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2015 ; 85
(5
): 1117-31
Nephropedia Template TP
gab.com Text
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English Wikipedia
Supply-demand mismatch transients in susceptible peri-infarct hot zones explain
the origins of spreading injury depolarizations
#MMPMID25741731
von Bornstädt D
; Houben T
; Seidel JL
; Zheng Y
; Dilekoz E
; Qin T
; Sandow N
; Kura S
; Eikermann-Haerter K
; Endres M
; Boas DA
; Moskowitz MA
; Lo EH
; Dreier JP
; Woitzik J
; Sakad?i? S
; Ayata C
Neuron
2015[Mar]; 85
(5
): 1117-31
PMID25741731
show ga
Peri-infarct depolarizations (PIDs) are seemingly spontaneous spreading
depression-like waves that negatively impact tissue outcome in both experimental
and human stroke. Factors triggering PIDs are unknown. Here, we show that
somatosensory activation of peri-infarct cortex triggers PIDs when the activated
cortex is within a critical range of ischemia. We show that the mechanism
involves increased oxygen utilization within the activated cortex, worsening the
supply-demand mismatch. We support the concept by clinical data showing that
mismatch predisposes stroke patients to PIDs as well. Conversely, transient
worsening of mismatch by episodic hypoxemia or hypotension also reproducibly
triggers PIDs. Therefore, PIDs are triggered upon supply-demand mismatch
transients in metastable peri-infarct hot zones due to increased demand or
reduced supply. Based on the data, we propose that minimizing sensory stimulation
and hypoxic or hypotensive transients in stroke and brain injury would reduce PID
incidence and their adverse impact on outcome.