氯胺酮对脑回状猪皮层扩展性去极化的光学和电学特性的影响。
The effect of ketamine on optical and electrical characteristics of spreading depolarizations in gyrencephalic swine cortex.
作者信息
Sánchez-Porras Renán, Santos Edgar, Schöll Michael, Stock Christian, Zheng Zelong, Schiebel Patrick, Orakcioglu Berk, Unterberg Andreas W, Sakowitz Oliver W
机构信息
Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany.
Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany.
出版信息
Neuropharmacology. 2014 Sep;84:52-61. doi: 10.1016/j.neuropharm.2014.04.018. Epub 2014 May 4.
Spreading depolarization (SD) is a wave of mass neuronal and glial depolarization that propagates across the cerebral cortex and has been implicated in the pathophysiology of brain injury states and migraine with aura. Analgesics and sedatives seem to have a significant effect on SD modulation. Studies have shown that ketamine, an NMDA receptor blocker, has the capacity to influence SD occurrence. The aim of this study was to analyze the dose-dependent effect of ketamine on SD susceptibility through electrocorticography (ECoG) and intrinsic optical signal (IOS) imaging in a gyrencephalic brain. Ketamine in a low-dose infusion (2 mg/kg/h) decreases SD spread and had an effect on the amplitude of SD deflections, as well as on duration, and speed. Moreover, during ketamine infusion at this dose, there was a sustained decrease in the hyperemic response following SD. However, a high-dose infusion (4 mg/kg/h) of ketamine inhibited SD induction and expansion. Furthermore, a high-dose bolus (4 mg/kg), 1 min after stimulation, blocked SD propagation abruptly within 1-2 min, and hindered SD induction and expansion for the following 15-30 min. The results suggest that ketamine may be therapeutically beneficial in preventing SDs. Nonetheless, an adequate dosage and way of administration should be considered and established for human use.
扩散性去极化(SD)是一种大量神经元和胶质细胞去极化的波,它在大脑皮层中传播,并与脑损伤状态和伴有先兆的偏头痛的病理生理学有关。镇痛药和镇静剂似乎对SD调节有显著影响。研究表明,NMDA受体阻滞剂氯胺酮有影响SD发生的能力。本研究的目的是通过脑皮层电图(ECoG)和脑回状脑的内在光学信号(IOS)成像,分析氯胺酮对SD易感性的剂量依赖性效应。低剂量输注(2毫克/千克/小时)的氯胺酮可减少SD的传播,并对SD偏转的幅度、持续时间和速度有影响。此外,在此剂量的氯胺酮输注期间,SD后的充血反应持续下降。然而,高剂量输注(4毫克/千克/小时)的氯胺酮可抑制SD的诱导和扩展。此外,在刺激后1分钟给予高剂量推注(4毫克/千克),可在1-2分钟内突然阻断SD的传播,并在随后的15-30分钟内阻碍SD的诱导和扩展。结果表明,氯胺酮在预防SD方面可能具有治疗益处。尽管如此,对于人类使用,应考虑并确定适当的剂量和给药方式。