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  4. Simulation of spreading depolarization trajectories in cerebral cortex: Correlation of velocity and susceptibility in patients with aneurysmal subarachnoid hemorrhage
 
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2017
Journal Article
Title

Simulation of spreading depolarization trajectories in cerebral cortex: Correlation of velocity and susceptibility in patients with aneurysmal subarachnoid hemorrhage

Abstract
In many cerebral grey matter structures including the neocortex, spreading depolarization (SD) is the principal mechanism of the near-complete breakdown of the transcellular ion gradients with abrupt water influx into neurons. Accordingly, SDs are abundantly recorded in patients with traumatic brain injury, spontaneous intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage (aSAH) and malignant hemispheric stroke using subdural electrode strips. SD is observed as a large slow potential change, spreading in the cortex at velocities between 2 and 9 mm/min. Velocity and SD susceptibility typically correlate positively in various animal models. In patients monitored in neurocritical care, the Co-Operative Studies on Brain Injury Depolarizations (COSBID) recommends several variables to quantify SD occurrence and susceptibility, although accurate measures of SD velocity have not been possible. Therefore, we developed an algorithm to estimate SD velocities based on reconstructing SD trajectories of the wave-front's curvature center from magnetic resonance imaging scans and time-of-SD-arrival-differences between subdural electrode pairs. We then correlated variables indicating SD susceptibility with algorithm-estimated SD velocities in twelve aSAH patients. Highly significant correlations supported the algorithm's validity. The trajectory search failed significantly more often for SDs recorded directly over emerging focal brain lesions suggesting in humans similar to animals that the complexity of SD propagation paths increase in tissue undergoing injury.
Author(s)
Milakara, Denny
Charité - Universitätsmedizin Berlin
Grozea, Cristian  
Fraunhofer-Institut für Offene Kommunikationssysteme FOKUS  
Dahlem, Markus
Humboldt-Univ. zu Berlin
Major, Sebastian
Charité - Universitätsmedizin Berlin
Winkler, Maren K.L.
Charité - Universitätsmedizin Berlin
Lückl, Janos
Charité - Universitätsmedizin Berlin
Scheel, Michael
Charité - Universitätsmedizin Berlin
Kola, Vasilis
Charité - Universitätsmedizin Berlin
Schoknecht, Karl
Charité - Universitätsmedizin Berlin
Lublinsky, Svetlana
Ben-Gurion University of the Negev, Beer-Sheva, Israel
Friedman, Alon
Ben-Gurion University of the Negev, Beer-Sheva, Israel / Dalhousie Univ., Halifax, Canada
Martus, Peter
Univ. of Tübingen
Hartings, Jed A.
University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Woitzik, Johannes
Charité - Universitätsmedizin Berlin
Dreier, Jens P.
Charité - Universitätsmedizin Berlin
Journal
NeuroImage: Clinical. Online journal  
Open Access
DOI
10.1016/j.nicl.2017.09.005
Additional full text version
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Language
English
Fraunhofer-Institut für Offene Kommunikationssysteme FOKUS  
Keyword(s)
  • 3D, three dimensional

  • alternating current (AC)

  • apparent diffusion coefficient (ADC)

  • co-operative studies on brain injury depolarization (COSBID)

  • computed tomography (CT)

  • cytotoxic edema

  • direct current (DC)

  • diffusion-weighted imaging (DWI)

  • electrode

  • electrocorticography (ECoG)

  • fluid-attenuated inversion recovery (FLAIR)

  • hounsfield unit

  • intracerebral hemorrhage (ICH)

  • intrinsic optical signal (IOS)

  • Ischemia

  • middle cerebral artery (MCA)

  • malignant hemispheric stroke (MHS)

  • magnetization prepared rapid gradient echo (MPRAGE)

  • magnetic resonance imaging (MRI)

  • nitric oxide (NO)

  • peak total SD-induced depression duration of a recording day (PTDDD)

  • radius difference

  • subarachnoid hemorrhage (SAH)

  • spreading depolarization (SD)

  • slow potential change (SPC)

  • spreading depression

  • stroke

  • subarachnoid hemorrhage

  • traumatic brain injury (TBI)

  • time-of-SD-arrival-difference (TOAD)

  • velocity difference

  • World Federation of Neurosurgical Society (WFNS)

  • aneurysmal subarachnoid hemorrhage (aSAH)

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