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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Light microscopic neuronal changes were studied in rats subjected to 10 min of global ischemia produced by compression of the major cardiac vessels. Observations of cresyl violet-stained sections revealed early changes involving predominantly GABAergic neurons in various locations. In rats killed 15 min after recirculation, the changes were characterized by the appearance of a clear peripheral zone with condensation of the remaining neuronal cytoplasm. After 1 h, these zones appeared to be compartmentalized into individual pearl-like vacuoles, especially prominent in the nucleus reticularis thalami. After 3 h, the cytoplasmic vacuoles disappeared and the neuronal changes, particularly in the cerebral cortex, striatum, hippocampus, and pars reticulata of the substantia nigra, consisted mainly of hyperchromasia or loss of Nissl substance. After 2 days, the cerebral cortex and thalamus contained occasional neurons with conspicuously large nucleoli. After 7 days, the hippocampus revealed an approximately 50% loss of CA1 pyramidal neurons, associated with intense microglial reactivity in the stratum radiatum, whereas the neuronal destruction was more complete in the nucleus reticularis thalami. Our observations suggest a possibility that early changes in GABAergic neurons may provide a period of neuronal disinhibition and thus contribute to an excitatory ischemic damage in regions connected by GABAergic circuitry.
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PMID:Global cerebral ischemia associated with cardiac arrest in the rat: I. Dynamics of early neuronal changes. 154 96

The authors report the observation of a 61-year-old female patient who, following a right frontal-temporal ischemia, presented disorientation with respect to her surroundings. She was convinced during her hospital stay that her house had been transformed into a hospital. There was no evidence of intellectual confusion or deterioration, and the neuropsychological examination revealed visuo-spatial disturbances only. A low basal cerebral blood flow was found in the right anterior hemisphere which further decreased when the patient was asked where he was. It is hypothesized that confabulatory responses corresponded to a disinhibition of the left hemisphere from the control of the hemisphere dominant in dealing with visuo-spatial data.
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PMID:[The delusion of place: contribution of the measurement of cerebral deficit]. 326 38

The role of the corpus callosum in diaschisis was examined through the acute effects of stereotactic corpus callosum section on cerebral blood flow and somatosensory or auditory evoked potentials bilaterally during unilateral brain retraction ischemia, using a previously reported swine model. Cerebral blood flow and evoked potential amplitude contralateral to retraction increased during retraction with the corpus callosum intact, compared with post-callosal section values. With retraction following callosal section, there was no increase in cerebral blood flow or evoked potential amplitude contralateral to retraction. Diaschisis during the early stages of a focal, unilateral injury takes the form of a contralateral disinhibition (as measured by cerebral blood flow and evoked potentials), an effect which is lost following callosal section.
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PMID:Corpus callosotomy effects on cerebral blood flow and evoked potentials (transcallosal diaschisis). 836 54

Molecular events underlying the mechanism by which brain injury elicits delayed transneuronal degeneration of neurons remote from the site of initial injury are not well understood. In rats, acute injury of the caudate nucleus (CN) and globus pallidus (GP) by local injection of excitotoxic ibotenic acid (IA) or by transient forebrain ischemia resulted in delayed cell death of neurons in the substantia nigra reticulata (SNr). To elucidate the involvement of glutamate receptor mediated hyperactivity of neurons produced by loss of inhibitory inputs in this delayed degeneration of SNr neurons, the region-specific expression of an immediate early gene, c-fos, and the effect of glutamate receptor antagonists on the c-fos expression were examined by using immunocytochemical and in situ hybridization analysis. Following unilateral IA-injection into the CN and GP, a robust expression of c-fos mRNA and Fos protein was induced specifically in neurons of both subthalamic nucleus (STN) and SNr deafferented by the IA-lesions 36 h after IA-injection. The delayed expression of Fos-protein in SNr neurons lasted for 48 h longer than that in STN neurons. Following unilateral IA-injection confined to the CN, an intense but short-term expression of Fos-protein was exhibited only in neurons of the deafferented SNr. c-fos mRNA and Fos protein were not expressed in neurons of the substantia nigra compacta at any time points examined. The induction of c-fos mRNA and Fos protein in neurons of the STN and SNr following IA-lesions of the CN and GP was reduced markedly by non-NMDA receptor antagonist (GYKI52466), but not by NMDA receptor antagonist (MK-801). The region-specific c-fos expression implies that deprivation of inhibitory afferents (disinhibition) due to destruction of presynaptic neurons can induce increased activity of postsynaptic neurons. The effect of GYKI52466 on the c-fos gene expression in neurons of the deafferented STN and SNr suggests that activation of non-NMDA receptors may be involved in a pathophysiological cascade for the transneuronal degeneration of SNr neurons.
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PMID:Deafferentiation-induced c-fos gene expression in subthalamic nucleus and substantia nigra reticulata is reduced by non-NMDA receptor antagonist. 871 29

The septo-hippocampal pathway contains a major gamma-aminobutyric acid (GABA) projection to dendritic fields within the hippocampus. To determine the importance of the septo-hippocampal pathway in ischemia-induced accumulation of GABA and subsequent cell death in area CA1 of hippocampus, septo-hippocampal deafferentation of adult gerbils was performed. Electrolytic lesions were produced in the medial or medial plus lateral septal regions in gerbils 7 days prior to being subjected to 5 min forebrain ischemia. The extent of deafferentation of the dorsal hippocampus was determined histochemically by acetylcholinesterase staining. Both the medial and medial plus lateral septal lesions produced nearly complete loss of acetylcholinesterase staining in the dorsal hippocampus indicating relatively complete deafferentation. During and following ischemia, in vivo microdialysis was used to measure extracellular GABA accumulation, which reached concentrations up to 1060 +/- 143% of basal. Septo-hippocampal deafferentation in both groups of lesioned animals failed to prevent the accumulation of GABA (and glutamate) induced by ischemia, indicating that ischemia-induced GABA accumulation in area CA1 arises principally from intrinsic GABAergic interneurons. Ischemic animals with medial septal lesions did not demonstrate neuroprotection or increased damage in the stratum pyramidale 7 days after reperfusion. Since the septo-hippocampal pathway provides the source of GABAergic disinhibition within the hippocampus, neither disinhibition nor the septo-hippocampal input appear to play an important role in the development of ischemia-induced neuronal death in the hippocampus.
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PMID:Ischemic injury and extracellular amino acid accumulation in hippocampal area CA1 are not dependent upon an intact septo-hippocampal pathway. 951 50

Seizures are one of the most frequent complications after cerebral ischemia in patients. Up to now it is unknown which mechanisms are responsible for this. As shown previously photothrombotic infarction in rat neocortex leads to a sweeping suppression of GABAergic inhibition. In this study we investigated whether and to what extent epileptiform discharges can be observed in this ischemia model. In neocortical slices from lesioned animals we did not find spontaneous epileptic activity or paroxysmal depolarisation shifts. However, ipsi- and contralateral to a photothrombotic lesion the frequency of double and multiple discharges was markedly increased when compared to unlesioned controls. Surprisingly, neither the drug lubeluzole which was has been shown to prevent the GABAergic disinhibition observed after photothrombotic lesioning of rat neocortex, nor the prevention of spreading depressions by the NMDA-receptor antagonist MK-801 during lesion induction significantly affected the frequency of epileptiform discharges. This indicates that the epileptiform discharges are probably caused by functional alterations of glutamatergic receptors.
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PMID:Epileptiform discharges to extracellular stimuli in rat neocortical slices after photothrombotic infarction. 958 47

The experiments strongly suggested that the reason why Purkinje cells die so easily after global brain ischemia relates to deficiencies in aldolase C and EAAT4 that allow them to survive pathologically intense synaptic input from the inferior olive after the restoration of blood flow. This conclusion is based on: (a) the remarkably tight correspondence between the regional absence of aldolase C and EAAT4 in Purkinje cells and the patterned loss of Purkinje cells after a bout of global brain ischemia; (b) the necessity of the olivocerebellar pathway for the ischemic death of Purkinje cells; and (c) the build-up of pathologically synchronous and high-frequency burst activity within the inferior olive during recovery from ischemia. Indeed, the correspondence between the absence of aldolase C and EAAT4 to sensitivity to ischemia could be demonstrated for zones of Purkinje cells as small as two neurons. A second finding was that Purkinje cells are not uniformly sensitive to transient ischemia, since they die most frequently in zones where aldolase C and EAAT4 are absent. One implication of the experiment is that factors beyond the unique synaptic and membrane properties of Purkinje cells play an important role in determining this neuron's high sensitivity to ischemia. The data strongly imply that two properties of Purkinje cells that make them susceptible to ischemic death are their reduced capability to sequester glutamate and reduced ability to generate energy during anoxia. The patterned death of Purkinje cells is sufficient to induce a form of audiogenic myoclonus, as determined with a neurotoxic dose of ibogaine. Ibogaine-induced myoclonus is recognized behaviorally as a reduced ability to habituate to a startle stimulus and resembles the myoclonic jerk of rats during recovery from a prolonged bout of global brain ischemia. Commonalities of ischemia and ibogaine-induced neurodegeneration are the intricately striped Purkinje cell loss in the posterior lobe and a nearly complete deafferentation of the lateral aspect of the fastigial nucleus from the cerebellar cortex, in particular the dorsolateral protuberance. Thus, the data point strongly to a cerebellar contribution to audiogenic myoclonus. Single-neuron electrophysiology experiments in monkeys have demonstrated that the evoked activity in the deep cerebellar nuclei occurs too late to initiate the startle response (60) and electromyography of the postischemic myoclonus of rats corroborates this view (see Chapter 31) (20). However, the nearly complete loss of GABAergic terminals in the dorsolateral protuberance after Purkinje cell death would be expected to dramatically increase its tonic firing and the background excitation of the brain-stem structures that it innervates. The fastigial nucleus innervates a large number of autonomic and motor structures in the brainstem and diencephalon, including the ventrolateral nucleus of the thalamus and the gigantocellular reticular nucleus in the medulla--structures that have been implicated in human posthypoxic myoclonus (6, 7). We propose that the posthypoxic myoclonic jerk of rats is, at least in part, due to disinhibition of the fastigial nucleus produced by patterned Purkinje cell death in the vermis. The argument is as follows: the loss of GABAergic inhibition in the fastigial nucleus after ischemia leads to diaschisis of the motor thalamus and reticular formation which, in turn, is responsible for enhanced motor excitability and myoclonus. That the audiogenic myoclonus after global brain ischemia in the rat gradually resolves over a period of 2 to 3 weeks is consistent with this view, as restoration of background excitability after CNS damage in rats has been documented to occur within this time-frame (61). Our view brings together the physiologic finding that posthypoxic myoclonus appears to originate in the sensory-motor cortices and/or reticular formation with the consistent anatomical finding of Purkinje cell loss after ischemia, and explains the puzzle of Marsden's unique cases of myoclonus associated with coeliac disease (1). Moreover, our argument is consistent with findings both in rats (62, 63) and humans (64) that damage to the vermis impairs the long-term habituation of the startle reflex. It remains to be determined whether the pathologically enhanced startle responses after vermal damage resemble brain-stem reticular or cortical myoclonus at the electrophysiologic level of analysis. What is the purpose of the regional expression of aldolase C and EAAT4 in Purkinje cells? The close correspondence between the spatial distribution of aldolase C and the parasagittal anatomy of the cerebellum (48) has led to the view that aldolase C may help specify connectivity during development. While the present experiments do not address this issue, they underscore the fact that aldolase plays a fundamental role in metabolism. Because Purkinje cells have a repressed expression of aldolase A (31), whatever role the absence of aldolase C may play during development comes at the price of metabolic frailty later in adulthood. From another point of view, aldolase C and EAAT4 appear to confer upon Purkinje cells the ability to survive their own climbing fiber. Indeed, climbing fibers form a distributed synapse that synchronously releases glutamate (or aspartate) at all levels of the dendritic tree simultaneously (65, 66). Such synchronous activation triggers calcium influx throughout the Purkinje cell dendrites at a magnitude that is unparalleled in the nervous system (12), and, thus, places an extraordinarily high metabolic demand on the Purkinje cell. The apparently reduced level of aldolase in a subpopulation of Purkinje cells provides the condition for energy failure and death during anoxia so long as the climbing fibers are intact or when climbing fiber activation is pharmacologically enhanced under normoxic conditions, such as after ibogaine (53-56). Lastly, the argument that diaschisis produced by patterned cerebellar degeneration leads to thalamo-cortical and reticular hyperexcitability agrees with C. David Marsden and his colleagues' bold demonstration of an inhibitory influence of cerebellar cortex on motor cortex in humans (67). Our anatomic data indicate that the spatially distinct zones of Purkinje cells, which are killed by global brain ischemia, may be the origin of such inhibition.
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PMID:Why do Purkinje cells die so easily after global brain ischemia? Aldolase C, EAAT4, and the cerebellar contribution to posthypoxic myoclonus. 1196 59

Twenty men with atherosclerotic lesion of lower extremity arteries verified by contrast angiography and ultrasound Doppler were examined. The patients' age varied from 36 to 69 years (mean 57 years). Six patients had IIB ischemia, 13 presented with degree III and one patient had degree IV ischemia according to the R. Fontaine classification modified by A. V. Pokrovsky. The MOS SF = 36 questionnaire was used to estimate the quality of life of all the patients. The individual typological properties of the personality were defined using the psychodiagnostic test (PDT). A significant decrease of the patients' quality of life was revealed according to the scales: physical function, physical role, physical pain, general health condition. A correlation was recorded between the patient's age and the parameters of the "physical function scale" (r=-0.63; p<0.005). The individual typological properties of the personality exert an effect on five of the eight SF = 36 scales. A feedback was discovered between neurotism and mental health (r=-0.455; P<0.05), conscientiousness and the physical role (r=-0,487; p<0.05); a direct relationship was found between disinhibition and physical pain (r=0.451; p<0.05), general activity and physical pain (r=0.535; p<0.05). An indistinctly pronounced feed back manifested itself between the "neurotism" and "physical pain" scales (r=-0.409), "psychotism" end the "physical role", (r=-0.437), "introversion" and "vitality" (r=-0.408), "femininity" and the "emotional role" (r=-0.404), and a direct relationship was established between the scales "esthetic impressionability" and "vitality" (r=0.406).
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PMID:[Quality of life of patients with atherosclerotic lesion of lower extremity arteries as dependent on individual and typological properties of the patient personality]. 1465 5

Lesion-induced cortical hyperexcitability has been demonstrated in animal models of cerebral ischemia and after human stroke. We used transcranial magnetic stimulation to investigate motor cortex excitability in ten patients who suffered short transient ischemic attacks (TIAs; i.e. duration <60 min) in the week before examination. Intracortical inhibition (ICI) and facilitation (ICF) were assessed using paired-pulse stimulation. Single-pulse stimulation was applied to investigate cortical silent period and transcallosal inhibition. The side affected by the TIA was compared to the normal side of each patient. We found ICI significantly reduced, and a trend towards enhanced ICF on the affected side. All other parameters remained normal. Motor cortex disinhibition may occur after short TIAs in spite of morphologically intact brain tissue. Possibly, these functional changes correlate to the protective neurometabolic mechanisms elicited by short episodes of focal ischemia in animal models and in man.
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PMID:Long-lasting motor cortex disinhibition after short transient ischemic attacks (TIAs) in humans. 1513 83

The purpose of the current study was to document the behavioral profile of ischemic rats in novel tasks including the elevated plus maze (EPM), the Vogel/conflict model of anxiety and novelty-induced feeding suppression paradigm as well as to further characterize using behavioral monitoring, the response of ischemic animals in existing paradigms such as the open field. Our findings revealed that ischemic animals spent significantly more time and made more entries in the open arm of the EPM as compared to sham animals, two behaviors indicative of decreased anxiety level. This anxiolytic effect appeared restricted to exploratory models of anxiety, as no differences in punished licking rate were observed between groups in the Vogel/conflict test. In the open field, behavioral monitoring revealed transient ischemia-induced hyperactivity, limited to the initial 15 min of a 30 min testing period. Increased activity in ischemic animals was primarily characterized by increased exploration and sniffing behavior with no significant alterations in rearing and grooming frequencies. Finally, using feeding behavior, our findings revealed a comparable rate of habituation to a novel environment in ischemic and sham rats. Taken together, these results suggest that ischemia-induced hyperactivity may involve a disinhibition to explore unfamiliar and/or mildly anxiogenic environments. However, the basis of such hyperactivity and the presence of habituation deficit following ischemia require further study and/or validation.
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PMID:Characterization of anxiety and habituation profile following global ischemia in rats. 1581 89


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