Journal
BRAIN
Volume 133, Issue -, Pages 1994-2006Publisher
OXFORD UNIV PRESS
DOI: 10.1093/brain/awq117
Keywords
focal brain ischaemia; stroke; spreading depression; peri-infarct depolarization; laser speckle imaging
Categories
Funding
- Deutsche Forschungsgemeinschaft (DFG) [DR 323/3-1, 323/5-1]
- Bundesministerium fur Bildung und Forschung (Center for Stroke Research Berlin) [01 EO 0801]
- Kompetenznetz Schlaganfall
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How does infarction in victims of stroke and other types of acute brain injury expand to its definitive size in subsequent days? Spontaneous depolarizations that repeatedly spread across the cerebral cortex, sometimes at remarkably regular intervals, occur in patients with all types of injury. Here, we show experimentally with in vivo real-time imaging that similar, spontaneous depolarizations cycle repeatedly around ischaemic lesions in the cerebral cortex, and enlarge the lesion in step with each cycle. This behaviour results in regular periodicity of depolarization when monitored at a single point in the lesion periphery. We present evidence from clinical monitoring to suggest that depolarizations may cycle in the ischaemic human brain, perhaps explaining progressive growth of infarction. Despite their apparent detrimental role in infarct growth, we argue that cycling of depolarizations around lesions might also initiate upregulation of the neurobiological responses involved in repair and remodelling.
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