领域继续朝着有效的临床干预方向发展，希望该报告将刺激收集所需的数据，以更细致地了解不同病理生理状态下的SD。
Spreading depolarizations (SDs) are profound disruptions of cellular homeostasis that slowly propagate through gray matter and present an extraordinary metabolic challenge to brain tissue. Recent work has shown that SDs occur commonly in human patients in the neurointensive care setting and have established a compelling case for their importance in the pathophysiology of acute brain injury. The International Conference on Spreading Depolarizations (iCSD) held in Boca Raton, Florida, in September of 2018 included a discussion session focused on the question of "Which SDs are deleterious to brain tissue?" iCSD is attended by investigators studying various animal species including invertebrates, in vivo and in vitro preparations, diseases of acute brain injury and migraine, computational modeling, and clinical brain injury, among other topics. The discussion included general agreement on many key issues, but also revealed divergent views on some topics that are relevant to the design of clinical interventions targeting SDs. A draft summary of viewpoints offered was then written by a multidisciplinary writing group of iCSD members, based on a transcript of the session. Feedback of all discussants was then formally collated, reviewed and incorporated into the final document. It is hoped that this report will stimulate collection of data that are needed to develop a more nuanced understanding of SD in different pathophysiological states, as the field continues to move toward effective clinical interventions.