Molecular Physiology and Metabolism of the Nervous System: A Clinical Perspective

ISBN : 9780195394276

Gary A. Rosenberg
240 Pages
187 x 259 mm
Pub date
May 2012
Contemporary Neurology Series
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The molecular basis for the physiology of the brain has advanced enormously in the past twenty years with an influx of new information gleaned through technological developments in neuroimaging and molecular discoveries. Molecular Physiology and Metabolism of the Nervous System, authored by Gary A. Rosenberg, an authority on the physiology of brain fluids and metabolism, combines the classic physiology that dates back to the beginning of the nineteenth century with the advances in molecular sciences, providing a strong framework for understanding the diseases that are commonly treated by neurologists. Molecular Physiology and Metabolism of the Nervous System focuses on the current neuropathology and implications of cerebrospinal fluid diseases and diseases of the blood-brain barrier: how the two affect stroke, infection, brain tumors, and increased intracranial pressure. The book discusses the effects of blood flow in stroke and dementia, the disruption of the blood-brain barrier in neuroinflammation, and the dysfunction due to brain edema and increased intracranial pressure. Molecular Physiology and Metabolism of the Nervous System is necessary reading for neurologists, neuroscientists, and residents in neurology, neurosurgery, and psychiatry, giving them a strong grounding in physiology and metabolism that will aid them in diagnosis and treatment.


Part I: Physiology of brain fluids and blood-brain barrier
Chapter 1: Anatomy of Fluid Interfaces that Protect the Microenvironment
1.1. Historical perspective
1.2 Cerebral microenvironment
1.3. Development of the brain-fluid interfaces
1.3.1. Neural tube, ependymal cells and stem cells
1.3.2. Cilated ependymal cells and CSF movement
1.3.3. Choroid plexuses, arachnoid and capillaries
1.4. Extracellular Space and Extracellular Matrix
1.5. Brain-Fluid Interfaces
1.5.1. Anatomy of the cerebral blood vessels
1.5.2. Brain cells interfaces with CSF at ependymal and pia
1.6. Dura, arachnoid and pial layers
1.7. What are sources of energy?
Chapter 2: Physiology of the Cerebrospinal and Interstitial Fluids
2.1. Introduction
2.2. Proteins in the CSF
2.3. CSF Pressure Reflects Venous Pressure in the Right Heart
2.4. Formation, Circulation and Absorption of CSF
2.4.1. Formation of CSF by choroid plexuses
2.4.2. Choroid plexus and disease biomarkers in CSF
2.4.3. Absorption of CSF at the arachnoid villi
2.5. Electrolyte balance in the CSF
2.6. Meninges and sites of masses and infection
2.7. Interstitial fluid
2.8. Lyphatic drainage
2.9. Water diffusion, bulk flow if ISH and diffusion tensor imaging
2.10. Neuropeptides and fluid homeostasis
2.11. Aquaporins and water transport in the CNS
Chapter 3: Neurovascular Unit
3.1. Early experiments on blood-brain barrier
3.2. The Neurovascular unit and tight junction proteins
3.3. Integrins, selectins and endothelial cell adhesion
3.4. Astrocytes, pericytes and basal lamina
3.5. Movement of substances into and out of brain
3.6. Glucose and amino acid transport
3.7. Proteases and the neurovascular unit
3.8. Matrix metalloproteinases (MMPs)
3.9. A disintegrin and metalloproteinase (ADAM)
3.10. Barrier systems evolved to an endothelial barrier
Part II: Metabolism, disorders of brain fluids, and mathematics of transport
Chapter 4: Glucose, Amino acid and Lipid Metabolism
4.1. Glucose metabolism
4.2. Amino acid neurotransmitters
4.3. Lipid metabolism
4.4. Eicosanoid metabolism
4.5. Hepatic encephalopathy
4.6. Hypoglycemia
4.7. Hyponatremia, osmotic demyelination and acid balance
4.7.1. Hyponatremia
4.7.2. Hyperglycemia
4.7.3. Acidosis
Chapter 5: Disorders of Cerebrospinal Circulation: Idiopathic Intracranial Hypertension (IIH) and Hydrocephalus
5.1. Introduction
5.2. Clinical Features of IIH
5.3. Treatment of IIH
5.4. Hydrocephalus
5.5. Hydrocephalus in children
5.6. Adult-onset hydrocephalus
5.6.1. Obstructive hydrocephalus
5.6.2. Normal-pressure hydrocephalus
Chapter 6: Quantification of Cerebral Blood Flow and Blood Brain Barrier Transport by NMR and PET
6.1. Introduction
6.2. Mathematical approach to cerebral blood flow and transport
6.2.1. Cerebral blood flow: Schmidt-Kety approach
6.2.2. Regional blood flow
6.2.3. Transport between blood and brain
6.3 Positron emission tomography (PET)
6.3.1. Single-injection external registration
6.3.2. Patlak graphical BBB method for autoradiography and MRI
6.4 Magnetic resonance imaging and spectroscopy
6.4.1. Multinuclear NMR
6.4.2. Relaxation phenomenon and the rotating frame
6.4.3. 31P-MRS
6.4.4. 13C-MRS
6.4.5. 1H-MRS
Part III: Ischemia, edema and inflammation
Chapter 7: Mechanisms of Ischemic/Hypoxic Brain Injury
7.1. Epidemiology, risk factors and prevention of stroke
7.2. Molecular cascades in ischemic tissue results from energy failure
7.3. Excitatory and inhibitory neurotransmitters
7.4. Neuroinflammation in stroke
7.5. Proteases in hypoxia/ischemia
7.6. Caspases and cell death
7.7. Tissue inhibitors of metalloproteinases (TIMPs) and apoptosis
7.8. Tight junction proteins and MMPs
7.9. MMPs and tPA-induced bleeding
7.10. Animal models in stroke
7.11. Arteriovenous malformations and cavernous hemangiomas
7.12. MRI, PET and EPR in hypoxia-ischemia
7.12.1. MRI and MRS
7.12.2. Positron emission tomography (PET)
7.12.3. Electron paramagnetic resonance
Chapter 8: Vascular Cognitive Impairment and Alzheimer's Disease
8.1. Regulation of cerebral blood flow
8.2. Hypoxia-ischemia in cardiac arrest
8.2.1 Prognosis for recovery after cardiac arrest
8.2.2 Cardiac surgery and memory loss
8.2.3 Delayed post anoxic leukoencephalopathy
8.3. Hypoxia inducible factors and gene expression
8.4. Intermittent hypoxia is a strong stimulus for HIF
8.5. Vascular cognitive impairment
8.6. White matter hyperintensities on MRI and Binswanger's disease
8.7. Alzheimer's disease, vascular disease and the amyloid hypothesis
Chapter 9: Effects of Altitude on the Brain
9.1. Introduction
9.2. Genetic tolerance to altitude
9.3. Acute mountain sickness and high altitude pulmonary edema
9.4. High altitude cerebral edema
9.5. Cognitive consequences of hypobaric hypoxia
9.6. Imaging of the brain at high altitude
9.7. Hypoxia-inducible factors and sleep disorders in AMS
9.8. Treatment of altitude illnesses
Chapter 10: Brain Edema
10.1. Introduction
10.2. Role of aquaporins in brain edema
10.3. Role of Neuroinflammation in the formation of vasogenic edema
10.3.1. Oxidative stress and brain edema
10.3.2 . Arachidonic acid and brain edema
10.3.3. Vascular endothelial growth factor and angiopoietins
10.4. Clinical conditions associated with brain edema
10.5. Imaging brain edema
10.6 . Treatment of brain edema and hypoxic/ischemic injury
10.7. Multiple drugs for treatment of ischemia
Chapter 11: Intracerebral Hemorrhage
11.1. Introduction
11.2. History of ICH
11.3. Molecular mechanisms in ICH
11.4. Clinical aspects of intracranial bleeding
11.5. Pathophysiology of ICH: Evidence from animal studies
11.6 Extrapolation of experimental results to treatments for ICH
Chapter 12: Autoimmunity, Hypoxia, and Inflammation in Demyelinating Diseases
12.1. Introduction
12.2. Heterogeneity of the pathological findings in MS
12.3. Proteases implicated in MS pathology
12.4. BBB disruption in MS
12.5. Devic's neuromyelitis optica
12.6. Nonimmunological processes in demyelination
12.7. Experimental allergic encephalomyelitis and pathogenesis of MS
12.8. Epilogue- synthesis and future directions

About the author: 

Gary A. Rosenberg, MD Chairman of Neurology Professor of Neurology, Neurosciences, Cell Biology and Physiology, and Mathematics and Statistics University of New Mexico Health Sciences Center Albuquerque, NM

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