Universität zu Köln

Schumm, Leonie, Lemale, Coline L., Major, Sebastian ORCID: 0000-0003-0970-1308, Hecht, Nils, Nieminen-Kelhae, Melina, Zdunczyk, Anna, Kowoll, Christina M., Martus, Peter, Thiel, Christiane M., Dreier, Jens P. and Woitzik, Johannes (2022). Physiological variables in association with spreading depolarizations in the late phase of ischemic stroke. J. Cereb. Blood Flow Metab., 42 (1). S. 121 - 136. THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 1559-7016

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Abstract

Physiological effects of spreading depolarizations (SD) are only well studied in the first hours after experimental stroke. In patients with malignant hemispheric stroke (MHS), monitoring of SDs is restricted to the postoperative ICU stay, typically day 2-7 post-ictus. Therefore, we investigated the role of physiological variables (temperature, intracranial pressure, mean arterial pressure and cerebral perfusion pressure) in relationship to SD during the late phase after MHS in humans. Additionally, an experimental stroke model was used to investigate hemodynamic consequences of SD during this time window. In 60 patients with MHS, the occurrence of 1692 SDs was preceded by a decrease in mean arterial pressure (-1.04 mmHg; p = .02) and cerebral perfusion pressure (-1.04 mmHg; p = .03). Twenty-four hours after middle cerebral artery occlusion in 50 C57Bl6/J mice, hypothermia led to prolonged SD-induced hyperperfusion (+2.8 min; p < .05) whereas hypertension mitigated initial hypoperfusion (-1.4 min and +18.5%Delta rCBF; p < .01). MRI revealed that SDs elicited 24 hours after experimental stroke were associated with lesion progression (15.9 vs. 14.8 mm(3); p < .01). These findings of small but significant effects of physiological variables on SDs in the late phase after ischemia support the hypothesis that the impact of SDs may be modified by adjusting physiological variables.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schumm, Leonie UNSPECIFIED UNSPECIFIED UNSPECIFIED Lemale, Coline L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Major, Sebastian UNSPECIFIED orcid.org/0000-0003-0970-1308 UNSPECIFIED Hecht, Nils UNSPECIFIED UNSPECIFIED UNSPECIFIED Nieminen-Kelhae, Melina UNSPECIFIED UNSPECIFIED UNSPECIFIED Zdunczyk, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Kowoll, Christina M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Martus, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Thiel, Christiane M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dreier, Jens P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Woitzik, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-592381
DOI:	10.1177/0271678X211039628
Journal or Publication Title:	J. Cereb. Blood Flow Metab.
Volume:	42
Number:	1
Page Range:	S. 121 - 136
Date:	2022
Publisher:	SAGE PUBLICATIONS INC
Place of Publication:	THOUSAND OAKS
ISSN:	1559-7016
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MIDDLE CEREBRAL-ARTERY; BLOOD-FLOW; PERIINFARCT DEPOLARIZATIONS; DEPRESSION; TISSUE; INJURY; EXCITOTOXICITY; TRANSIENTS; OCCLUSION; MIGRAINE Multiple languages Endocrinology & Metabolism; Hematology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59238