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How Spreading Depolarization Can Be the Pathophysiological Correlate of Both Migraine Aura and Stroke

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Neurovascular Events After Subarachnoid Hemorrhage

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 120))

Abstract

The term spreading depolarization describes a mechanism of abrupt, massive ion translocation between neurons and the interstitial space, which leads to a cytotoxic edema in the gray matter of the brain. In energy-compromised tissue, spreading depolarization is preceded by a nonspreading silencing (depression of spontaneous activity) because of a neuronal hyperpolarization. By contrast, in tissue that is not energy compromised, spreading depolarization is accompanied by a spreading silencing (spreading depression) of spontaneous activity caused by a depolarization block. It is assumed that the nonspreading silencing translates into the initial clinical symptoms of ischemic stroke and the spreading silencing (spreading depression) into the symptoms of migraine aura. In energy-compromised tissue, spreading depolarization facilitates neuronal death, whereas, in healthy tissue, it is relatively innocuous. Therapies targeting spreading depolarization in metabolically compromised tissue may potentially treat conditions of acute cerebral injury such as aneurysmal subarachnoid hemorrhage.

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Acknowledgments

This work was supported by grants of the Deutsche Forschungsgemeinschaft (DFG DR 323/6-1) and the Bundesministerium für Bildung und Forschung (Center for Stroke Research Berlin, 01 EO 0801; Bernstein Center for Computational Neuroscience Berlin 01GQ1001C B2) to Dr. Dreier; the German Israeli Foundation (GIF No. 124/2008) to Dr. Friedman and Dr. Dreier; the ERA-NET NEURON (01EW1212) to Dr. MacVicar, Dr. Friedman, and Dr. Dreier; DFG DR 323/5-1 to Dr. Friedman, Dr. Woitzik and Dr. Dreier; DFG WO 1704/1-1 to Dr. Woitzik; and US Army CDMRP PH/TBI research program to Dr. Hartings.

Conflict of Interest Statement

 We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Center for Stroke Research Berlin, Charité University Medicine Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany

    Jens P. Dreier, Clemens Reiffurth, Johannes Woitzik, Christoph Drenckhahn & Claudia Windler

  2. Department of Neurology, Charité University Medicine Berlin, 10117, Berlin, Germany

    Jens P. Dreier, Johannes Woitzik & Christoph Drenckhahn

  3. Department of Experimental Neurology, Charité University Medicine Berlin, 10117, Berlin, Germany

    Jens P. Dreier & Clemens Reiffurth

  4. Department of Neurosurgery, University of Cincinnati, Cincinnati, OH, USA

    Jed A. Hartings

  5. Department of Physiogy, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Alon Friedman

  6. Department of Neurobiology, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Alon Friedman

  7. Brain Research Centre, University of British Columbia, Vancouver, BC, Canada

    Brian MacVicar

  8. Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

    Brian MacVicar

  9. Department of Systems Neuroscience, Cajal Institute-CSIC, Madrid, Spain

    Oscar Herreras

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  1. Jens P. Dreier
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Correspondence to Jens P. Dreier .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Javier Fandino

  2. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Serge Marbacher

  3. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Ali-Reza Fathi

  4. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Carl Muroi

  5. Department of Neurosurgery Neurointensive Care Unit, University Hospital Zurich, Zurich, Switzerland

    Emanuela Keller

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Dreier, J.P. et al. (2015). How Spreading Depolarization Can Be the Pathophysiological Correlate of Both Migraine Aura and Stroke. In: Fandino, J., Marbacher, S., Fathi, AR., Muroi, C., Keller, E. (eds) Neurovascular Events After Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 120. Springer, Cham. https://doi.org/10.1007/978-3-319-04981-6_23

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  • DOI: https://doi.org/10.1007/978-3-319-04981-6_23

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