Department of Neurology, University of Pennsylvania, Philadelphia, USA; Department of Neurology, University of Szeged, Szeged, Hungary; Department of Medical Physics and Informatics, Szeged, Hungary.
Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA; Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, USA.
Neuroscience. 2023 Jan 15;509:132-144. doi: 10.1016/j.neuroscience.2022.11.028. Epub 2022 Nov 29.
Spreading depolarizations (SD) refer to the near-complete depolarization of neurons that is associated with brain injuries such as ischemic stroke. The present gold standard for SD monitoring in humans is invasive electrocorticography (ECoG). A promising non-invasive alternative to ECoG is diffuse optical monitoring of SD-related flow and hemoglobin transients. To investigate the clinical utility of flow and hemoglobin transients, we analyzed their association with infarction in rat focal brain ischemia. Optical images of flow, oxy-hemoglobin, and deoxy-hemoglobin were continuously acquired with Laser Speckle and Optical Intrinsic Signal imaging for 2 h after photochemically induced distal middle cerebral artery occlusion in Sprague-Dawley rats (n = 10). Imaging was performed through a 6 × 6 mm window centered 3 mm posterior and 4 mm lateral to Bregma. Rats were sacrificed after 24 h, and the brain slices were stained for assessment of infarction. We mapped the infarcted area onto the imaging data and used nine circular regions of interest (ROI) to distinguish infarcted from non-infarcted tissue. Transients propagating through each ROI were characterized with six parameters (negative, positive, and total amplitude; negative and positive slope; duration). Transients were also classified into three morphology types (positive monophasic, biphasic, negative monophasic). Flow transient morphology, positive amplitude, positive slope, and total amplitude were all strongly associated with infarction (p < 0.001). Associations with infarction were also observed for oxy-hemoglobin morphology, oxy-hemoglobin positive amplitude and slope, and deoxy-hemoglobin positive slope and duration (all p < 0.01). These results suggest that flow and hemoglobin transients accompanying SD have value for detecting infarction.
去极化扩散(SD)是指神经元的几乎完全去极化,与缺血性中风等脑损伤有关。目前人类监测 SD 的金标准是侵入性皮质电图(ECoG)。SD 相关血流和血红蛋白瞬变的有前途的非侵入性替代方法是扩散光学监测。为了研究血流和血红蛋白瞬变的临床应用,我们分析了它们与大鼠局灶性脑缺血梗死的关系。在 Sprague-Dawley 大鼠光化学诱导的远端大脑中动脉闭塞后 2 小时内,通过激光散斑和光学固有信号成像连续获得血流、氧合血红蛋白和脱氧血红蛋白的光学图像(n=10)。成像通过中心位于 Bregma 后 3mm 和外侧 4mm 的 6×6mm 窗口进行。大鼠在 24 小时后处死,并对脑切片进行染色以评估梗死。我们将梗死区域映射到成像数据上,并使用 9 个圆形感兴趣区(ROI)来区分梗死组织和非梗死组织。用六个参数(负向、正向和总幅度;负向和正向斜率;持续时间)来描述通过每个 ROI 的瞬变。瞬变也分为三种形态类型(正向单相、双相、负向单相)。血流瞬变形态、正向幅度、正向斜率和总幅度均与梗死强烈相关(p<0.001)。也观察到与梗死相关的氧合血红蛋白形态、氧合血红蛋白正向幅度和斜率以及脱氧血红蛋白正向斜率和持续时间(均 p<0.01)。这些结果表明,伴随 SD 的血流和血红蛋白瞬变具有检测梗死的价值。
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