Microemboli may link spreading depression, migraine aura, and patent foramen ovale.
Microemboli may link spreading depression, migraine aura, and patent foramen ovale.
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DOI：
10.1002/ana.21871
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发表时间：
2010-02
影响因子：
11.2
通讯作者：
Moskowitz, Michael A.
中科院分区：
文献类型：
--
作者：
Nozari, Ala;Dilekoz, Ergin;Sukhotinsky, Inna;Stein, Thor;Eikermann-Haerter, Katharina;Liu, Christina;Wang, Yumei;Frosch, Matthew P.;Waeber, Christian;Ayata, Cenk;Moskowitz, Michael A.
卵圆孔未闭和肺动静脉分流与脑栓塞、中风和先兆偏头痛等严重并发症相关。这些疾病之间的病理生理机制尚不清楚。我们的目的是在实验动物模型中建立微栓塞与偏头痛先兆之间的联系机制。我们将微粒或空气微栓子引入小鼠颈动脉循环，以确定不足以引起梗死的短暂微血管闭塞是否触发皮层扩张性抑制（CSD），这是一种传播缓慢的去极化，是偏头痛先兆的基础。空气微栓子可靠地触发CSD而不引起梗死。聚苯乙烯微球（10μm）或胆固醇晶体（<70μm）在28只小鼠中有16只触发了CSD，其中60%的小鼠（CSD组的40%）在一系列脑切片的详细组织学分析中没有显示梗死或炎症。在选取的15只动物中，有14只在磁共振成像检查（9.4T， T2加权）中未发现损伤证据。CSD的发生似乎与血流减少的程度和持续时间有关，其触发机制取决于脑灌注减少，而不是持续的组织损伤。在小鼠模型中，微栓子触发CSD，通常不会引起微梗死。矛盾栓塞可能将心脏和心外右至左分流与偏头痛先兆联系起来。如果适用于人类，偏头痛先兆的一个子集可能属于低灌注障碍的频谱，同时伴有短暂性脑缺血发作和无症状性梗死。
Patent foramen ovale and pulmonary arteriovenous shunts are associated with serious complications such as cerebral emboli, stroke, and migraine with aura. The pathophysiological mechanisms that link these conditions are unknown. We aimed to establish a mechanism linking microembolization to migraine aura in an experimental animal model. We introduced particulate or air microemboli into the carotid circulation in mice to determine whether transient microvascular occlusion, insufficient to cause infarcts, triggered cortical spreading depression (CSD), a propagating slow depolarization that underlies migraine aura. Air microemboli reliably triggered CSD without causing infarction. Polystyrene microspheres (10μm) or cholesterol crystals (<70μm) triggered CSD in 16 of 28 mice, with 60% of the mice (40% of those with CSD) showing no infarcts or inflammation on detailed histological analysis of serial brain sections. No evidence of injury was detected on magnetic resonance imaging examination (9.4T; T2 weighted) in 14 of 15 selected animals. The occurrence of CSD appeared to be related to the magnitude and duration of flow reduction, with a triggering mechanism that depended on decreased brain perfusion but not sustained tissue damage. In a mouse model, microemboli triggered CSD, often without causing microinfarction. Paradoxical embolization then may link cardiac and extracardiac right-to-left shunts to migraine aura. If translatable to humans, a subset of migraine auras may belong to a spectrum of hypoperfusion disorders along with transient ischemic attacks and silent infarcts.
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影响因子：
2.9
作者：
Matsushima, K;Schmidt-Kastner, R;Hakim, AM
通讯作者：
Hakim, AM
影响因子：
14.5
作者：
Dreier, Jens P.;Woitzik, Johannes;Strong, Anthony J.
通讯作者：
Strong, Anthony J.
DOI：
10.1097/01.wcb.0000122745.72175.d5
发表时间：
2004-07-01
影响因子：
6.3
作者：
Ayata, C;Dunn, AK;Moskowitz, MA
通讯作者：
Moskowitz, MA
影响因子：
158.5
作者：
LECHAT, P;MAS, JL;GROSGOGEAT, Y
通讯作者：
GROSGOGEAT, Y
影响因子：
11.2
作者：
Dohmen, Christian;Sakowitz, Oliver W.;Graf, Rudolf
通讯作者：
Graf, Rudolf