The negative ultraslow potential, electrophysiological correlate of infarction in the human cortex

Abstract

Experimental studies indicate that, following focal or global ischaemia, progressive recruitment of neocortical neurons into death begins when spreading depolarization gives way to a negative ultraslow potential. By monitoring patients with subarachnoid haemorrhage, Lückl et al. identify this process as the electrophysiological correlate of infarction and a neuromonitoring-detected medical emergency.

Migraine aura, a predictor of near-death experiences in a crowdsourced study

“…In the most common scenario, arrest of systemic circulation, respiration and ECoG activity develops more or less simultaneously, while terminal SD follows the complete arrest of ECoG activity with a latency of 13 to 266 seconds (Dreier et al, 2018). Along this sequence, the invasively recorded direct current (DC)/alternate (AC)-ECoG activity can be roughly divided into four different phases which are illustrated with an original recording from a previous study (Dreier et al, 2018) in Figure 1B : In phase 1, spontaneous ECoG activity is still measurable; phase 2 is characterized by a complete loss of ECoG activity starting simultaneously in different cortical regions and layers, which is referred to as non-spreading depression of spontaneous activity (Dreier, 2011); in phase 3, the terminal SD starts but, from a phenomenologically point of view, is initially similar to SD spreading in healthy grey brain matter ( Figure 1A ) (Dreier & Reiffurth, 2015; Hartings et al, 2017a); and finally, in phase 4 a negative ultraslow potential signals the second phase of terminal SD (Oliveira-Ferreira et al, 2010; Hartings et al, 2017b; Dreier et al, 2018, 2019; Lückl et al, 2018; Carlson et al, 2018).…”

Spreading depolarization and repolarization during cardiac arrest as an ultra-early marker of neurological recovery in a preclinical model

“…Since the depolarization period is commonly believed to be injurious, 63,64 we examined the total combined duration of depolarization pre-and post-CPR. There was no association between combined depolarization duration and NDS, likely due to earlier depolarizing rats also repolarizing earlier (Fig.…”

Peer Review #1 of "Migraine aura, a predictor of near-death experiences in a crowdsourced study (v0.2)"

“…In the most common scenario, arrest of systemic circulation, respiration and ECoG activity develops more or less simultaneously, while terminal SD follows the complete arrest of ECoG activity with a latency of 13 to 266 seconds (Dreier et al, 2018). Along this sequence, the Manuscript to be reviewed invasively recorded direct current (DC)/alternate (AC)-ECoG activity can be roughly divided into four different phases which are illustrated with an original recording from a previous study (Dreier et al, 2018) in Figure 1B: In phase 1, spontaneous ECoG activity is still measurable; phase 2 is characterized by a complete loss of ECoG activity starting simultaneously in different cortical regions and layers, which is referred to as non-spreading depression of spontaneous activity (Dreier, 2011); in phase 3, the terminal SD starts but, from a phenomenologically point of view, is initially similar to SD spreading in healthy grey brain matter ( Figure 1A) (Dreier & Reiffurth, 2015;Hartings et al, 2017a); and finally, in phase 4 a negative ultraslow potential signals the second phase of terminal SD (Oliveira-Ferreira et al, 2010;Hartings et al, 2017b;Dreier et al, 2018Dreier et al, , 2019Lückl et al, 2018;Carlson et al, 2018).…”

“…It is important to understand that this terminal SD marks the onset of the toxic cellular changes that ultimately lead to death, but it is not a marker of death per se, since the SD is reversible -to a certain point -with restoration of the circulation (Hossmann & Sato, 1970;Heiss & Rosner, 1983;Memezawa, Smith & Siesjö, 1992;Ayad, Verity & Rubinstein, 1994;Shen et al, 2005;Pignataro, Simon & Boison, 2007;Nozari et al, 2010;Lückl et al, 2018). Thus, in contrast to what happens during coma or sedation, when the brain dies, it undergoes a massive and unstoppable depolarization process (and hence, a very last state of "activation") (Dreier, 2011).…”