Spreading Depolarizations and Subarachnoid Hemorrhage
Cortical spreading depolarizations (SD) are strongly associated with worse tissue injury and clinical outcomes in the setting of aneurysmal subarachnoid hemorrhage (SAH). Animal studies have suggested a causal relationship, and new therapies to target SDs are starting to be tested in clinical studie...
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| Veröffentlicht in: | Neurotherapeutics 2020-04, Vol.17 (2), p.497-510 |
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| creator | Sugimoto, Kazutaka Chung, David Y. |
| description | Cortical spreading depolarizations (SD) are strongly associated with worse tissue injury and clinical outcomes in the setting of aneurysmal subarachnoid hemorrhage (SAH). Animal studies have suggested a causal relationship, and new therapies to target SDs are starting to be tested in clinical studies. A recent set of single-center randomized trials assessed the effect of the phosphodiesterase inhibitor cilostazol in patients with SAH. Cilostazol led to improved functional outcomes and SD-related metrics in treated patients through a putative mechanism of improved cerebral blood flow. Another promising therapeutic approach includes attempts to block SDs with, for example, the NMDA receptor antagonist ketamine. SDs have emerged not only as a therapeutic target but also as a potentially useful biomarker for brain injury following SAH. Additional clinical and preclinical experimental work is greatly needed to assess the generalizability of existing therapeutic trials and to better delineate the relationship between SDs, SAH, and functional outcome. |
| doi_str_mv | 10.1007/s13311-020-00850-5 |
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Animal studies have suggested a causal relationship, and new therapies to target SDs are starting to be tested in clinical studies. A recent set of single-center randomized trials assessed the effect of the phosphodiesterase inhibitor cilostazol in patients with SAH. Cilostazol led to improved functional outcomes and SD-related metrics in treated patients through a putative mechanism of improved cerebral blood flow. Another promising therapeutic approach includes attempts to block SDs with, for example, the NMDA receptor antagonist ketamine. SDs have emerged not only as a therapeutic target but also as a potentially useful biomarker for brain injury following SAH. Additional clinical and preclinical experimental work is greatly needed to assess the generalizability of existing therapeutic trials and to better delineate the relationship between SDs, SAH, and functional outcome.</description><subject>Aneurysm</subject><subject>Animals</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Blood flow</subject><subject>Brain injury</subject><subject>Cerebral blood flow</subject><subject>Clinical trials</subject><subject>Cortical Spreading Depression - physiology</subject><subject>Glutamic acid receptors (ionotropic)</subject><subject>Humans</subject><subject>Ketamine</subject><subject>N-Methyl-D-aspartic acid receptors</subject><subject>Neurobiology</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Phosphodiesterase</subject><subject>Phosphodiesterase inhibitors</subject><subject>Review</subject><subject>Spreading depression</subject><subject>Subarachnoid hemorrhage</subject><subject>Subarachnoid Hemorrhage - physiopathology</subject><subject>Therapeutic applications</subject><issn>1933-7213</issn><issn>1878-7479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpdUctKBDEQDKL4_gEPsuDFy2jnNZNcBPENggf1HDKZ3t2R2WRMdgT9erOub_rQDVUUVV2E7FE4ogDVcaKcU1oAgwJASSjkCtmkqlJFJSq9mm_NeVExyjfIVkpPAJJzrdbJBmeLAbFJ5H0f0Tatn4zOsQ-dje2bnbfBp5H1zeh-qG20bupD24yucRZinNoJ7pC1se0S7n7ubfJ4efFwdl3c3l3dnJ3eFj0r1bwo6zEtS60c8mZcAWO2FogOBK-dQ11RLZA2UJcOeE4wLmsh0WUQVWlVNrtNTpa6_VDPsHHo59F2po_tzMZXE2xr_iK-nZpJeDEVU1wwnQUOPwVieB4wzc2sTQ67znoMQzKMa8GklqAy9eAf9SkM0ed4hglKQVJWLhzt_3b0beXro5nAl4SUIT_B-CNDwSx6M8veTO7NfPRmJH8HI7qIug</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Sugimoto, Kazutaka</creator><creator>Chung, David Y.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200401</creationdate><title>Spreading Depolarizations and Subarachnoid Hemorrhage</title><author>Sugimoto, Kazutaka ; Chung, David Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p268t-6bf16698ce3df7022ab4eec043bcce97194e1d0b6c03008f6b45ec3bce86a8533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aneurysm</topic><topic>Animals</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Blood flow</topic><topic>Brain injury</topic><topic>Cerebral blood flow</topic><topic>Clinical trials</topic><topic>Cortical Spreading Depression - physiology</topic><topic>Glutamic acid receptors (ionotropic)</topic><topic>Humans</topic><topic>Ketamine</topic><topic>N-Methyl-D-aspartic acid receptors</topic><topic>Neurobiology</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Phosphodiesterase</topic><topic>Phosphodiesterase inhibitors</topic><topic>Review</topic><topic>Spreading depression</topic><topic>Subarachnoid hemorrhage</topic><topic>Subarachnoid Hemorrhage - physiopathology</topic><topic>Therapeutic applications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sugimoto, Kazutaka</creatorcontrib><creatorcontrib>Chung, David Y.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database (ProQuest)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurotherapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sugimoto, Kazutaka</au><au>Chung, David Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Spreading Depolarizations and Subarachnoid Hemorrhage</atitle><jtitle>Neurotherapeutics</jtitle><stitle>Neurotherapeutics</stitle><addtitle>Neurotherapeutics</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>17</volume><issue>2</issue><spage>497</spage><epage>510</epage><pages>497-510</pages><issn>1933-7213</issn><eissn>1878-7479</eissn><abstract>Cortical spreading depolarizations (SD) are strongly associated with worse tissue injury and clinical outcomes in the setting of aneurysmal subarachnoid hemorrhage (SAH). Animal studies have suggested a causal relationship, and new therapies to target SDs are starting to be tested in clinical studies. A recent set of single-center randomized trials assessed the effect of the phosphodiesterase inhibitor cilostazol in patients with SAH. Cilostazol led to improved functional outcomes and SD-related metrics in treated patients through a putative mechanism of improved cerebral blood flow. Another promising therapeutic approach includes attempts to block SDs with, for example, the NMDA receptor antagonist ketamine. SDs have emerged not only as a therapeutic target but also as a potentially useful biomarker for brain injury following SAH. 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| subjects | Aneurysm Animals Biomedical and Life Sciences Biomedicine Blood flow Brain injury Cerebral blood flow Clinical trials Cortical Spreading Depression - physiology Glutamic acid receptors (ionotropic) Humans Ketamine N-Methyl-D-aspartic acid receptors Neurobiology Neurology Neurosciences Neurosurgery Phosphodiesterase Phosphodiesterase inhibitors Review Spreading depression Subarachnoid hemorrhage Subarachnoid Hemorrhage - physiopathology Therapeutic applications |
| title | Spreading Depolarizations and Subarachnoid Hemorrhage |
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