Generalized periodic discharges after acute cerebral ischemia: Reflection of selective synaptic failure?

Highlights • Generalized periodic discharges after acute cerebral ischemia might reflect selective ischemic damage of glutamatergic synapses on inhibitory cortical interneurons. • Disinhibition of cortical pyramidal neurons is a candidate mechanism for the generation of generalized periodic discharg...

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Veröffentlicht in:	Clinical neurophysiology 2014-02, Vol.125 (2), p.255-262
Hauptverfasser:	Tjepkema-Cloostermans, Marleen C, Hindriks, Rikkert, Hofmeijer, Jeannette, van Putten, Michel J.A.M
Format:	Artikel
Sprache:	eng
Schlagworte:	Action Potentials - physiology Adult Brain Ischemia - complications Brain Ischemia - pathology Brain Ischemia - physiopathology Cardiac arrest Cerebral ischemia Cortical Synchronization - physiology Electroencephalography Generalized periodic discharges Glutamic Acid - metabolism Hippocampus - drug effects Hippocampus - pathology Hippocampus - physiopathology Humans Interneurons - drug effects Interneurons - pathology Interneurons - physiology Meanfield model Models, Neurological Neurology Pyramidal Cells - drug effects Pyramidal Cells - pathology Pyramidal Cells - physiology Selective ischemic vulnerability Synapses - drug effects Synapses - pathology Synapses - physiology Synaptic failure
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Zusammenfassung:	Highlights • Generalized periodic discharges after acute cerebral ischemia might reflect selective ischemic damage of glutamatergic synapses on inhibitory cortical interneurons. • Disinhibition of cortical pyramidal neurons is a candidate mechanism for the generation of generalized periodic discharges. • Treatment of generalized periodic discharges with anti-epileptic drugs appears futile in most patients after cardiac arrest, which might be explained by irreversible selective synaptic damage.
ISSN:	1388-2457 1872-8952
DOI:	10.1016/j.clinph.2013.08.005