Abstract
White matter is affected in human stroke and treatment strategies derived from experimental work on young adults focused exclusively on gray matter have been ineffective in the more clinically relevant aging population. The risk for stroke increases with age and the white matter also inherently becomes more vulnerable to injury with age. Age-related changes in the molecular architecture of white matter dictate the predominant injury mechanisms and determine the functional outcome. A prominent increase in the main Na+-dependent glutamate transporter, GLT-1, together with increased glutamate levels may reflect an increased need for glutamate signaling in the aging white matter to maintain function. Conversely, these adaptive modifications become detrimental under ischemic conditions, leading to increased vulnerability and robust injury. Mitochondria gather and elongate to effectively buffer Ca2+ but fail to produce sufficient ATP during an ischemic challenge to sustain aging axon function. Consequently, protective interventions in young white matter become injurious or ineffective to promote recovery in aging white matter after an ischemic episode. An age-specific understanding of the mechanisms of injury processes in white matter is essential to design dynamic therapeutic approaches for stroke victims.
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The studies from the author’s laboratory that are described in this chapter were supported by National Institutes of Health/National Institute of Aging grant R01AG033720.
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Baltan, S. (2014). Age-Dependent Mechanisms of White Matter Injury After Stroke. In: Baltan, S., Carmichael, S., Matute, C., Xi, G., Zhang, J. (eds) White Matter Injury in Stroke and CNS Disease. Springer Series in Translational Stroke Research, vol 4. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9123-1_16
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