Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
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J. Cereb. Blood Flow Metab. · Jul 2013
Early inhibition of MMP activity in ischemic rat brain promotes expression of tight junction proteins and angiogenesis during recovery.
In cerebral ischemia, matrix metalloproteinases (MMPs) have a dual role by acutely disrupting tight junction proteins (TJPs) in the blood-brain barrier (BBB) and chronically promoting angiogenesis. Since TJP remodeling of the neurovascular unit (NVU) is important in recovery and early inhibition of MMPs is neuroprotective, we hypothesized that short-term MMP inhibition would reduce infarct size and promote angiogenesis after ischemia. Adult spontaneously hypertensive rats had a transient middle cerebral artery occlusion with reperfusion. ⋯ The GM6001, which reduced tissue loss at 3 to 4 weeks, significantly increased new vessel formation with expression of TJPs and MMPs. Our results show that pericytes and astrocytes act spatiotemporally, contributing to extraendothelial TJP formation, and that MMPs are involved in BBB restoration during recovery. Early MMP inhibition benefits neurovascular remodeling after stroke.
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J. Cereb. Blood Flow Metab. · Jul 2013
Clinical TrialLaser speckle imaging allows real-time intraoperative blood flow assessment during neurosurgical procedures.
Currently, there is no adequate technique for intraoperative monitoring of cerebral blood flow (CBF). To evaluate laser speckle imaging (LSI) for assessment of relative CBF, LSI was performed in 30 patients who underwent direct surgical revascularization for treatment of arteriosclerotic cerebrovascular disease (ACVD), Moyamoya disease (MMD), or giant aneurysms, and in 8 control patients who underwent intracranial surgery for reasons other than hemodynamic compromise. The applicability and sensitivity of LSI was investigated through baseline perfusion and CO2 reactivity testing. ⋯ The applicability and sensitivity of LSI was shown by a significantly reduced CO2 reactivity in ACVD (9.6±9%) and MMD (8.5±8%) compared with control (31.2±5%; P<0.0001). In high- and intermediate-flow bypass patients, LSI was characterized by a dynamic real-time response to acute perfusion changes and ultimately confirmed a sufficient flow substitution through the bypass graft. Thus, LSI can be used for sensitive and continuous, non-invasive real-time visualization and measurement of relative cortical CBF in excellent spatial-temporal resolution.