Brain Energetics in Patients Undergoing STA-MCA Anastomosis

  • J. M. Fein


The response of cortical pyridine nucleotide (NADH) fluorescence levels to surface electrical stimulation was evaluated from multiple areas in five patients undergoing STA-MCA bypass. The level of NADH fluorescence as monitored with a reflectofluorometer is a function of the relative amount of reduced NADH in the total NADH-NAD pool within neuronal mitochondria. In the steady state this level is directly related to the severity of ischemia and inversely related to the level of oxidative metabolic activity. Increased electrophysiologic activity produced by direct cortical stimulation, evoked cortical response, seizure activity, or during the initial phase of spreading depression is associated with a rapid change in the NADH level. In this study direct cortical stimulation was chosen to elicit the metabolic response since the topographic and temporal relations of the two facilitate repeated measurement and kinetic analysis of the redox transient. 8, 9, 14


Pyridine Nucleotide Fluorescence Transient Transient Ischemic Attack Mitochondrial NADH Direct Cortical Stimulation 
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© Springer-Verlag New York Inc. 1980

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  • J. M. Fein

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