Povroznik Jessica M, Ozga Jenny E, Vonder Haar Cole, Engler-Chiurazzi Elizabeth B
Center for Basic and Translational Stroke Research.
Department of Physiology, Pharmacology, and Neuroscience.
Behav Pharmacol. 2018 Oct;29(7):638-653. doi: 10.1097/FBP.0000000000000432.
Stroke is a worldwide leading cause of death and long-term disability with concurrent secondary consequences that are largely comprised of mood dysfunction, as well as sensory, motor, and cognitive deficits. This review focuses on the cognitive deficits associated with stroke specific to executive dysfunction (including decision making, working memory, and cognitive flexibility) in humans, nonhuman primates, and additional animal models. Further, we review some of the cellular and molecular underpinnings of the individual components of executive dysfunction and their neuroanatomical substrates after stroke, with an emphasis on the changes that occur during biogenic monoamine neurotransmission. We concentrate primarily on changes in the catecholaminergic (dopaminergic and noradrenergic) and serotonergic systems at the levels of neurotransmitter synthesis, distribution, reuptake, and degradation. We also discuss potential secondary stroke-related behavioral deficits (specifically, poststroke depression as well as drug-abuse potential and addiction) and their relationship with stroke-induced deficits in executive function, an especially important consideration given that the average age of the human stroke population is decreasing. In the final sections, we address pharmacological considerations for the treatment of ischemia and the subsequent functional impairment, as well as current limitations in the field of stroke and executive function research.
中风是全球主要的死亡和长期残疾原因，其并发的继发性后果主要包括情绪功能障碍以及感觉、运动和认知缺陷。本综述聚焦于人类、非人灵长类动物及其他动物模型中与中风相关的特定认知缺陷，即执行功能障碍（包括决策、工作记忆和认知灵活性）。此外，我们回顾了中风后执行功能障碍各组成部分的一些细胞和分子基础及其神经解剖学底物，重点关注生物源性单胺神经传递过程中发生的变化。我们主要关注儿茶酚胺能（多巴胺能和去甲肾上腺素能）和5-羟色胺能系统在神经递质合成、分布、再摄取和降解水平上的变化。我们还讨论了与中风相关的潜在继发性行为缺陷（特别是中风后抑郁以及药物滥用可能性和成瘾）及其与中风诱发缺陷的关系，鉴于人类中风人群的平均年龄在下降，这是一个尤其重要的考虑因素。在最后部分，我们阐述了治疗缺血及后续功能损害的药理学考量，以及中风与执行功能研究领域当前的局限性。
