The Critical Role of Spreading Depolarizations in Early Brain Injury Consensus and Contention /

Background: When a patient arrives in the emergency department following a stroke, a traumatic brain injury, or sudden cardiac arrest, there is no therapeutic drug available to help protect their jeopardized neurons. One crucial reason is that we have not identified the molecular mechanisms leading...

Teljes leírás

Elmentve itt :
Bibliográfiai részletek
Szerzők: Andrew R.D. R. David
Hartings Jed A.
Ayata Cenk
Brennan K.C
Dawson-Scully Ken D.
Farkas Eszter
Herreras Oscar
Kirov Sergei A.
Müller Michael
Ollen‑Bittle Nikita
Reiffurth Clemens
Revah Omer
Robertson R. Meldrum
Shuttleworth C. William
Ullah Ghanim
Dreier Jens P.
Dokumentumtípus: Cikk
Megjelent: 2022
Sorozat:NEUROCRITICAL CARE 37 No. Suppl. 1
Tárgyszavak:
doi:10.1007/s12028-021-01431-w

mtmt:32766743
Online Access:http://publicatio.bibl.u-szeged.hu/25661
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520 3 |a Background: When a patient arrives in the emergency department following a stroke, a traumatic brain injury, or sudden cardiac arrest, there is no therapeutic drug available to help protect their jeopardized neurons. One crucial reason is that we have not identified the molecular mechanisms leading to electrical failure, neuronal swelling, and blood vessel constriction in newly injured gray matter. All three result from a process termed spreading depolarization (SD). Because we only partially understand SD, we lack molecular targets and biomarkers to help neurons survive after losing their blood flow and then undergoing recurrent SD. Methods: In this review, we introduce SD as a single or recurring event, generated in gray matter following lost blood flow, which compromises the Na+/K+ pump. Electrical recovery from each SD event requires so much energy that neurons often die over minutes and hours following initial injury, independent of extracellular glutamate. Results: We discuss how SD has been investigated with various pitfalls in numerous experimental preparations, how overtaxing the Na+/K+ ATPase elicits SD. Elevated K+ or glutamate are unlikely natural activators of SD. We then turn to the properties of SD itself, focusing on its initiation and propagation as well as on computer modeling. Conclusions: Finally, we summarize points of consensus and contention among the authors as well as where SD research may be heading. In an accompanying review, we critique the role of the glutamate excitotoxicity theory, how it has shaped SD research, and its questionable importance to the study of early brain injury as compared with SD theory. © 2022, The Author(s). 
650 4 |a Általános orvostudomány 
700 0 1 |a Hartings Jed A.  |e aut 
700 0 1 |a Ayata Cenk  |e aut 
700 0 1 |a Brennan K.C.  |e aut 
700 0 2 |a Dawson-Scully Ken D.  |e aut 
700 0 2 |a Farkas Eszter  |e aut 
700 0 2 |a Herreras Oscar  |e aut 
700 0 2 |a Kirov Sergei A.  |e aut 
700 0 2 |a Müller Michael  |e aut 
700 0 2 |a Ollen‑Bittle Nikita  |e aut 
700 0 2 |a Reiffurth Clemens  |e aut 
700 0 2 |a Revah Omer  |e aut 
700 0 2 |a Robertson R. Meldrum  |e aut 
700 0 2 |a Shuttleworth C. William  |e aut 
700 0 2 |a Ullah Ghanim  |e aut 
700 0 2 |a Dreier Jens P.  |e aut 
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