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Liang S, Jiang X, Zhang Q, Duan S, Zhang T, Huang Q, Sun X, Liu H, Dong J, Liu W, Tao J, Zhao S, Nie B, Chen L, Shan B. Abnormal Metabolic Connectivity in Rats at the Acute Stage of Ischemic Stroke. Neurosci Bull 2018; 34:715-724. [PMID: 30083891 PMCID: PMC6129253 DOI: 10.1007/s12264-018-0266-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 05/18/2018] [Indexed: 01/29/2023] Open
Abstract
Stroke at the acute stage is a major cause of disability in adults, and is associated with dysfunction of brain networks. However, the mechanisms underlying changes in brain connectivity in stroke are far from fully elucidated. In the present study, we investigated brain metabolism and metabolic connectivity in a rat ischemic stroke model of middle cerebral artery occlusion (MCAO) at the acute stage using 18F-fluorodeoxyglucose positron emission tomography. Voxel-wise analysis showed decreased metabolism mainly in the ipsilesional hemisphere, and increased metabolism mainly in the contralesional cerebellum. We used further metabolic connectivity analysis to explore the brain metabolic network in MCAO. Compared to sham controls, rats with MCAO showed most significantly reduced nodal and local efficiency in the ipsilesional striatum. In addition, the MCAO group showed decreased metabolic central connection of the ipsilesional striatum with the ipsilesional cerebellum, ipsilesional hippocampus, and bilateral hypothalamus. Taken together, the present study demonstrated abnormal metabolic connectivity in rats at the acute stage of ischemic stroke, which might provide insight into clinical research.
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Affiliation(s)
- Shengxiang Liang
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, 450001, China
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Xiaofeng Jiang
- School of Public Health and Family Medicine, Capital Medical University, Beijing, 100068, China
| | - Qingqing Zhang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Shaofeng Duan
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Tianhao Zhang
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qi Huang
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xi Sun
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, 450001, China
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
| | - Hua Liu
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jie Dong
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, 450001, China
| | - Weilin Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Shujun Zhao
- College of Physical Science and Technology, Zhengzhou University, Zhengzhou, 450001, China.
| | - Binbin Nie
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China.
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China.
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Baoci Shan
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
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Harutyunyan G, Harutyunyan G, Mkhoyan G. New Viewpoint in Exaggerated Increase of PtiO 2 With Normobaric Hyperoxygenation and Reasons to Limit Oxygen Use in Neurotrauma Patients. Front Med (Lausanne) 2018; 5:119. [PMID: 29872657 PMCID: PMC5972302 DOI: 10.3389/fmed.2018.00119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 04/10/2018] [Indexed: 01/06/2023] Open
Affiliation(s)
| | | | - Gagik Mkhoyan
- Anesthesiology and Intensive Care, Erebouni Medical Center, Yerevan, Armenia
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Deuchar GA, Brennan D, Holmes WM, Shaw M, Macrae IM, Santosh C. Perfluorocarbon Enhanced Glasgow Oxygen Level Dependent (GOLD) Magnetic Resonance Metabolic Imaging Identifies the Penumbra Following Acute Ischemic Stroke. Am J Cancer Res 2018; 8:1706-1722. [PMID: 29556351 PMCID: PMC5858177 DOI: 10.7150/thno.21685] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 12/16/2017] [Indexed: 01/27/2023] Open
Abstract
The ability to identify metabolically active and potentially salvageable ischaemic penumbra is crucial for improving treatment decisions in acute stroke patients. Our solution involves two complementary novel MRI techniques (Glasgow Oxygen Level Dependant (GOLD) Metabolic Imaging), which when combined with a perfluorocarbon (PFC) based oxygen carrier and hyperoxia can identify penumbra due to dynamic changes related to continued metabolism within this tissue compartment. Our aims were (i) to investigate whether PFC offers similar enhancement of the second technique (Lactate Change) as previously demonstrated for the T2*OC technique (ii) to demonstrate both GOLD metabolic imaging techniques working concurrently to identify penumbra, following administration of Oxycyte® (O-PFC) with hyperoxia. Methods: An established rat stroke model was utilised. Part-1: Following either saline or PFC, magnetic resonance spectroscopy was applied to investigate the effect of hyperoxia on lactate change in presumed penumbra. Part-2; rats received O-PFC prior to T2*OC (technique 1) and MR spectroscopic imaging, which was used to identify regions of tissue lactate change (technique 2) in response to hyperoxia. In order to validate the techniques, imaging was followed by [14C]2-deoxyglucose autoradiography to correlate tissue metabolic status to areas identified as penumbra. Results: Part-1: PFC+hyperoxia resulted in an enhanced reduction of lactate in the penumbra when compared to saline+hyperoxia. Part-2: Regions of brain tissue identified as potential penumbra by both GOLD metabolic imaging techniques utilising O-PFC, demonstrated maintained glucose metabolism as compared to adjacent core tissue. Conclusion: For the first time in vivo, enhancement of both GOLD metabolic imaging techniques has been demonstrated following intravenous O-PFC+hyperoxia to identify ischaemic penumbra. We have also presented preliminary evidence of the potential therapeutic benefit offered by O-PFC. These unique theranostic applications would enable treatment based on metabolic status of the brain tissue, independent of time from stroke onset, leading to increased uptake and safer use of currently available treatment options.
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Animal models of ischaemic stroke and characterisation of the ischaemic penumbra. Neuropharmacology 2017; 134:169-177. [PMID: 28923277 DOI: 10.1016/j.neuropharm.2017.09.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/08/2017] [Accepted: 09/13/2017] [Indexed: 02/07/2023]
Abstract
Over the past forty years, animal models of focal cerebral ischaemia have allowed us to identify the critical cerebral blood flow thresholds responsible for irreversible cell death, electrical failure, inhibition of protein synthesis, energy depletion and thereby the lifespan of the potentially salvageable penumbra. They have allowed us to understand the intricate biochemical and molecular mechanisms within the 'ischaemic cascade' that initiate cell death in the first minutes, hours and days following stroke. Models of permanent, transient middle cerebral artery occlusion and embolic stroke have been developed each with advantages and limitations when trying to model the complex heterogeneous nature of stroke in humans. Yet despite these advances in understanding the pathophysiological mechanisms of stroke-induced cell death with numerous targets identified and drugs tested, a lack of translation to the clinic has hampered pre-clinical stroke research. With recent positive clinical trials of endovascular thrombectomy in acute ischaemic stroke the stroke community has been reinvigorated, opening up the potential for future translation of adjunctive treatments that can be given alongside thrombectomy/thrombolysis. This review discusses the major animal models of focal cerebral ischaemia highlighting their advantages and limitations. Acute imaging is crucial in longitudinal pre-clinical stroke studies in order to identify the influence of acute therapies on tissue salvage over time. Therefore, the methods of identifying potentially salvageable ischaemic penumbra are discussed. This article is part of the Special Issue entitled 'Cerebral Ischemia'.
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Vallatos A, Gilmour L, Chalmers AJ, Holmes WM. Multiple boli arterial spin labeling for high signal-to-noise rodent brain perfusion imaging. Magn Reson Med 2017; 79:1020-1030. [PMID: 28516482 DOI: 10.1002/mrm.26706] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/18/2017] [Accepted: 03/19/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE A systematic method is proposed for optimizing a promising preclinical arterial spin labeling (ASL) sequence based on the use of a train of adiabatic radiofrequency pulses labeling successive boli of blood water. METHODS The sequence optimization is performed and evaluated using brain imaging experiments in mice and in rats. It involves the investigation of several parameters, ranging from the number of adiabatic pulses and labeling duration to the properties of the adiabatic hyperbolic secant pulses (ie, amplitude and frequency modulation). RESULTS Species-dependent parameters are identified, allowing for robust fast optimization protocols to be introduced. The resulting optimized multiple boli ASL (mbASL) sequence provides with significantly higher average signal-to-noise ratios (SNR) per voxel volume than currently encountered in ASL studies (278 mm-3 in mice and 172 mm-3 in rats). Comparing with the commonly used flow-sensitive alternating inversion recovery technique (FAIR), mbASL-to-FAIR SNR ratios reach 203% for mice and 725% for rats. CONCLUSION When properly optimized, mbASL can offer a robust, high SNR ASL alternative for rodent brain perfusion studies Magn Reson Med 79:1020-1030, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Antoine Vallatos
- Glasgow Experimental MRI Centre, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Lesley Gilmour
- Wolfson Wohl Translational Cancer Research Center, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Anthony J Chalmers
- Wolfson Wohl Translational Cancer Research Center, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - William M Holmes
- Glasgow Experimental MRI Centre, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
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Affiliation(s)
- Christopher McCabe
- Institute of Neuroscience & Psychology, College of Medical, Veterinary & Life Sciences, Wellcome Surgical Institute, University of Glasgow, Glasgow, UK
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Shen Q, Huang S, Duong TQ. T2*-weighted fMRI time-to-peak of oxygen challenge in ischemic stroke. J Cereb Blood Flow Metab 2016; 36:283-91. [PMID: 26661164 PMCID: PMC4759668 DOI: 10.1177/0271678x15606461] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 07/11/2015] [Indexed: 11/16/2022]
Abstract
T2 (*)-weighted MRI of transient oxygen challenge (OC) showed exaggerated OC percent changes in the ischemic tissue at risk compared to normal tissue. One ambiguity is that regions with high vascular density also showed exaggerated OC percent changes. This study explored time-to-peak (TTP) of the OC percent changes to improve the utility of T2 (*)-weighted OC MRI. Experiments were performed longitudinally at 30 min, 150 min and 24 h after transient (60-min) stroke in rats. Ischemic core, normal, and mismatch tissue were classified pixel-by-pixel based on apparent diffusion coefficient and cerebral blood flow. Major findings were: (i) Delayed OC TTP was localized to and corresponded well with the perfusion-diffusion mismatch. (ii) By contrast, the exaggerated OC percent changes were less localized, with changes not only in the at-risk tissue but also in some areas of the contralesional hemisphere with venous vessel origins. (iii) The OC time-course of the mismatch tissue was biphasic, with a faster initial increase followed by a slower increase. (iv) At-risk tissue with delayed TTP and exaggerated OC was normal after reperfusion and the at-risk tissue was mostly (83 ± 18%) rescued by reperfusion as indicated by normal 24-h T2. OC TTP offers unique information toward better characterization of at-risk tissue in ischemic stroke.
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Affiliation(s)
- Qiang Shen
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX, USA Department of Ophthalmology, University of Texas Health Science Center, San Antonio, TX, USA Department of Radiology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Shiliang Huang
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX, USA
| | - Timothy Q Duong
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX, USA Department of Ophthalmology, University of Texas Health Science Center, San Antonio, TX, USA Department of Radiology, University of Texas Health Science Center, San Antonio, TX, USA South Texas Veterans Health Care System, Department of Veterans Affairs, San Antonio, TX, USA
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Dani KA, Warach S. Metabolic imaging of ischemic stroke: the present and future. AJNR Am J Neuroradiol 2014; 35:S37-43. [PMID: 24722308 DOI: 10.3174/ajnr.a3789] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Measures of cerebral metabolism may be useful in the selection of patients for reperfusion therapies and as end points in clinical trials. However, there are currently no clinically routine techniques that provide such data directly. We review how imaging modalities in current clinical use may provide surrogate markers of metabolic activity. Promising techniques for metabolic imaging that are currently in the pipeline are reviewed.
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Affiliation(s)
- K A Dani
- From the Institute of Neurosciences and Psychology (K.A.D.), University of Glasgow, Institute of Neurological Sciences, Glasgow, United Kingdom
| | - S Warach
- Department of Neurology and Neurotherapeutics (S.W.), UT Southwestern, Dallas, Texas.
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Shen Q, Du F, Huang S, Duong TQ. Effects of cerebral ischemic and reperfusion on T2*-weighted MRI responses to brief oxygen challenge. J Cereb Blood Flow Metab 2014; 34:169-75. [PMID: 24129750 PMCID: PMC3887355 DOI: 10.1038/jcbfm.2013.179] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/19/2013] [Accepted: 09/19/2013] [Indexed: 11/09/2022]
Abstract
This study characterized the effects of cerebral ischemia and reperfusion on T2*-weighted magnetic resonance image (MRI) responses to brief oxygen challenge (OC) in transient (60 minutes) cerebral ischemia in rats. During occlusion, the ischemic core tissue showed no significant OC response, whereas the perfusion-diffusion mismatch tissue showed markedly higher percent changes relative to normal tissue. After reperfusion, much of the pixels with initial exaggerated OC responses showed normal OC responses, and the majority of these tissues were salvaged as defined by endpoint T2 MRI. The initial core pixels showed exaggerated OC responses after reperfusion, but the majority of the core pixels eventually became infarct, suggesting exaggerated OC responses do not necessarily reflect salvageable tissue. Twenty-four hours after stroke, basal T1 increased in the ischemic core. Oxygen challenge decreased T1 significantly in the core, indicative of the substantial increases in dissolved oxygen in the core as the result of hyperperfusion. We concluded that exaggerated T2*-weighted MRI responses to OC offer useful insight in ischemic tissue fates. However, exaggerated OC pixels are not all salvageable, and they exhibited complex dynamics depending on reperfusion status, hyperperfusion, and edema effects.
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Affiliation(s)
- Qiang Shen
- 1] Department of Research Imaging Institute, San Antonio, Texas, USA [2] Department of Ophthalmology, San Antonio, Texas, USA [3] Department of Radiology, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Fang Du
- Department of Research Imaging Institute, San Antonio, Texas, USA
| | - Shiliang Huang
- Department of Research Imaging Institute, San Antonio, Texas, USA
| | - Timothy Q Duong
- 1] Department of Research Imaging Institute, San Antonio, Texas, USA [2] Department of Ophthalmology, San Antonio, Texas, USA [3] Department of Radiology, University of Texas Health Science Center, San Antonio, Texas, USA [4] South Texas Veterans Health Care System, Department of Veterans Affairs, San Antonio, Texas, USA
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Yang Y, Gao L, Fu J, Zhang J, Li Y, Yin B, Chen W, Geng D. Apparent diffusion coefficient evaluation for secondary changes in the cerebellum of rats after middle cerebral artery occlusion. Neural Regen Res 2013; 8:2942-50. [PMID: 25206615 PMCID: PMC4146177 DOI: 10.3969/j.issn.1673-5374.2013.31.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 10/05/2013] [Indexed: 11/18/2022] Open
Abstract
Supratentorial cerebral infarction can cause functional inhibition of remote regions such as the cerebellum, which may be relevant to diaschisis. This phenomenon is often analyzed using positron emission tomography and single photon emission CT. However, these methods are expensive and radioactive. Thus, the present study quantified the changes of infarction core and remote regions after unilateral middle cerebral artery occlusion using apparent diffusion coefficient values. Diffusion-weighted imaging showed that the area of infarction core gradually increased to involve the cerebral cortex with increasing infarction time. Diffusion weighted imaging signals were initially increased and then stabilized by 24 hours. With increasing infarction time, the apparent diffusion coefficient value in the infarction core and remote bilateral cerebellum both gradually decreased, and then slightly increased 3–24 hours after infarction. Apparent diffusion coefficient values at remote regions (cerebellum) varied along with the change of supratentorial infarction core, suggesting that the phenomenon of diaschisis existed at the remote regions. Thus, apparent diffusion coefficient values and diffusion weighted imaging can be used to detect early diaschisis.
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Affiliation(s)
- Yunjun Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Lingyun Gao
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Jun Fu
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Jun Zhang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yuxin Li
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Bo Yin
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Weijian Chen
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Daoying Geng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
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Abstract
Stroke is a serious healthcare problem with high mortality and long-term disability. However, to date, our ability to prevent and cure stroke remains limited. One important goal in stroke research is to identify the extent and location of lesion for treatment. In addition, accurately differentiating salvageable tissue from infarct and evaluating therapeutic efficacies are indispensible. These objectives could potentially be met with the assistance of modern neuroimaging techniques. This paper reviews current imaging methods commonly used in ischemic stroke research. These methods include positron emission tomography, computed tomography, T1 MRI, T2 MRI, diffusion and perfusion MRI, diffusion tensor imaging, blood-brain barrier permeability MRI, pH-weighted MRI, and functional MRI.
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Affiliation(s)
- Hsiao-Ying Wey
- University of Texas Health Science Center, San Antonio, Texas, USA
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Abstract
In ischemic stroke, positron-emission tomography (PET) established the imaging-based concept of penumbra. It defines hypoperfused, but functionally impaired, tissue with preserved viability that can be rescued by timely reperfusion. Diffusion-weighted and perfusion-weighted (PW) magnetic resonance imaging (MRI) translated the concept of penumbra to the concept of mismatch. However, the use of mismatch-based patient stratification for reperfusion therapy remains a matter of debate. The equivalence of mismatch and penumbra, as well as the validity of the classical mismatch concept is questioned for several reasons. First, methodological differences between PET and MRI lead to different definitions of the tissue at risk. Second, the mismatch concept is still poorly standardized among imaging facilities causing relevant variability in stroke research. Third, relevant conceptual issues (e.g., the choice of the adequate perfusion measure, the best quantitative approach to perfusion maps, and the required size of the mismatch) need further refinement. Fourth, the use of single thresholds does not account for the physiological heterogeneity of the penumbra and probabilistic approaches may be more promising. The implementation of this current knowledge into an optimized state-of-the-art mismatch model and its validation in clinical stroke studies remains a major challenge for future stroke research.
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Affiliation(s)
- Jan Sobesky
- Department of Neurology and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany.
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