Concept of excitotoxicity applied to patient care

            One of the guest speakers presenting at our Neuroscience Seminar that caught my particular attention was Dr. Ye. In his research paper "Early ischemia enhances action potential-dependent, spontaneous glutamatergic responses in CA1 neurons", Dr. Ye discusses the processes occurring in the brain following a cardiac ischemia. It has been a longstanding supposition that the damage caused to the brain as a result of inadequate blood supply was primarily due to lack of oxygen or glucose thus causing mass cell death. It has been fairly recently ( in the middle of the 20th century) proposed that it is actually the spike in glutamate that is most lethal to the cells during that process. In his paper, Ye discusses that following ischemia, glutamate- an excitatory neurotransmitter- accumulates extracellularly and causes neurons to go through apoptosis. It is therefore the phenomenon of "excitotoxicity" that is the primary cause of damage to the neurons during ischemia.

           

            Numerous studies have been done in the same area of interest as Dr. Ye's. They led to the development of protocols regarding care for patients with different types of ischemia. One of the changes that resulted from the research findings is the cooling of patients following a myocardial infarction, for instance. The logic behind this practice is that lower temperature slows the process of glutamate release. As one might assume, hospitals are well equipped to efficiently and effectively decrease the body temperature of a patient. However, it was interesting to read in one article (here is a link: http://www.sciencedaily.com/releases/2012/06/120629120326.htm) that this special handling of patients- the cooling of the patient's body - can also be done prior to being received in a clinical setting. It is hoped that cooling pads that require no electricity will be used in pre-hospital handling of patients who need their body temperature to be decreased. The article reminds the reader that the presence of defibrillators  in public places is required by the law. Maybe in the near future cooling devices will also be available and commonplace just like the familiar defibrillator?

 

 

References:

 

" Help for Cardiac Arrest Patients -- Fast and Without Electricity."ScienceDaily. ScienceDaily, 29 June 2012. Web. 11 Dec. 2012.

 

Ye, Hui, Shirin Jalini, Liang Zhang, Milton Charlton, and Peter Carlen. "Early Ischemia Enhances Action Potentialdependent,." Journal of Cerebral Blood Flow & Metabolism (2009): 1-11. Print.