Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
Stroke. 2012 Nov;43(11):3052-62. doi: 10.1161/STROKEAHA.112.653204. Epub 2012 Aug 23.
Age is the most important risk factor for ischemic stroke. Recent experiments evidenced an age-associated rarefaction of the native collateral vasculature. The purpose of this study was to assess in what way age and arteriogenesis influence cortical perfusion and recovery of hemodynamic impairment in aged and young C57/BL6 mice.
After model establishment of chronic cerebral hypoperfusion in the C57/BL6 strain, sustained hemodynamic impairment was induced by permanent unilateral internal carotid artery occlusion in animals aged 4 to 6 weeks, 12 weeks, and 18 months. Functional and morphological outcome was assessed by laser speckle imaging before and during acetazolamide challenge on Days 0, 3, 7, and 14 and latex/carbon black angiography and immunohistochemistry on Day 21.
Although internal carotid artery occlusion did not result in a reduction of baseline perfusion, it led to significant hemodynamic impairment in all age groups. Furthermore, baseline perfusion in sham and cerebrovascular reactivity after internal carotid artery occlusion were significantly lower in animals aged 18 months (468±57 Flux; 20.8%±17%) compared with mice aged 4 to 6 weeks (568±120 Flux; 30.3%±17%) and 12 weeks (591±72 Flux; 34.2%±12%) from the beginning until Day 7 of the monitoring period. Functional outcome was in line with a 27% reduction of native leptomeningeal anastomoses in aged mice and only limited collateral outgrowth compared with young animals. Strikingly, all age groups reached spontaneous functional compensation by Day 14.
Next to limited collateral remodeling, our results suggest that a hampered cerebrovascular response with age could intensify the risk for hemodynamic stroke in the elderly.
年龄是缺血性中风最重要的危险因素。最近的实验证明,与年龄相关的原生侧支血管稀疏。本研究旨在评估年龄和动脉生成如何影响皮质灌注和恢复老年和年轻 C57/BL6 小鼠的血液动力学损伤。
在 C57/BL6 品系建立慢性大脑低灌注模型后,通过永久性单侧颈内动脉闭塞在 4 至 6 周、12 周和 18 个月龄的动物中诱导持续的血液动力学损伤。在第 0、3、7 和 14 天进行乙酰唑胺挑战之前和期间通过激光散斑成像评估功能和形态学结果,并在第 21 天进行乳胶/碳黑血管造影和免疫组织化学检查。
尽管颈内动脉闭塞并未导致基线灌注减少,但它导致所有年龄组的血液动力学损伤显著。此外,与 4 至 6 周龄(568±120 Flux;30.3%±17%)和 12 周龄(591±72 Flux;34.2%±12%)的小鼠相比,18 个月龄的动物的基线灌注(468±57 Flux;20.8%±17%)和颈内动脉闭塞后的脑血管反应性在监测期开始直至第 7 天显著降低。功能结果与老年小鼠原生软脑膜吻合减少 27%以及与年轻动物相比侧支生长有限相符。引人注目的是,所有年龄组在第 14 天均达到自发功能代偿。
除了有限的侧支重塑外,我们的结果表明,随着年龄的增长,脑血管反应能力下降可能会增加老年人发生血液动力学性中风的风险。