Nimodipine and the Aging Brain: A Balancing Act

Published on April 27, 2023

Imagine your brain as a vast network of rivers, carrying oxygen and nutrients to all corners. Just like any river system, there are times when the flow may be reduced or impaired. In aging brains, the ability to regulate this flow, known as cerebrovascular reactivity (CVR), starts to decline. This is evidenced by a decrease in the cerebral response to increased carbon dioxide levels. Researchers discovered that this decline is associated with senescence (cellular aging) of smooth muscle cells and astrocytes in the brain. But here’s where it gets interesting: nimodipine, a medication that blocks calcium channels, can actually boost CVR in aging brains! However, when it comes to acute cerebral ischemia (a sudden restriction of blood flow to the brain), nimodipine might not have the same positive effects. In fact, it could worsen the impairment of CVR in these critical situations. So while nimodipine shows potential as a therapeutic option for aging brains, more research is needed to fully understand its benefits and risks in the context of acute ischemic stroke. If you’re curious to learn more about this fascinating topic, be sure to check out the full article!

IntroductionThe efficacy of cerebrovascular reactivity (CVR) is taken as an indicator of cerebrovascular health.Methods and ResultsWe found that CVR tested with the inhalation of 10 % CO2 declined in the parietal cortex of 18-20-month-old rats. The CVR deficit in old rats was coincident with cerebrovascular smooth muscle cell and astrocyte senescence, revealed by the immuno-labeling of the cellular senescence marker p16 in these cells. In a next series of experiments, CVR was severely impaired in the acute phase of incomplete global forebrain ischemia produced by the bilateral occlusion of the common carotid arteries in young adult rats. In acute ischemia, CVR impairment often manifested as a perfusion drop rather than blood flow elevation in response to hypercapnia. Next, nimodipine, an L-type voltage-gated calcium channel antagonist was administered topically to rescue CVR in both aging, and cerebra ischemia. Nimodipine augmented CVR in the aged brain, but worsened CVR impairment in acute cerebral ischemia.DiscussionA careful evaluation of benefits and side effects of nimodipine is recommended, especially in acute ischemic stroke.

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