Figlewski Krystian, Andersen Henning, Stærmose Tobias, von Weitzel-Mudersbach Paul, Nielsen Jørgen Feldbæk, Blicher Jakob Udby
Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark.
Centre for Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark.
Heliyon. 2018 Sep 20;4(9):e00790. doi: 10.1016/j.heliyon.2018.e00790. eCollection 2018 Sep.
Transient ischemic attack (TIA) is an ischemic episode of neurologic dysfunction characterized by a spontaneous clinical resolution of symptoms within 24 hours. Mechanisms of this remarkable recovery are not yet well understood. In patients with permanent brain injury caused by a stroke cortical levels of γ-Aminobutyric acid (GABA) are decreased. In this study, we aimed to investigate, whether similar alterations of cortical GABA are also present in patients with TIA. Ten first-time TIA patients with temporary unilateral motor symptoms from upper limb and 10 control subjects underwent Magnetic Resonance Spectroscopy (MRS) with SPECIAL technique. GABA:creatine (GABA:CR) ratios were measured in the hand area of the primary motor cortex in both hemispheres. GABA:CR ratios were significantly lower in the symptomatic hemisphere of TIA patients when compared with healthy subjects. Whether reduced GABA is induced directly by transient ischemia or is a secondary compensatory mechanism, which facilitate re-establishment of normal function remains to be elucidated. Further research investigating our findings in larger samples will aid in understanding of the clinical significance of GABA alterations in TIA patients. GABA MRS may provide vital information about mechanisms involved in recovery after transient ischemia, which may have crucial importance for development of new neuroprotective strategies in stroke.
短暂性脑缺血发作（TIA）是一种神经功能障碍的缺血性发作，其特征是症状在24小时内自发临床缓解。这种显著恢复的机制尚未完全清楚。在因中风导致永久性脑损伤的患者中，皮质γ-氨基丁酸（GABA）水平降低。在本研究中，我们旨在调查TIA患者是否也存在类似的皮质GABA改变。10例首次发作且有上肢临时单侧运动症状的TIA患者和10名对照受试者接受了采用SPECIAL技术的磁共振波谱（MRS）检查。在双侧大脑半球的初级运动皮层手部区域测量GABA:肌酸（GABA:CR）比值。与健康受试者相比，TIA患者有症状半球的GABA:CR比值显著降低。GABA降低是由短暂性缺血直接诱导的，还是一种促进正常功能重新建立的继发性代偿机制，仍有待阐明。在更大样本中对我们的发现进行进一步研究将有助于理解TIA患者GABA改变的临床意义。GABA MRS可能提供有关短暂性缺血后恢复所涉及机制的重要信息，这对于中风新神经保护策略的开发可能至关重要。
