Smith Justin M, James Michael F, Fraser James A, Huang Christopher L-H
Physiological Laboratory, University of Cambridge, Downing Street, Cambridge CB2 3EG, UK.
Expert Rev Neurother. 2008 May;8(5):759-68. doi: 10.1586/14737175.8.5.759.
This perspective discusses cortical spreading depression (CSD) phenomena and their translational significance for human migraine aura and the peri-infarct events following cerebral ischemia and injury. They begin with interstitial K(+) release and accumulation following neuronal stimulation, and a buffering astrocytic K(+) influx and remote liberation propagating waves of neuronal hyperexcitability and depression. Diffusion-weighted echoplanar MRI demonstrates CSD features in gyrencephalic brains recapitulating human migraine aura, spatial and temporal features of single primary events and multiple secondary events, their stimulus dependence, pharmacological properties, and their relationship to blood oxygenation level-dependent signals and late cerebrovascular changes. The article finally explores prospects for physiological studies of CSD gaining fuller insights both into mechanisms underlying the pathology of the corresponding human condition and possible approaches to management.
这篇综述讨论了皮层扩散性抑制（CSD）现象及其对人类偏头痛先兆以及脑缺血和损伤后梗死周围事件的转化意义。它们始于神经元刺激后细胞外钾离子（K⁺）的释放和积累，以及缓冲性星形胶质细胞钾离子内流和远程释放，从而传播神经元过度兴奋和抑制的波。扩散加权回波平面磁共振成像（MRI）显示，在脑回脑型大脑中，CSD特征重现了人类偏头痛先兆、单个原发性事件和多个继发性事件的时空特征、它们的刺激依赖性、药理学特性，以及它们与血氧水平依赖性信号和晚期脑血管变化的关系。文章最后探讨了CSD生理学研究的前景，以期更全面地了解相应人类疾病病理的潜在机制和可能的治疗方法。
