Dynamic changes in brain glucose and lactate in pericontusional areas of the human cerebral cortex, monitored with rapid sampling on-line microdialysis: Relationship with depolarisation-like events

TY - JOUR

T1 - Dynamic changes in brain glucose and lactate in pericontusional areas of the human cerebral cortex, monitored with rapid sampling on-line microdialysis

T2 - Relationship with depolarisation-like events

AU - Parkin, Mark C.

AU - Hopwood, Sarah E.

AU - Jones, Deborah A.

AU - Hashemi, Parastoo

AU - Landolt, Hans

AU - Fabricius, Martin

AU - Lauritzen, Martin

AU - Boutelle, Martyn G.

AU - Strong, Anthony J.

PY - 2005/3/1

Y1 - 2005/3/1

N2 - The pathophysiology of peri-lesion boundary zones in acute brain injury is highly dynamic, and it is now clear that spreading-depression-like events occur frequently in areas of cerebral cortex adjacent to contusions in the injured human brain. An automated method to assay microdialysate from peri-lesion cerebral cortex in 11 patients with intracranial haematomas requiring surgery was used. Perfusate (2 μL/min) flowed directly into a flow-injection system for assay of glucose and lactate at intervals typically of 30 secs each. Four channels of electrocorticogram (ECoG) were recorded from a subdural strip adjacent to the catheter. Several patterns of change in metabolites were identified in different time domains. Overall, the number of transient lactate events was significantly correlated with the number of glucose events (r 2 = 0.48, P = 0.027, n = 10). Progressive reduction in dialysate glucose was very closely correlated with the aggregate number of ECoG events (r2 = 0.76, P = 0.0004, n = 11). It is proposed that the recently documented adverse impact of low dialysate glucose on clinical outcome may be because of recurrent, spontaneous spreading-depression-like events in the perilesion cortex.

AB - The pathophysiology of peri-lesion boundary zones in acute brain injury is highly dynamic, and it is now clear that spreading-depression-like events occur frequently in areas of cerebral cortex adjacent to contusions in the injured human brain. An automated method to assay microdialysate from peri-lesion cerebral cortex in 11 patients with intracranial haematomas requiring surgery was used. Perfusate (2 μL/min) flowed directly into a flow-injection system for assay of glucose and lactate at intervals typically of 30 secs each. Four channels of electrocorticogram (ECoG) were recorded from a subdural strip adjacent to the catheter. Several patterns of change in metabolites were identified in different time domains. Overall, the number of transient lactate events was significantly correlated with the number of glucose events (r 2 = 0.48, P = 0.027, n = 10). Progressive reduction in dialysate glucose was very closely correlated with the aggregate number of ECoG events (r2 = 0.76, P = 0.0004, n = 11). It is proposed that the recently documented adverse impact of low dialysate glucose on clinical outcome may be because of recurrent, spontaneous spreading-depression-like events in the perilesion cortex.

KW - Brain-trauma

KW - Electroencephalogram

KW - Glucose

KW - Human

KW - Lactate

KW - Microdialysis

KW - Spreading-cortical-depression

UR - http://www.scopus.com/inward/record.url?scp=14644406225&partnerID=8YFLogxK

U2 - 10.1038/sj.jcbfm.9600051

DO - 10.1038/sj.jcbfm.9600051

M3 - Journal article

C2 - 15703701

AN - SCOPUS:14644406225

SN - 0271-678X

VL - 25

SP - 402

EP - 413

JO - Journal of Cerebral Blood Flow and Metabolism

JF - Journal of Cerebral Blood Flow and Metabolism

IS - 3

ER -