PDF(Pubmed)
Abstract：
Ischemic stroke is characterized by a complex cascade of events starting from vessel occlusion. The term \"penumbra\" denotes the area of severely hypo-perfused brain tissue surrounding the ischemic core that can be potentially recovered if blood flow is reestablished. From the neurophysiological perspective, there are local alterations-reflecting the loss of function of the core and the penumbra-and widespread changes in neural networks functioning, since structural and functional connectivity is disrupted. These dynamic changes are closely related to blood flow in the affected area. However, the pathological process of stroke does not end after the acute phase, but it determines a long-term cascade of events, including changes of cortical excitability, that are quite precocious and might precede clinical evolution. Neurophysiological tools-such as Transcranial Magnetic Stimulation (TMS) or Electroencephalography (EEG)-have enough time resolution to efficiently reflect the pathological changes occurring after stroke. Even if they do not have a role in acute stroke management, EEG and TMS might be helpful for monitoring ischemia evolution-also in the sub-acute and chronic stages. The present review aims to describe the changes occurring in the infarcted area after stroke from the neurophysiological perspective, starting from the acute to the chronic phase.
摘要：
缺血性卒中的特征在于从血管闭塞开始的复杂事件级联。术语“半影”表示缺血核心周围的严重灌注不足的脑组织的区域，如果重新建立血流，则可以潜在地恢复。从神经生理学的角度来看,有局部变化-反映了核心和半影功能的丧失-以及神经网络功能的广泛变化，因为结构和功能连接被破坏。这些动态变化与受影响区域的血流密切相关。然而,中风的病理过程在急性期后不会结束，但它决定了一系列长期的事件，包括皮质兴奋性的改变,相当早熟，可能先于临床进化。神经生理学工具，例如经颅磁刺激（TMS）或脑电图（EEG），具有足够的时间分辨率，可以有效地反映中风后发生的病理变化。即使它们在急性中风管理中没有作用，EEG和TMS可能有助于监测亚急性和慢性阶段的缺血演变。本综述旨在从神经生理学角度描述卒中后梗死区发生的变化。从急性期到慢性期。
