Institute for Stroke and Dementia Research (ISD), Munich University Hospital, Munich, Germany.
Graduate School of Systemic Neurosciences (GSN), Munich University Hospital, Munich, Germany.
J Cereb Blood Flow Metab. 2020 Jun;40(6):1193-1202. doi: 10.1177/0271678X19863021. Epub 2019 Jul 11.
CO-reactivity and neurovascular coupling are sequentially lost within the first 24 h after subarachnoid hemorrhage (SAH). Whether and when these impairments recover is not known. Therefore, we investigated the reactivity of pial and intraparenchymal vessels by in vivo two-photon microscopy one month after experimental SAH. C57BL/6 mice were subjected to either sham surgery or SAH by filament perforation. One month later, cerebral blood flow following CO-challenge and forepaw stimulation was assessed by laser Doppler fluxmetry. Diameters of pial and intraparenchymal arterioles were quantified by in vivo two-photon microscopy. One month after SAH, pial and parenchymal vessels dilated in response to CO. Neurovascular coupling was almost completely absent after SAH: vessel diameter did not change upon forepaw stimulation compared to a 20% increase in sham-operated mice. The current results demonstrate that neurovascular function differentially recovers after SAH: while CO-reactivity normalizes within one month after SAH, neurovascular coupling is still absent. These findings show an acute and persistent loss of neurovascular coupling after SAH that may serve as a link between early brain injury and delayed cerebral ischemia, two distinct pathophysiological phenomena after SAH that were so far believed not to be directly related.
蛛网膜下腔出血(SAH)后 24 小时内,脑血管的 CO 反应性和神经血管耦联会相继丧失。目前尚不清楚这些损伤是否以及何时能够恢复。因此,我们通过活体双光子显微镜检查,研究了实验性 SAH 1 个月后脑膜和脑实质血管的反应性。C57BL/6 小鼠接受假手术或通过纤维穿孔进行 SAH。1 个月后,通过激光多普勒流速计评估 CO 挑战和前爪刺激后的脑血流。通过活体双光子显微镜定量测量脑膜和脑实质小动脉的直径。SAH 1 个月后,CO 可引起脑膜和脑实质血管扩张。SAH 后神经血管耦联几乎完全消失:与假手术组相比,前爪刺激时血管直径没有变化,仅增加了 20%。目前的结果表明,SAH 后神经血管功能恢复情况不同:尽管 CO 反应性在 SAH 后 1 个月内恢复正常,但神经血管耦联仍然缺失。这些发现表明,SAH 后存在急性和持续的神经血管耦联丧失,这可能是早期脑损伤和迟发性脑缺血之间的联系,迟发性脑缺血是 SAH 后的两种不同病理生理现象,此前认为它们之间没有直接关系。