Persisting depletion of brain glucose following cortical spreading depression, despite apparent hyperaemia: evidence for risk of an adverse effect of Leao's spreading depression
Open accessAbstract
Rapid sampling microdialysis (rsMD) directed towards the cerebral cortex has allowed identification of a combined time-series signature for glucose and lactate that characterizes peri-infarct depolarization in experimental focal ischaemia, but no comparable data exist for ‘classical’ cortical spreading depression (CSD) associated with hyperaemia in the normally perfused brain. Here, we examined the rsMD responses of dialysate glucose and lactate to five hyperaemic spreading depressions induced with intracortical microinjections, typically of 1 mol/L KCl, in open-skull preparations in five cats under chloralose anaesthesia. Depolarization was verified with microelectrodes, and laser speckle flowmetry was used to examine propagation of the events and perfusion responses near the MD probe. Ten minutes after depolarization, dialysate glucose fell and lactate rose by 28% and 58% respectively. There was no recovery of dialysate glucose 30 mins after depolarization. Mean baseline indicative cerebral blood flow was 25.5 ± 4.1 mL/100 g/min and mean maximum hyperaemic increase was by 29.6 ± 6 mL/100 g/min; hyperaemia remained present 30 mins after CSD. As CSD events are repetitive, frequent, and often clustered temporally in human acute brain injury, these results indicate a high risk of depletion of extracellular glucose in association with depolarization events of a pattern previously thought to be largely benign.
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Clinical data show the whole spectrum of waves and even short spreading depolarizations will impose a significant metabolic challenge, especially when they invade the hypoperfused peri-contusional cortex.
“Yet, the clinical data show the whole spectrum of waves and even short spreading depolarizations will impose a significant metabolic challenge (Hashemi et al., 2009;Feuerstein et al., 2010), especially when they will invade the hypoperfused peri-contusional cortex.”
From Evolution of neuronal and astroglial disruption in the peri-contusional cortex of mice revealed by in vivo two-photon imaging (2013) · cites this paper as Hashemi et al., 2009
The Introduction (page unavailable) distinguishes short and long depolarizations in patients, and the Discussion reports clinical glucose and lactate changes associated with depolarizations. The Conclusion reports a sustained glucose decrease after a single experimentally induced CSD, supporting a metabolic challenge even from a brief event. It does not establish from clinical data that every short event will have this effect, or specifically examine invasion of hypoperfused peri-contusional cortex. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn normal cortex spreading depolarization is the pathophysiological correlate of the migraine aura, but even here it can cause a shortage of energy supply and can be accompanied by a short period of tissue hypoxia with a complex pattern of distribution across the capillary bed.
“In normal cortex spreading depolarization is the pathophysiological correlate of the migraine aura (Lauritzen, 1994), but even here it can cause a shortage of energy supply (Hashemi et al., 2009) and can be accompanied by a short period of tissue hypoxia with a complex pattern of distribution across the capillary bed (Takano et al., 2007;Yuzawa et al., 2012).”
From Evolution of neuronal and astroglial disruption in the peri-contusional cortex of mice revealed by in vivo two-photon imaging (2013) · cites this paper as Hashemi et al., 2009
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- Authors
- Hashemi, P., Bhatia, R., Nakamura, H., Dreier, J. P., Graf, R., Strong, A. J., & Boutelle, M. G.
- Affiliations
- Imperial College London (GB)
- King's College London (GB)
- Max Planck Society (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Hashemi, Parastoo
- Venue
- Journal of Cerebral Blood Flow & Metabolism
- Publisher
- SAGE Publications
- Published
- 2008-09-24
- Volume
- 29
- Issue
- 1
- Pages
- 166-175
- ISSN
- 0271-678X (ISSN-L)
- 1559-7016
- OpenAlex
- W1997402492
- Semantic Scholar
- 52a6a836ecc760c1818ddceb43eb45198ee5a65e
- Cited by
- 101
- References
- 43
- Citations by year
- 2024: 2 · 2023: 3 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 5 · 2018: 1 · 2017: 2 · 2016: 7 · 2015: 8 · 2014: 10 · 2013: 6 · 2012: 12
- FWCI
- 8.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Cerebral Blood Flow & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Max Planck Institute for Plasma Physics (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Engineering and Physical Sciences Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- cortical spreading depression, hyperemia, lactate, peri-infarct depolarization, cerebral blood flow, laser speckle flowmetry, acute brain injury, cats
- MeSH terms
- Animals, Brain, Cats, Glucose, Hyperemia, Male, Risk Factors, Cortical Spreading Depression, Microdialysis, Lactic Acid
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