Brain’s Energy After Stroke: From a Cellular Perspective Toward Behavior

Abstract

Stroke is a neurological condition that impacts activity performance and quality of life for survivors. While neurological impairments after the event explain the performance of patients in specific activities, the origin of such impairments has traditionally been explained as a consequence of structural and functional damage to the nervous system. However, there are important mechanisms related to energy efficiency (trade-off between biological functions and energy consumption) at different levels that can be related to these impairments and restrictions: first, at the neuronal level, where the availability of energy resources is the initial cause of the event, as well as determines the possibilities of spontaneous recovery. Second, at the level of neural networks, where the “small world” operation of the network is compromised after the stroke, implicating a high energetic cost and inefficiency in the information transfer, which is related to the neurological recovery and clinical status. Finally, at the behavioral level, the performance limitations are related to the highest cost of energy or augmented energy expenditure during the tasks to maintain the stability of the segment, system, body, and finally, the behavior of the patients. In other words, the postural homeostasis. In this way, we intend to provide a synthetic vision of the energy impact of stroke, from the particularities of the operation of the nervous system, its implications, as one of the determinant factors in the possibilities of neurological, functional, and behavioral recovery of our patients.

Pathophysiology and Current Drug Treatments for Post-Stroke Depression: A Review

“…The reduction of the body’s energy efficiency due to the functional damage to the nervous system decreases upper limb and lower limb functions. Thus, it is difficult for one to have postural control of the limb functions and perform daily activities such as dressing post-stroke [ 24 ]. In addition, dysfunction in the neuronal circuitry and alterations in basal metabolism of PSD patients impair their motor capabilities.…”

“…The arising weakness and spasticity make the affected individuals have stereotypical hemiplegic gait [ 25 ]. Therefore, they have low or poor biomechanical performance despite the body using a lot of energy to function healthily [ 24 ]. The lower limb muscles are often organized in synergy modules during walking, which enables a stable stance weight, and swing phases.…”

The dentate gyrus differentially metabolizes glucose and alternative fuels during rest and stimulation

“…Neurons require energy in the form of ATP to maintain ion gradients for action potential conduction, to transport cargo throughout the cell, and to reuptake, recycle, and repackage neurotransmitters, among many other cellular activities (Harris et al., 2012). Because these functions rely on a constant supply of ATP, neurons are particularly sensitive to energy disruptions, such as low oxygen or low blood sugar conditions, found during stroke or severe diabetic hypoglycemia (Mariman et al., 2022; Rehni & Dave, 2018). While important, maintaining a consistent energy supply throughout the brain is a complicated task.…”