Impact of intracranial hypertension and cerebral perfusion pressure on spreading depolarization.

IF 4.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Takuma Nishimoto, Fumiaki Oka, Takao Inoue, Hiroshi Moriyama, Reo Kawano, Michiyasu Suzuki, David Y Chung, Cenk Ayata, Hideyuki Ishihara
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Abstract

Spreading depolarization (SD) develops after stroke and traumatic brain injury and may contribute to secondary brain damage. These diseases are often accompanied by intracranial hypertension, but little is known about the effects of intracranial pressure (ICP) on SD. Here, we study the effect of increased ICP on hemodynamic and metabolic response to SD in rats. SDs were triggered at different ICPs and cerebral perfusion pressures (CPP). The regional cerebral blood flow (rCBF), partial pressure of brain tissue oxygen (PbtO2), cerebral extracellular glucose and lactate concentrations were recorded. Fluoro-Jade staining was used to quantify neuronal injury in cortex. At high ICP (50 mmHg) with low CPP (30 mmHg), rCBF and PbtO2 were monophasically decreased in contrast to a monophasically increased pattern under normal conditions. Neuronal death increased in both hemispheres but much more on the side where SDs were triggered. At high ICP (50 mmHg) with normal CPP (70 mmHg), CBF and metabolism during SD did not differ from baseline, and neuronal death did not increase even on the side of SD induction. These data suggest that maintaining CPP at 70 mmHg, even when the ICP is as high as 50 mmHg, preserves normal blood flow and metabolism during SD events and prevents neuronal degeneration.

颅内高压和脑灌注压对展期去极化的影响
脑卒中和脑外伤后会出现扩展性去极化(SD),并可能导致继发性脑损伤。这些疾病通常伴有颅内高压,但人们对颅内压(ICP)对 SD 的影响知之甚少。在此,我们研究了ICP升高对大鼠血液动力学和新陈代谢对SD反应的影响。在不同的 ICP 和脑灌注压 (CPP) 下触发 SD。记录区域脑血流量(rCBF)、脑组织氧分压(PbtO2)、脑细胞外葡萄糖和乳酸浓度。荧光玉染色用于量化大脑皮层的神经元损伤。在高 ICP(50 mmHg)和低 CPP(30 mmHg)条件下,rCBF 和 PbtO2 呈单相降低,而正常条件下则呈单相升高。两个半球的神经元死亡都增加了,但触发 SD 的一侧增加得更多。在高 ICP(50 mmHg)和正常 CPP(70 mmHg)条件下,SD 期间的 CBF 和新陈代谢与基线没有差异,即使在诱发 SD 的一侧,神经元死亡也没有增加。这些数据表明,即使当 ICP 高达 50 mmHg 时,将 CPP 保持在 70 mmHg,也能在 SD 事件期间保持正常的血流和新陈代谢,并防止神经元变性。
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来源期刊
Journal of Cerebral Blood Flow and Metabolism
Journal of Cerebral Blood Flow and Metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.80%
发文量
300
审稿时长
3 months
期刊介绍: JCBFM is the official journal of the International Society for Cerebral Blood Flow & Metabolism, which is committed to publishing high quality, independently peer-reviewed research and review material. JCBFM stands at the interface between basic and clinical neurovascular research, and features timely and relevant research highlighting experimental, theoretical, and clinical aspects of brain circulation, metabolism and imaging. The journal is relevant to any physician or scientist with an interest in brain function, cerebrovascular disease, cerebral vascular regulation and brain metabolism, including neurologists, neurochemists, physiologists, pharmacologists, anesthesiologists, neuroradiologists, neurosurgeons, neuropathologists and neuroscientists.
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