Department of Medical Physics and Informatics, Faculty of Medicine and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary.
J Gerontol A Biol Sci Med Sci. 2014 Nov;69(11):1363-70. doi: 10.1093/gerona/glu066. Epub 2014 May 7.
Recurrent waves of spreading depolarization (SD) spontaneously occur minutes after the onset of focal ischemia in the brain and keep generating for a number of days to follow. It has become widely accepted that ischemia-related SDs are part of the pathophysiology of cerebrovascular diseases and predict worse outcome. SDs may exacerbate ischemic injury via related atypical hemodynamic responses. The incidence of ischemic stroke is known to increase markedly with age; yet, very few studies investigated whether age alters SD evolution and whether a potential age-specific pattern of SD would contribute to the age-related intensification of infarct development. Experimental data demonstrate that aging has a marked impact on SD evolution and corresponding changes in cerebral blood flow. We hypothesize that an age-specific pattern of the SD-associated hemodynamic response must be involved in augmenting the expansion of ischemic brain damage in the elderly patients and that structural and functional (mal)adaptation of the cerebrovascular system with aging serves as a potential basis for compromised vascular reactivity and subsequent tissue damage. The concept put forward is expected to stimulate further investigation to achieve a comprehensive overview of the implication of SD in injury progression in the aged brain.
反复出现的弥散性去极化波（SD）在大脑局灶性缺血发作后几分钟内自发发生，并持续数天。人们普遍认为，与缺血相关的 SD 是脑血管疾病病理生理学的一部分，并预测预后更差。SD 可能通过相关的非典型血流动力学反应加重缺血性损伤。已知缺血性中风的发病率随年龄显著增加；然而，很少有研究调查年龄是否改变 SD 的演变，以及潜在的年龄特异性 SD 模式是否会导致与年龄相关的梗死发展加剧。实验数据表明，衰老对 SD 演变和相应的脑血流变化有显著影响。我们假设，与 SD 相关的血流动力学反应的年龄特异性模式必须参与增强老年患者缺血性脑损伤的扩展，并且衰老时脑血管系统的结构和功能（失调）适应作为血管反应性降低和随后组织损伤的潜在基础。提出的概念预计将刺激进一步的研究，以全面了解 SD 在老年大脑损伤进展中的作用。
