Enhanced Microdialysis for CSD Monitoring

用于 CSD 监测的增强型微透析

• 批准号: 9035808
• 负责人: Adrian C Michael
• 金额: $ 21.75万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9035808
• 关键词: Address; Animals; Anti-Inflammatory Agents; Anti-inflammatory; Beds; Blood flow; Brain; Brain Injuries; Cessation of life; Clinical; Data; Development; Dexamethasone; Diagnostic; Dose; Environment; Epidemic; Event; Gliosis; Glucose; Goals; Human; Implant; Injury; Institutional Review Boards; Intensive Care; Ischemia; Lead; Letters; Measurement; Medical Staff; Metabolic; Microdialysis; Migraine; Monitor; Neurons; Outcome; Patient Care; Patients; Penetration; Performance; Rattus; Recurrence; Reporting; Risk; Role; Route; Safety; Sampling; Secondary to; Severities; Side; Site; Spreading Cortical Depression; Technology; Time; Tissues; Traumatic Brain Injury; Vegetative States; brain tissue; clinically relevant; controlled cortical impact; deprivation; disability; improved; injured; interstitial; member; microsensor; public health relevance; response; spreading depression

 DESCRIPTION (provided by applicant): Brain injury gives rise to the phenomenon of cortical spreading depression. In healthy brain, spreading depressions are associated with migraine but are not known to cause brain damage. In the injured brain, recurrent spreading depressions lead to secondary brain injury and correlate significantly with poor patient outcomes including death, vegetative state, or severe disability 6 months after the primary injury. Microdialysis in patients with brain injury shows that spreading depressions deplete brain glucose, reflecting the sudden and intense demand for energy to drive ATP-dependent repolarization of brain tissue after the depolarization wave passes. Glucose delivery via the blood flow fails to keep pace with the demand and brain tissue becomes glucose deprived. This glucose deprivation is implicated in secondary injury to the at-‐risk penumbral tissue, resulting in expansion of the injury core. At present, clinical microdialysis is not used to assess the metabolic severity of spreading depressions due to variability in the results. The objective of this project is to develop, in experimental animals, "dexamethasone-enhanced microdialysis" as an approach to eliminate ischemia and gliosis at the microdialysis probe site and thereby improve the reliability of microdialysis measurements over the 1-10 day clinically relevant time window post-injury.

 描述（适用提供）：脑损伤引起了皮质扩散抑郁症的现象。在健康的大脑中，扩散抑制与偏头痛有关，但尚不知道会造成脑部损伤。在受伤的大脑中，反复的扩散抑制会导致继发性脑损伤，并与差的患者结局显着相关，包括死亡，植物性状态或严重的严重残疾，在初次损伤后6个月。脑损伤患者的微透析表明，扩散抑制会有所不同，这反映了沉积波通过后对脑组织驱动ATP依赖性重极化的突然和强烈的需求。通过血流传递的葡萄糖递送无法跟上需求的步伐，而脑组织被剥夺了葡萄糖。这种葡萄糖的剥夺暗示是对处于处于危险的半肿瘤组织的继发性损伤，导致损伤核心的扩大。目前，由于结果可变性，临床微透析不用于评估扩散下降的代谢严重程度。该项目的目的是在实验动物中开发“地塞米松增强的微透析”，以作为消除微透析探针位点上缺血和神经胶质的一种方法，从而提高了可靠性。 在伤害后1-10天临床相关的时间窗口中，微透析测量值。