Which Spreading Depolarizations Are Deleterious To Brain Tissue?

C. William Shuttleworth, R. David Andrew, Yama Akbari, Cenk Ayata, Ramani Balu, K. C. Brennan, Martyn Boutelle, Andrew P. Carlson, Jens P. Dreier, Martin Fabricius, Eszter Farkas, Brandon Foreman, Raimund Helbok, Nils Henninger, Sharon L. Jewell, Stephen C. Jones, Sergei A. Kirov, Britta E. Lindquist, Carolina B. Maciel, David OkonkwoKatelyn M. Reinhart, R. Meldrum Robertson, Eric S. Rosenthal, Tomas Watanabe, Jed A. Hartings

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Spreading depolarizations (SDs) are profound disruptions of cellular homeostasis that slowly propagate through gray matter and present an extraordinary metabolic challenge to brain tissue. Recent work has shown that SDs occur commonly in human patients in the neurointensive care setting and have established a compelling case for their importance in the pathophysiology of acute brain injury. The International Conference on Spreading Depolarizations (iCSD) held in Boca Raton, Florida, in September of 2018 included a discussion session focused on the question of “Which SDs are deleterious to brain tissue?” iCSD is attended by investigators studying various animal species including invertebrates, in vivo and in vitro preparations, diseases of acute brain injury and migraine, computational modeling, and clinical brain injury, among other topics. The discussion included general agreement on many key issues, but also revealed divergent views on some topics that are relevant to the design of clinical interventions targeting SDs. A draft summary of viewpoints offered was then written by a multidisciplinary writing group of iCSD members, based on a transcript of the session. Feedback of all discussants was then formally collated, reviewed and incorporated into the final document. It is hoped that this report will stimulate collection of data that are needed to develop a more nuanced understanding of SD in different pathophysiological states, as the field continues to move toward effective clinical interventions.

Original languageEnglish (US)
Pages (from-to)317-322
Number of pages6
JournalNeurocritical Care
Issue number1
StatePublished - Feb 1 2020
Externally publishedYes


  • Ischemia
  • Spreading depolarization
  • Spreading depression
  • Subarachnoid hemorrhage
  • Trauma

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine


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