Reeson Patrick, Jeffery Andrew, Brown Craig E
Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada.
Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada Department of Biology, University of Victoria, Victoria, British Columbia, Canada Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
Diabetes. 2016 Jul;65(7):1779-88. doi: 10.2337/db16-0064.
Type 1 diabetes is known to cause circulatory problems in the eyes, heart, and limbs, and the brain is no exception. Because of the insidious effects of diabetes on brain circulation, patients with diabetes are two to four times more likely to have an ischemic stroke and are less likely to regain functions that are lost. To provide a more mechanistic understanding of this clinically significant problem, imaging studies have focused on how stroke affects neural and vascular networks in experimental models of type 1 diabetes. The emerging picture is that diabetes leads to maladaptive changes in the cerebrovascular system that ultimately limit neuronal rewiring and recovery of functions after stroke. At the cellular and systems level, diabetes is associated with abnormal cerebral blood flow in surviving brain regions and greater disruption of the blood-brain barrier. The abnormal vascular responses to stroke can be partly attributed to aberrant vascular endothelial growth factor (VEGF) signaling because genetic or pharmacological inhibition of VEGF signaling can mitigate vascular dysfunction and improve stroke recovery in diabetic animals. These experimental studies offer new insights and strategies for optimizing stroke recovery in diabetic populations.
1型糖尿病已知会引发眼部、心脏和四肢的循环问题，大脑也不例外。由于糖尿病对脑循环的潜在影响，糖尿病患者发生缺血性中风的可能性是正常人的两到四倍，而且丧失的功能恢复的可能性较小。为了更深入地了解这一具有临床意义的问题的机制，影像学研究聚焦于中风如何影响1型糖尿病实验模型中的神经和血管网络。新出现的情况是，糖尿病会导致脑血管系统发生适应性不良变化，最终限制中风后神经元的重新布线和功能恢复。在细胞和系统层面，糖尿病与存活脑区的脑血流量异常以及血脑屏障的更大破坏有关。中风时异常的血管反应部分可归因于血管内皮生长因子（VEGF）信号异常，因为对VEGF信号进行基因或药物抑制可以减轻血管功能障碍并改善糖尿病动物的中风恢复情况。这些实验研究为优化糖尿病患者的中风恢复提供了新的见解和策略。
