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van der Knaap N, Franx BAA, Majoie CBLM, van der Lugt A, Dijkhuizen RM. Implications of Post-recanalization Perfusion Deficit After Acute Ischemic Stroke: a Scoping Review of Clinical and Preclinical Imaging Studies. Transl Stroke Res 2024; 15:179-194. [PMID: 36653525 PMCID: PMC10796479 DOI: 10.1007/s12975-022-01120-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/20/2023]
Abstract
The goal of reperfusion therapy for acute ischemic stroke (AIS) is to restore cerebral blood flow through recanalization of the occluded vessel. Unfortunately, successful recanalization does not always result in favorable clinical outcome. Post-recanalization perfusion deficits (PRPDs), constituted by cerebral hypo- or hyperperfusion, may contribute to lagging patient recovery rates, but its clinical significance remains unclear. This scoping review provides an overview of clinical and preclinical findings on post-ischemic reperfusion, aiming to elucidate the pattern and consequences of PRPD from a translational perspective. The MEDLINE database was searched for quantitative clinical and preclinical studies of AIS reporting PRPD based on cerebral circulation parameters acquired by translational tomographic imaging methods. PRPD and stroke outcome were mapped on a charting table, creating an overview of PRPD after AIS. Twenty-two clinical and twenty-two preclinical studies were included. Post-recanalization hypoperfusion is rarely reported in clinical studies (4/22) but unequivocally associated with detrimental outcome. Post-recanalization hyperperfusion is more commonly reported (18/22 clinical studies) and may be associated with positive or negative outcome. PRPD has been replicated in animal studies, offering mechanistic insights into causes and consequences of PRPD and allowing delineation of possible courses of PRPD. Complex relationships exist between PRPD and stroke outcome. Diversity in methods and lack of standardized definitions in reperfusion studies complicate the characterization of reperfusion patterns. Recommendations are made to advance the understanding of PRPD mechanisms and to further disentangle the relation between PRPD and disease outcome.
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Affiliation(s)
- Noa van der Knaap
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Bart A A Franx
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands.
| | - Charles B L M Majoie
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Aad van der Lugt
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands.
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Brunner C, Montaldo G, Urban A. Functional ultrasound imaging of stroke in awake rats. eLife 2023; 12:RP88919. [PMID: 37988288 PMCID: PMC10662948 DOI: 10.7554/elife.88919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
Anesthesia is a major confounding factor in preclinical stroke research as stroke rarely occurs in sedated patients. Moreover, anesthesia affects both brain functions and the stroke outcome acting as neurotoxic or protective agents. So far, no approaches were well suited to induce stroke while imaging hemodynamics along with simultaneous large-scale recording of brain functions in awake animals. For this reason, the first critical hours following the stroke insult and associated functional alteration remain poorly understood. Here, we present a strategy to investigate both stroke hemodynamics and stroke-induced functional alterations without the confounding effect of anesthesia, i.e., under awake condition. Functional ultrasound (fUS) imaging was used to continuously monitor variations in cerebral blood volume (CBV) in +65 brain regions/hemispheres for up to 3 hr after stroke onset. The focal cortical ischemia was induced using a chemo-thrombotic agent suited for permanent middle cerebral artery occlusion in awake rats and followed by ipsi- and contralesional whiskers stimulation to investigate on the dynamic of the thalamocortical functions. Early (0-3 hr) and delayed (day 5) fUS recording enabled to characterize the features of the ischemia (location, CBV loss), spreading depolarizations (occurrence, amplitude) and functional alteration of the somatosensory thalamocortical circuits. Post-stroke thalamocortical functions were affected at both early and later time points (0-3 hr and 5 days) after stroke. Overall, our procedure facilitates early, continuous, and chronic assessments of hemodynamics and cerebral functions. When integrated with stroke studies or other pathological analyses, this approach seeks to enhance our comprehension of physiopathologies towards the development of pertinent therapeutic interventions.
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Affiliation(s)
- Clément Brunner
- Neuro-Electronics Research FlandersLeuvenBelgium
- Vlaams Instituut voor BiotechnologieLeuvenBelgium
- Interuniversity Microelectronics CentreLeuvenBelgium
- Department of Neurosciences, KU LeuvenLeuvenBelgium
| | - Gabriel Montaldo
- Neuro-Electronics Research FlandersLeuvenBelgium
- Vlaams Instituut voor BiotechnologieLeuvenBelgium
- Interuniversity Microelectronics CentreLeuvenBelgium
- Department of Neurosciences, KU LeuvenLeuvenBelgium
| | - Alan Urban
- Neuro-Electronics Research FlandersLeuvenBelgium
- Vlaams Instituut voor BiotechnologieLeuvenBelgium
- Interuniversity Microelectronics CentreLeuvenBelgium
- Department of Neurosciences, KU LeuvenLeuvenBelgium
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3
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Prophylactic Zinc Administration Combined with Swimming Exercise Prevents Cognitive-Emotional Disturbances and Tissue Injury following a Transient Hypoxic-Ischemic Insult in the Rat. Behav Neurol 2022; 2022:5388944. [PMID: 35637877 PMCID: PMC9146809 DOI: 10.1155/2022/5388944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 03/04/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022] Open
Abstract
Exercise performance and zinc administration individually yield a protective effect on various neurodegenerative models, including ischemic brain injury. Therefore, this work was aimed at evaluating the combined effect of subacute prophylactic zinc administration and swimming exercise in a transient cerebral ischemia model. The prophylactic zinc administration (2.5 mg/kg of body weight) was provided every 24 h for four days before a 30 min common carotid artery occlusion (CCAO), and 24 h after reperfusion, the rats were subjected to swimming exercise in the Morris Water Maze (MWM). Learning was evaluated daily for five days, and memory on day 12 postreperfusion; anxiety or depression-like behavior was measured by the elevated plus maze and the motor activity by open-field test. Nitrites, lipid peroxidation, and the activity of superoxide dismutase (SOD) and catalase (CAT) were assessed in the temporoparietal cortex and hippocampus. The three nitric oxide (NO) synthase isoforms, chemokines, and their receptor levels were measured by ELISA. Nissl staining evaluated hippocampus cytoarchitecture and Iba-1 immunohistochemistry activated the microglia. Swimming exercise alone could not prevent ischemic damage but, combined with prophylactic zinc administration, reversed the cognitive deficit, decreased NOS and chemokine levels, prevented tissue damage, and increased Iba-1 (+) cell number. These results suggest that the subacute prophylactic zinc administration combined with swimming exercise, but not the individual treatment, prevents the ischemic damage on day 12 postreperfusion in the transient ischemia model.
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Ganesh A, Goyal M, Wilson AT, Ospel JM, Demchuk AM, Mikulis D, Poublanc J, Krings T, Anderson R, Tymianski M, Hill MD. Association of Iatrogenic Infarcts With Clinical and Cognitive Outcomes in the Evaluating Neuroprotection in Aneurysm Coiling Therapy Trial. Neurology 2022; 98:e1446-e1458. [PMID: 35169007 DOI: 10.1212/wnl.0000000000200111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 01/11/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Small iatrogenic brain infarcts are often seen on diffusion-weighted MRI (DWI) following surgical or endovascular procedures, but there are few data on their clinical effects. We examined the association of iatrogenic infarcts with outcomes in the ENACT (Evaluating Neuroprotection in Aneurysm Coiling Therapy) randomized controlled trial of nerinetide in patients undergoing endovascular repair of intracranial aneurysms. METHODS In this post hoc analysis, we used multivariable models to evaluate the association of the presence and number of iatrogenic infarcts on DWI with neurologic impairment (NIH Stroke Scale [NIHSS]), functional status (modified Rankin Scale [mRS]), and cognitive and neuropsychiatric outcomes (30-minute test battery) at 1-4 days and 30 days postprocedure. We also related infarct number to a z score-derived composite outcome score using quantile regression. RESULTS Among 184 patients (median age 56 years [interquartile range (IQR) 50-64]), 124 (67.4%) had postprocedural DWI lesions (median 4, IQR 2-10.5). Nerinetide treatment was associated with fewer iatrogenic infarcts but no overall significant clinical treatment effects. Patients with infarcts had lower Mini-Mental State Examination (MMSE) scores at 2-4 days (median 28 vs 29, adjusted coefficient [acoef] -1.11, 95% CI -1.88 to -0.34, p = 0.005). Higher lesion counts were associated with worse day 1 NIHSS (adjusted odds ratio for NIHSS ≥1: 1.07, 1.02-1.12, p = 0.009), day 2-4 mRS (adjusted common odds ratio [acOR] 1.05, 1.01-1.09, p = 0.005), and day 2-4 MMSE (acoef -0.07, -0.13 to -0.003, p = 0.040) scores. At 30 days, infarct number remained associated with worse mRS (acOR 1.04, 1.01-1.07, p = 0.016) and Hopkins Verbal Learning Test (HVLT) delayed recall scores (acoef -0.21, -0.39 to -0.03, p = 0.020). Patients with infarcts trended towards lower 30-day Digit Symbol Substitution Test (DSST) scores (acoef -3.73, -7.36 to -0.10, p = 0.044). Higher lesion count was associated with worse composite outcome scores at both 1-4 days and 30 days (30-day acoef -0.12, 95% CI -0.21 to -0.03, p = 0.008). Among those with infarcts, day 1 NIHSS and day 2-4 mRS correlated with 30-day NIHSS, DSST, HVLT, and mRS scores, whereas day 2-4 MMSE correlated with 30-day NIHSS and DSST scores (Spearman ρ 0.47, p = 0.001). DISCUSSION Iatrogenic brain infarcts were associated with subtle differences in postprocedural (1-4 days) and 30-day outcomes on different measures in this middle-aged cohort, with earlier dysfunction correlating with later differences. TRIAL REGISTRATION INFORMATION Clinical trials registration NCT00728182.
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Affiliation(s)
- Aravind Ganesh
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - Mayank Goyal
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - Alexis T Wilson
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - Johanna Maria Ospel
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - Andrew M Demchuk
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - David Mikulis
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - Julien Poublanc
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - Timo Krings
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - Roberta Anderson
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - Michael Tymianski
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
| | - Michael D Hill
- From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G., M.G., A.T.W., J.M.O., A.M.D., M.D.H.), Department of Community Health Sciences (A.G., M.D.H.), Hotchkiss Brain Institute (A.G., M.G., A.M.D., M.D.H.), and Department of Radiology (M.G., A.M.D., M.D.H.), University of Calgary, Canada; Department of Radiology (J.M.O.), University Hospital Basel, University of Basel, Switzerland; Department of Medical Imaging (D.M., J.P.) and Division of Neuroradiology (T.K.), Toronto Western Hospital, University Health Network and University of Toronto; NoNO Inc. (R.A., M.T.), Toronto; Division of Neurosurgery and Neurovascular Therapeutics Program (M.T.), University Health Network, Toronto; Departments of Surgery and Physiology (M.T.), University of Toronto; Toronto Western Hospital Research Institute (M.T.); and Department of Medicine (M.D.H.), University of Calgary Cumming School of Medicine, Canada
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Faillot M, Chaillet A, Palfi S, Senova S. Rodent models used in preclinical studies of deep brain stimulation to rescue memory deficits. Neurosci Biobehav Rev 2021; 130:410-432. [PMID: 34437937 DOI: 10.1016/j.neubiorev.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
Deep brain stimulation paradigms might be used to treat memory disorders in patients with stroke or traumatic brain injury. However, proof of concept studies in animal models are needed before clinical translation. We propose here a comprehensive review of rodent models for Traumatic Brain Injury and Stroke. We systematically review the histological, behavioral and electrophysiological features of each model and identify those that are the most relevant for translational research.
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Affiliation(s)
- Matthieu Faillot
- Neurosurgery department, Henri Mondor University Hospital, APHP, DMU CARE, Université Paris Est Créteil, Mondor Institute for Biomedical Research, INSERM U955, Team 15, Translational Neuropsychiatry, France
| | - Antoine Chaillet
- Laboratoire des Signaux et Systèmes (L2S-UMR8506) - CentraleSupélec, Université Paris Saclay, Institut Universitaire de France, France
| | - Stéphane Palfi
- Neurosurgery department, Henri Mondor University Hospital, APHP, DMU CARE, Université Paris Est Créteil, Mondor Institute for Biomedical Research, INSERM U955, Team 15, Translational Neuropsychiatry, France
| | - Suhan Senova
- Neurosurgery department, Henri Mondor University Hospital, APHP, DMU CARE, Université Paris Est Créteil, Mondor Institute for Biomedical Research, INSERM U955, Team 15, Translational Neuropsychiatry, France.
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6
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Ter Schiphorst A, Charron S, Hassen WB, Provost C, Naggara O, Benzakoun J, Seners P, Turc G, Baron JC, Oppenheim C. Tissue no-reflow despite full recanalization following thrombectomy for anterior circulation stroke with proximal occlusion: A clinical study. J Cereb Blood Flow Metab 2021; 41:253-266. [PMID: 32960688 PMCID: PMC8370008 DOI: 10.1177/0271678x20954929] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Despite early thrombectomy, a sizeable fraction of acute stroke patients with large vessel occlusion have poor outcome. The no-reflow phenomenon, i.e. impaired microvascular reperfusion despite complete recanalization, may contribute to such "futile recanalizations". Although well reported in animal models, no-reflow is still poorly characterized in man. From a large prospective thrombectomy database, we included all patients with intracranial proximal occlusion, complete recanalization (modified thrombolysis in cerebral infarction score 2c-3), and availability of both baseline and 24 h follow-up MRI including arterial spin labeling perfusion mapping. No-reflow was operationally defined as i) hypoperfusion ≥40% relative to contralateral homologous region, assessed with both visual (two independent investigators) and automatic image analysis, and ii) infarction on follow-up MRI. Thirty-three patients were eligible (median age: 70 years, NIHSS: 18, and stroke onset-to-recanalization delay: 208 min). The operational criteria were met in one patient only, consistently with the visual and automatic analyses. This patient recanalized 160 min after stroke onset and had excellent functional outcome. In our cohort of patients with complete and stable recanalization following thrombectomy for intracranial proximal occlusion, severe ipsilateral hypoperfusion on follow-up imaging associated with newly developed infarction was a rare occurrence. Thus, no-reflow may be infrequent in human stroke and may not substantially contribute to futile recanalizations.
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Affiliation(s)
- Adrien Ter Schiphorst
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Sylvain Charron
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neuroradiology, Hôpital Sainte-Anne, Université de Paris, Paris, France
| | - Wagih Ben Hassen
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neuroradiology, Hôpital Sainte-Anne, Université de Paris, Paris, France
| | - Corentin Provost
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neuroradiology, Hôpital Sainte-Anne, Université de Paris, Paris, France
| | - Olivier Naggara
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neuroradiology, Hôpital Sainte-Anne, Université de Paris, Paris, France
| | - Joseph Benzakoun
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neuroradiology, Hôpital Sainte-Anne, Université de Paris, Paris, France
| | - Pierre Seners
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neurology, Hôpital Sainte-Anne, Université de Paris, Paris, France
| | - Guillaume Turc
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neurology, Hôpital Sainte-Anne, Université de Paris, Paris, France
| | - Jean-Claude Baron
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neurology, Hôpital Sainte-Anne, Université de Paris, Paris, France
| | - Catherine Oppenheim
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neuroradiology, Hôpital Sainte-Anne, Université de Paris, Paris, France
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7
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Hughes JL, Beech JS, Jones PS, Wang D, Menon DK, Aigbirhio FI, Fryer TD, Baron JC. Early-stage 11C-Flumazenil PET predicts day-14 selective neuronal loss in a rodent model of transient focal cerebral ischemia. J Cereb Blood Flow Metab 2020; 40:1997-2009. [PMID: 31637947 PMCID: PMC7786851 DOI: 10.1177/0271678x19883040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Predicting tissue outcome early after stroke is an important goal. MRI >3 h accurately predicts infarction but is insensitive to selective neuronal loss (SNL). Previous studies suggest that chronic-stage 11C-flumazenil PET (FMZ-PET) is a validated marker of SNL in rats, while early-stage FMZ-PET may predict infarction. Whether early FMZ-PET also predicts SNL is unknown. Following 45-min distal MCA occlusion, adult rats underwent FMZ-PET at 1 h and 48 h post-reperfusion to map distribution volume (VT), which reflects GABA-A receptor binding. NeuN immunohistochemistry was performed at Day 14. In each rat, VT and %NeuN loss were determined in 44 ROIs spanning the hemisphere. NeuN revealed isolated SNL and cortical infarction in five and one rats, respectively. In the SNL subgroup, VT-1 h was mildly reduced and only weakly predicted SNL, while VT-48 h was significantly increased and predicted SNL both individually (p < 0.01, Kendall) and across the group (p < 0.001), i.e. the higher the VT, the stronger the SNL. Similar correlations were found in the rat with infarction. Our findings suggest GABA-A receptors are still present on injured neurons at the 48 h timepoint, and the increased 48 h VT observed here is consistent with earlier rat studies showing early GABA-A receptor upregulation. That FMZ binding at 48 h was predictive of SNL may have clinical implications.
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Affiliation(s)
- Jessica L Hughes
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - John S Beech
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK
| | - P Simon Jones
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Dechao Wang
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - David K Menon
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Franklin I Aigbirhio
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Tim D Fryer
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Jean-Claude Baron
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.,Inserm U1266, Paris Descartes University, Sainte-Anne Hospital, Paris, France
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8
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Saft M, Gonzales-Portillo B, Park YJ, Cozene B, Sadanandan N, Cho J, Garbuzova-Davis S, Borlongan CV. Stem Cell Repair of the Microvascular Damage in Stroke. Cells 2020; 9:cells9092075. [PMID: 32932814 PMCID: PMC7563611 DOI: 10.3390/cells9092075] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/20/2020] [Accepted: 09/04/2020] [Indexed: 02/07/2023] Open
Abstract
Stroke is a life-threatening disease that leads to mortality, with survivors subjected to long-term disability. Microvascular damage is implicated as a key pathological feature, as well as a therapeutic target for stroke. In this review, we present evidence detailing subacute diaschisis in a focal ischemic stroke rat model with a focus on blood–brain barrier (BBB) integrity and related pathogenic processes in contralateral brain areas. Additionally, we discuss BBB competence in chronic diaschisis in a similar rat stroke model, highlighting the pathological changes in contralateral brain areas that indicate progressive morphological brain disturbances overtime after stroke onset. With diaschisis closely approximating stroke onset and progression, it stands as a treatment of interest for stroke. Indeed, the use of stem cell transplantation for the repair of microvascular damage has been investigated, demonstrating that bone marrow stem cells intravenously transplanted into rats 48 h post-stroke survive and integrate into the microvasculature. Ultrastructural analysis of transplanted stroke brains reveals that microvessels display a near-normal morphology of endothelial cells and their mitochondria. Cell-based therapeutics represent a new mechanism in BBB and microvascular repair for stroke.
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Affiliation(s)
| | | | - You Jeong Park
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA; (Y.J.P.); (J.C.); (S.G.-D.)
| | | | | | - Justin Cho
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA; (Y.J.P.); (J.C.); (S.G.-D.)
| | - Svitlana Garbuzova-Davis
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA; (Y.J.P.); (J.C.); (S.G.-D.)
| | - Cesar V. Borlongan
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA; (Y.J.P.); (J.C.); (S.G.-D.)
- Correspondence: ; Tel.: +813-974-3988
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9
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Leftin A, Rosenberg JT, Yuan X, Ma T, Grant SC, Frydman L. Multiparametric classification of sub-acute ischemic stroke recovery with ultrafast diffusion, 23 Na, and MPIO-labeled stem cell MRI at 21.1 T. NMR IN BIOMEDICINE 2020; 33:e4186. [PMID: 31797472 PMCID: PMC8170591 DOI: 10.1002/nbm.4186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/11/2019] [Accepted: 07/22/2019] [Indexed: 05/05/2023]
Abstract
MRI leverages multiple modes of contrast to characterize stroke. High-magnetic-field systems enhance the performance of these MRI measurements. Previously, we have demonstrated that individually sodium and stem cell tracking metrics are enhanced at ultrahigh field in a rat model of stroke, and we have developed robust single-scan diffusion-weighted imaging approaches that utilize spatiotemporal encoding (SPEN) of the apparent diffusion coefficient (ADC) for these challenging field strengths. Here, we performed a multiparametric study of middle cerebral artery occlusion (MCAO) biomarker evolution focusing on comparison of these MRI biomarkers for stroke assessment during sub-acute recovery in rat MCAO models at 21.1 T. T2 -weighted MRI was used as the benchmark for identification of the ischemic lesion over the course of the study. The number of MPIO-induced voids measured by gradient-recalled echo, the SPEN measurement of ADC, and 23 Na MRI values were determined in the ischemic area and contralateral hemisphere, and relative performances for stroke classification were compared by receiver operator characteristic analysis. These measurements were associated with unique time-dependent trajectories during stroke recovery that changed the sensitivity and specificity for stroke monitoring during its evolution. Advantages and limitations of these contrasts, and the use of ultrahigh field for multiparametric stroke assessment, are discussed.
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Affiliation(s)
- Avigdor Leftin
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
- Department of Radiology, Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Jens T Rosenberg
- The National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, USA
| | - Xuegang Yuan
- FAMU-FSU Chemical and Biochemical Engineering, Florida State University, Tallahassee, FL, USA
| | - Teng Ma
- FAMU-FSU Chemical and Biochemical Engineering, Florida State University, Tallahassee, FL, USA
| | - Samuel C Grant
- The National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, USA
- FAMU-FSU Chemical and Biochemical Engineering, Florida State University, Tallahassee, FL, USA
| | - Lucio Frydman
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
- FAMU-FSU Chemical and Biochemical Engineering, Florida State University, Tallahassee, FL, USA
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10
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Camps T, Amat M, Manteca X. A Review of Medical Conditions and Behavioral Problems in Dogs and Cats. Animals (Basel) 2019; 9:E1133. [PMID: 31842492 PMCID: PMC6941081 DOI: 10.3390/ani9121133] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/06/2019] [Accepted: 12/09/2019] [Indexed: 12/11/2022] Open
Abstract
Not all animals behave identically when faced with the same situation. These individual differences in the expression of their behavior could be due to many factors, including medical conditions. These medical problems can change behavior directly or indirectly. The aims of this review are to describe the state of the art of the relationship among some medical and behavioral problems, and to propose new lines of investigation. The revision is focused on the relation between behavioral problems and pain, endocrine diseases, neurological problems, vomeronasal organ alterations, and cardiac disorders. These problems represent a diagnostic challenge from a practical point of view. The most common sign of pain in animals is a change in behavior. Although the relation of pain to behavioral problems has been widely studied, it is not absolutely clear. As an example, the relation between sleep disorders and pain is poorly known in veterinary medicine. New studies in humans and laboratory animals show that a reciprocal relationship does, in fact, exist. More specifically, the literature suggests that the temporal effect of sleep deprivation on pain may be stronger than that of pain on sleep. Some behavioral problems could modify the sleep-awake cycle (e.g., cognitive dysfunction). The impact of these behavioral problems on pain perception is completely unknown in dogs and cats. Thyroid hormones play an important role, regarding behavioral control. Both hypothyroidism and hyperthyroidism have been related to behavioral changes. Concerning hypothyroidism, this relationship remains controversial. Nonetheless, new neuro-imaging studies provide objective evidence that brain structure and function are altered in hypothyroid patients, both in laboratory animals and in humans. There are many neurological problems that could potentially change behavior. This paper reviews those neurological problems that could lead to behavioral changes without modifying neurological examination. The most common problems are tumors that affect central nervous system silent zones, mild traumatic brain injury, ischemic attacks, and epilepsy. Most of these diseases and their relationship to behavior are poorly studied in dogs and cats. To better understand the pathophysiology of all of these problems, and their relation to behavioral problems, may change the diagnostic protocol of behavioral problems.
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Affiliation(s)
- Tomàs Camps
- Etovets: Behavioral Medicine and Animal Welfare, 07010 Palma, Spain
| | - Marta Amat
- School of Veterinary Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain; (M.A.); (X.M.)
| | - Xavier Manteca
- School of Veterinary Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain; (M.A.); (X.M.)
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11
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Assessing the Effects of Cytoprotectants on Selective Neuronal Loss, Sensorimotor Deficit and Microglial Activation after Temporary Middle Cerebral Occlusion. Brain Sci 2019; 9:brainsci9100287. [PMID: 31652564 PMCID: PMC6827002 DOI: 10.3390/brainsci9100287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/18/2019] [Accepted: 10/20/2019] [Indexed: 01/21/2023] Open
Abstract
Although early reperfusion after stroke salvages the still-viable ischemic tissue, peri-infarct selective neuronal loss (SNL) can cause sensorimotor deficits (SMD). We designed a longitudinal protocol to assess the effects of cytoprotectants on SMD, microglial activation (MA) and SNL, and specifically tested whether the KCa3.1-blocker TRAM-34 would prevent SNL. Spontaneously hypertensive rats underwent 15 min middle-cerebral artery occlusion and were randomized into control or treatment group, which received TRAM-34 intraperitoneally for 4 weeks starting 12 h after reperfusion. SMD was assessed longitudinally using the sticky-label test. MA was quantified at day 14 using in vivo [11C]-PK111195 positron emission tomography (PET), and again across the same regions-of-interest template by immunofluorescence together with SNL at day 28. SMD recovered significantly faster in the treated group (p = 0.004). On PET, MA was present in 5/6 rats in each group, with no significant between-group difference. On immunofluorescence, both SNL and MA were present in 5/6 control rats and 4/6 TRAM-34 rats, with a non-significantly lower degree of MA but a significantly (p = 0.009) lower degree of SNL in the treated group. These findings document the utility of our longitudinal protocol and suggest that TRAM-34 reduces SNL and hastens behavioural recovery without marked MA blocking at the assessed time-points.
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12
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Crofts A, Kelly ME, Gibson CL. Imaging Functional Recovery Following Ischemic Stroke: Clinical and Preclinical fMRI Studies. J Neuroimaging 2019; 30:5-14. [PMID: 31608550 PMCID: PMC7003729 DOI: 10.1111/jon.12668] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/12/2019] [Accepted: 09/25/2019] [Indexed: 12/18/2022] Open
Abstract
Disability and effectiveness of physical therapy are highly variable following ischemic stroke due to different brain regions being affected. Functional magnetic resonance imaging (fMRI) studies of patients in the months and years following stroke have given some insight into how the brain recovers lost functions. Initially, new pathways are recruited to compensate for the lost region, showing as a brighter blood oxygen‐level‐dependent (BOLD) signal over a larger area during a task than in healthy controls. Subsequently, activity is reduced to baseline levels as pathways become more efficient, mimicking the process of learning typically seen during development. Preclinical models of ischemic stroke aim to enhance understanding of the biology underlying recovery following stroke. However, the pattern of recruitment and focusing seen in humans has not been observed in preclinical fMRI studies that are highly variable methodologically. Resting‐state fMRI studies show more consistency; however, there are still confounding factors to address. Anesthesia and method of stroke induction are the two main sources of variability in preclinical studies; improvements here can reduce variability and increase the intensity and reproducibility of the BOLD response detected by fMRI. Differences in task or stimulus and differences in analysis method also present a source of variability. This review compares clinical and preclinical fMRI studies of recovery following stroke and focuses on how refinement of preclinical models and MRI methods may obtain more representative fMRI data in relation to human studies.
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Affiliation(s)
- Andrew Crofts
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Michael E Kelly
- Preclinical Imaging Facility, Core Biotechnology Services, University of Leicester, Leicester, UK
| | - Claire L Gibson
- School of Psychology, University of Nottingham, Nottingham, UK
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13
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Akhoundzadeh K, Vakili A. Occurrence of priapism after transient right MCAO in Swiss albino mice. Somatosens Mot Res 2019; 36:151-155. [DOI: 10.1080/08990220.2019.1632182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Kobra Akhoundzadeh
- Faculty of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
- Physiology Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Abedin Vakili
- Physiology Research Center, Semnan University of Medical Sciences, Semnan, Iran
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14
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Wu Z, Hu J, Du F, Zhou X, Xiang Q, Miao F. Long-Term Changes of Diffusion Tensor Imaging and Behavioural Status after Acupuncture Treatment in Rats with Transient Focal Cerebral Ischaemia. Acupunct Med 2018; 30:331-8. [PMID: 23074236 DOI: 10.1136/acupmed-2012-010172] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background The effect of acupuncture treatment in cerebral ischaemia is controversial. A study was undertaken to assess its effects in rats with transient middle cerebral artery occlusion (tMCAO) and discuss its mechanisms. Methods 21 Sprague–Dawley rats were divided into three groups. Group 1 underwent tMCAO and subsequently received acupuncture treatment, Group 2 underwent tMCAO without treatment and Group 3 only underwent sham operation. The evolution of diffusion tensor imaging (DTI) features in ischaemic lesions from acute to chronic periods was assessed and the correlations with behavioural tests and histopathological changes were examined. Results tMCAO rats displayed side-specific sensorimotor deficits after occlusion. Behavioural scores of rats in group 1 reduced gradually with acupuncture treatment. No significant difference in lesion size on T2-weighted imaging was found between the two tMCAO groups. Relative apparent diffusion coefficient (rADC) and relative fractional anisotropy (rFA) values in the centre and at the edge of the ischaemic lesions reduced at first and then increased to varying degrees. Only changes in the rFA value at the edge of the ischaemic lesions were significantly different between the two tMCAO groups. A more significant increase in growth-associated protein B-50 and synaptophysin protein expression was found in group 1 than in the other groups. No significant correlations were found between behavioural scores, DTI appearances and immunohistochemical results. Conclusions The acupuncture points applied were effective, and improving neuronal regeneration may have a role in the mechanism of acupuncture treatment of post-stroke paralysis of the limbs in rats. MRI, particularly the fractional anisotropy value of DTI, is an appropriate parameter to evaluate the recovery status.
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Affiliation(s)
- Zhiyuan Wu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jinqing Hu
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Fang Du
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xiaoyan Zhou
- Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Qiongyao Xiang
- Department of Pathology, Cancer Hospital, Fudan University, Shanghai, People's Republic of China
| | - Fei Miao
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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15
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Brunner C, Korostelev M, Raja S, Montaldo G, Urban A, Baron JC. Evidence from functional ultrasound imaging of enhanced contralesional microvascular response to somatosensory stimulation in acute middle cerebral artery occlusion/reperfusion in rats: A marker of ultra-early network reorganization? J Cereb Blood Flow Metab 2018; 38:1690-1700. [PMID: 29972329 PMCID: PMC6168914 DOI: 10.1177/0271678x18786359] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Following middle cerebral artery (MCA) stroke, enhanced contralesional evoked responses have been consistently reported both in man and rodents as part of plastic processes thought to influence motor recovery. How early this marker of large-scale network reorganization develops has however been little addressed, yet has clinical relevance for rehabilitation strategies targeting plasticity. Previous work in mice has reported enhanced contralesional responses to unaffected-side forepaw stimulation as early as 45 min after MCA small branch occlusion. Using functional ultrasound imaging (fUSi) in anesthetized rats subjected to distal temporary MCA occlusion (MCAo), we assessed here (i) whether enhanced contralesional responses also occurred with unaffected-side whisker pad stimulation, and if so, how early after MCAo; and (ii) the time course of this abnormal response during occlusion and after reperfusion. We replicate in a more proximal MCA occlusion model the earlier findings of ultra-early enhanced contralesional evoked responses. In addition, we document this phenomenon within minutes after MCAo, and its persistence throughout the entire 90-min occlusion as well as 90-min reperfusion periods studied. These findings suggest that plastic processes may start within minutes following MCAo in rodents. If replicated in man, they might have implications regarding how early plasticity-enhancing therapies can be initiated after stroke.
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Affiliation(s)
- Clément Brunner
- 1 Inserm U894, Université Paris Descartes, Paris, France.,2 Neuro-Electronics Research Flanders (NERF; A Research Initiative by IMEC, VIB and KU Leuven), Catholic University Leuven, Leuven, Belgium
| | | | - Sushmitha Raja
- 1 Inserm U894, Université Paris Descartes, Paris, France
| | - Gabriel Montaldo
- 2 Neuro-Electronics Research Flanders (NERF; A Research Initiative by IMEC, VIB and KU Leuven), Catholic University Leuven, Leuven, Belgium
| | - Alan Urban
- 2 Neuro-Electronics Research Flanders (NERF; A Research Initiative by IMEC, VIB and KU Leuven), Catholic University Leuven, Leuven, Belgium
| | - Jean-Claude Baron
- 1 Inserm U894, Université Paris Descartes, Paris, France.,3 Department of Neurology, Hôpital Sainte-Anne, Paris, France
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16
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Andrews MMM, Peruzzaro S, Raupp S, Wilks J, Rossignol J, Dunbar GL. Using the behavioral flexibility operant task to detect long-term deficits in rats following middle cerebral artery occlusion. Behav Brain Res 2018; 356:1-7. [PMID: 30107224 DOI: 10.1016/j.bbr.2018.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/07/2018] [Accepted: 08/10/2018] [Indexed: 11/26/2022]
Abstract
Stroke is a leading cause of death and disability and currently only has one FDA approved pharmacological treatment (tissue plasminogen activator), which is only administered to a fraction of stroke patients due to contraindications. New treatments are desperately needed but most treatments fail in clinical trials, even after showing benefit in animal models of stroke. To increase the translatability of animal stroke research to humans, sensitive functional measures for both the acute and chronic stages in animal models of stroke are needed. The objective of this study was to determine the sensitivity of certain behavioral tasks, up to seven weeks following occlusion of the middle cerebral artery (MCAo) in rats. A battery of behavioral tasks, including rotorod, cylinder, and limb-placement, was conducted weekly for seven weeks. Also, a behavioral flexibility operant task was introduced at the end of the study to measure cognitive deficits. All functional outcome measures showed significant differences between stroke and control groups, indicating that these tasks are sensitive enough to detect deficits in a long-term MCAo study in rats. This provides useful information for those trying to increase translatability in their own stroke research by providing long-term sensitive testing paradigms in a relevant stroke model.
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Affiliation(s)
- Melissa M M Andrews
- Field Neurosciences Institute Laboratory for Restorative Neurology, Central Michigan University, Mount Pleasant, MI 48859, United States; Program in Neuroscience, Central Michigan University, Mount Pleasant, MI 48859, United States.
| | - Sarah Peruzzaro
- Field Neurosciences Institute Laboratory for Restorative Neurology, Central Michigan University, Mount Pleasant, MI 48859, United States; Program in Neuroscience, Central Michigan University, Mount Pleasant, MI 48859, United States.
| | - Shelby Raupp
- Program in Neuroscience, Central Michigan University, Mount Pleasant, MI 48859, United States; Department of Psychology, Central Michigan University, Mount Pleasant, MI 48859, United States.
| | - Jordin Wilks
- Program in Neuroscience, Central Michigan University, Mount Pleasant, MI 48859, United States; Department of Psychology, Central Michigan University, Mount Pleasant, MI 48859, United States.
| | - Julien Rossignol
- Field Neurosciences Institute Laboratory for Restorative Neurology, Central Michigan University, Mount Pleasant, MI 48859, United States; Program in Neuroscience, Central Michigan University, Mount Pleasant, MI 48859, United States; College of Medicine, Central Michigan University, Mount Pleasant, MI 48859, United States.
| | - Gary L Dunbar
- Field Neurosciences Institute Laboratory for Restorative Neurology, Central Michigan University, Mount Pleasant, MI 48859, United States; Program in Neuroscience, Central Michigan University, Mount Pleasant, MI 48859, United States; Department of Psychology, Central Michigan University, Mount Pleasant, MI 48859, United States; Field Neurosciences Inst., 4677 Towne Centre Rd. Suite 101 Saginaw, MI 48604, United States.
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17
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Baron JC. Mapping neuronal density in peri-infarct cortex with PET. Hum Brain Mapp 2017; 38:5822-5824. [PMID: 28731596 DOI: 10.1002/hbm.23733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/05/2017] [Accepted: 07/10/2017] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jean-Claude Baron
- Department of Neurology, Hopital Sainte-Anne, Inserm U894, Paris Descartes University, France.,Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom
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18
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Yi KS, Choi CH, Lee SR, Lee HJ, Lee Y, Jeong KJ, Hwang J, Chang KT, Cha SH. Sustained diffusion reversal with in-bore reperfusion in monkey stroke models: Confirmed by prospective magnetic resonance imaging. J Cereb Blood Flow Metab 2017; 37:2002-2012. [PMID: 27401804 PMCID: PMC5464696 DOI: 10.1177/0271678x16659302] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although early diffusion lesion reversal after recanalization treatment of acute ischaemic stroke has been observed in clinical settings, the reversibility of lesions observed by diffusion-weighted imaging remains controversial. Here, we present consistent observations of sustained diffusion lesion reversal after transient middle cerebral artery occlusion in a monkey stroke model. Seven rhesus macaques were subjected to endovascular transient middle cerebral artery occlusion with in-bore reperfusion confirmed by repeated prospective diffusion-weighted imaging. Early diffusion lesion reversal was defined as lesion reversal at 3 h after reperfusion. Sustained diffusion lesion reversal was defined as the difference between the ADC-derived pre-reperfusion maximal ischemic lesion volume (ADCD-P Match) and the lesion on 4-week follow-up FLAIR magnetic resonance imaging. Diffusion lesions were spatiotemporally assessed using a 3-D voxel-based quantitative technique. The ADCD-P Match was 9.7 ± 6.0% (mean ± SD) and the final infarct was 1.2-6.0% of the volume of the ipsilateral hemisphere. Early diffusion lesion reversal and sustained diffusion lesion reversal were observed in all seven animals, and the calculated percentages compared with their ADCD-P Match ranged from 8.3 to 51.9% (mean ± SD, 26.9 ± 15.3%) and 41.7-77.8% (mean ± SD, 65.4 ± 12.2%), respectively. Substantial sustained diffusion lesion reversal and early reversal were observed in all animals in this monkey model of transient focal cerebral ischaemia.
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Affiliation(s)
- Kyung Sik Yi
- 1 Department of Radiology, Chungbuk National University Hospital, Chungbuk, Republic of Korea
| | - Chi-Hoon Choi
- 1 Department of Radiology, Chungbuk National University Hospital, Chungbuk, Republic of Korea
| | - Sang-Rae Lee
- 2 National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, Republic of Korea
| | - Hong Jun Lee
- 3 Medical Research Institute, Chung-Ang University, Seoul, Korea
| | - Youngjeon Lee
- 2 National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, Republic of Korea
| | - Kang-Jin Jeong
- 2 National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, Republic of Korea
| | - Jinwoo Hwang
- 4 Clinical Science, Philips Healthcare, Seoul, Republic of Korea
| | - Kyu-Tae Chang
- 2 National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Chungbuk, Republic of Korea
| | - Sang-Hoon Cha
- 1 Department of Radiology, Chungbuk National University Hospital, Chungbuk, Republic of Korea.,5 College of Medicine, Chungbuk National University, Chungbuk, Republic of Korea
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19
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Brunner C, Isabel C, Martin A, Dussaux C, Savoye A, Emmrich J, Montaldo G, Mas JL, Baron JC, Urban A. Mapping the dynamics of brain perfusion using functional ultrasound in a rat model of transient middle cerebral artery occlusion. J Cereb Blood Flow Metab 2017; 37:263-276. [PMID: 26721392 PMCID: PMC5363744 DOI: 10.1177/0271678x15622466] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 01/07/2023]
Abstract
Following middle cerebral artery occlusion, tissue outcome ranges from normal to infarcted depending on depth and duration of hypoperfusion as well as occurrence and efficiency of reperfusion. However, the precise time course of these changes in relation to tissue and behavioral outcome remains unsettled. To address these issues, a three-dimensional wide field-of-view and real-time quantitative functional imaging technique able to map perfusion in the rodent brain would be desirable. Here, we applied functional ultrasound imaging, a novel approach to map relative cerebral blood volume without contrast agent, in a rat model of brief proximal transient middle cerebral artery occlusion to assess perfusion in penetrating arterioles and venules acutely and over six days thanks to a thinned-skull preparation. Functional ultrasound imaging efficiently mapped the acute changes in relative cerebral blood volume during occlusion and following reperfusion with high spatial resolution (100 µm), notably documenting marked focal decreases during occlusion, and was able to chart the fine dynamics of tissue reperfusion (rate: one frame/5 s) in the individual rat. No behavioral and only mild post-mortem immunofluorescence changes were observed. Our study suggests functional ultrasound is a particularly well-adapted imaging technique to study cerebral perfusion in acute experimental stroke longitudinally from the hyper-acute up to the chronic stage in the same subject.
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Affiliation(s)
- Clément Brunner
- Stroke Research Group, Centre de Psychiatrie et Neuroscience, INSERM U894, Hôpital Sainte-Anne, Paris, France.,SANOFI Research and Development, Lead Generation to Candidate Realization, Chilly-Mazarin, France
| | - Clothilde Isabel
- Stroke Research Group, Centre de Psychiatrie et Neuroscience, INSERM U894, Hôpital Sainte-Anne, Paris, France
| | - Abraham Martin
- Molecular Imaging Unit, CIC biomaGUNE, San Sebastián, Spain
| | - Clara Dussaux
- Stroke Research Group, Centre de Psychiatrie et Neuroscience, INSERM U894, Hôpital Sainte-Anne, Paris, France
| | - Anne Savoye
- Stroke Research Group, Centre de Psychiatrie et Neuroscience, INSERM U894, Hôpital Sainte-Anne, Paris, France
| | | | - Gabriel Montaldo
- Stroke Research Group, Centre de Psychiatrie et Neuroscience, INSERM U894, Hôpital Sainte-Anne, Paris, France
| | - Jean-Louis Mas
- Stroke Research Group, Centre de Psychiatrie et Neuroscience, INSERM U894, Hôpital Sainte-Anne, Paris, France
| | - Jean-Claude Baron
- Stroke Research Group, Centre de Psychiatrie et Neuroscience, INSERM U894, Hôpital Sainte-Anne, Paris, France
| | - Alan Urban
- Stroke Research Group, Centre de Psychiatrie et Neuroscience, INSERM U894, Hôpital Sainte-Anne, Paris, France
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Abstract
PURPOSE OF REVIEW This article provides an overview of the recent literature regarding the application of in-vivo brain imaging techniques to animal models of ischemic stroke. RECENT FINDINGS Major breakthroughs concerned the effects of sensory stimulation on neuronal function, local hemodynamics, and tissue outcome in the hyperacute phase of stroke; the novel application to stroke of hybrid scanners allowing simultaneous PET and magnetic resonance; the refinements of magnetic resonance-based oxygen imaging, allowing to map the ischemic penumbra in a completely noninvasive way; the implementation of new PET ligands to selectively map poststroke neuronal death and neuroinflammation; and the use of novel mesoscale imaging techniques to demonstrate the major role of interhemispheric connectivity in poststroke plasticity and functional recovery. SUMMARY The array of techniques to map in vivo the key pathophysiological brain processes involved in stroke is currently enlarging at an amazing pace. This is paralleled by ever-increasing sophistication in postprocessing tools. The combination of techniques allowing simultaneous access to several variables is particularly powerful as it affords unprecedented insights into the intimate processes underlying the tissue and neuronal changes that follow a stroke. These major leaps forward will hopefully lead to therapeutic breakthroughs aiming at improving functional outcome after stroke.
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Mandeville ET, Ayata C, Zheng Y, Mandeville JB. Translational MR Neuroimaging of Stroke and Recovery. Transl Stroke Res 2016; 8:22-32. [PMID: 27578048 DOI: 10.1007/s12975-016-0497-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/16/2016] [Accepted: 08/18/2016] [Indexed: 12/26/2022]
Abstract
Multiparametric magnetic resonance imaging (MRI) has become a critical clinical tool for diagnosing focal ischemic stroke severity, staging treatment, and predicting outcome. Imaging during the acute phase focuses on tissue viability in the stroke vicinity, while imaging during recovery requires the evaluation of distributed structural and functional connectivity. Preclinical MRI of experimental stroke models provides validation of non-invasive biomarkers in terms of cellular and molecular mechanisms, while also providing a translational platform for evaluation of prospective therapies. This brief review of translational stroke imaging discusses the acute to chronic imaging transition, the principles underlying common MRI methods employed in stroke research, and the experimental results obtained by clinical and preclinical imaging to determine tissue viability, vascular remodeling, structural connectivity of major white matter tracts, and functional connectivity using task-based and resting-state fMRI during the stroke recovery process.
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Affiliation(s)
- Emiri T Mandeville
- Neuroprotection Research Laboratory, Massachusetts General Hospital, Charlestown, MA, USA. .,Department of Radiology, Massachusetts General Hospital, Bldg 149 13th Street, Charlestown, MA, 02129, USA.
| | - Cenk Ayata
- Neurovascular Research Laboratory, Massachusetts General Hospital, Charlestown, MA, USA.,Department of Radiology, Massachusetts General Hospital, Bldg 149 13th Street, Charlestown, MA, 02129, USA
| | - Yi Zheng
- Neurovascular Research Laboratory, Massachusetts General Hospital, Charlestown, MA, USA.,Department of Radiology, Massachusetts General Hospital, Bldg 149 13th Street, Charlestown, MA, 02129, USA
| | - Joseph B Mandeville
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.,Department of Radiology, Massachusetts General Hospital, Bldg 149 13th Street, Charlestown, MA, 02129, USA
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22
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Zhang Y, Hao D, Lv X, Li S, Tian Y, Zheng D, Zeng Y. Quantification of MRI and MRS characteristics changes in a rat model at different stage of cerebral ischemia. Neurol Res 2016; 38:640-6. [PMID: 27214576 DOI: 10.1080/01616412.2016.1181345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND A better understanding the mechanisms of cerebral ischemia is important both for diagnosis and treatment. OBJECTIVE The study aimed to quantify several characteristics of magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) to indicate the brain tissue changes at different stage of cerebral ischemia in rats. METHODS In the present study, a rat model of cerebral ischemia was established by middle cerebral artery occlusion (MCAO) in the left hemisphere. MRI and MRS were performed on 15 Sprague Dawley rats 4 H, 24 H, and 1 W after MCAO. Apparent diffusion coefficient (ADC), relative ADC including FNR, PNR, PNF, and metabolite ratio NCC were proposed to reflect the changes of water diffusion and metabolism in brain tissue. RESULTS ADCs of focal zone and penumbra zone from 1 W group were significantly larger than those from 4H group, respectively (both p < 0.05). PNR and PNF of 24H and 1 W groups were significantly less than 4H group (all p < 0.01). NCCs of focal zone and penumbra zone were significantly less than the normal zone within 4H, 24H, and 1 W groups, respectively (both p < 0.01). While NCCs of penumbra zone from 24H and 1 W groups were significantly larger than 4H group (both p < 0.01). CONCLUSION We conclude that combination of MRI and MRS characteristics can provide significant indicators for ischemic damage at different stage of cerebral ischemia in a rat model.
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Affiliation(s)
- Yan Zhang
- a College of Life Science and Bioengineering , Beijing University of Technology , Beijing , China
| | - Dongmei Hao
- a College of Life Science and Bioengineering , Beijing University of Technology , Beijing , China
| | - Xiuhua Lv
- a College of Life Science and Bioengineering , Beijing University of Technology , Beijing , China
| | - Shaowu Li
- b Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Yunqing Tian
- c State Intellectual Property Office of the P.R.C , Beijing , China
| | - Dingchang Zheng
- d Faculty of Medical Science, Health and Wellbeing Academy , Anglia Ruskin University , Chelmsford , UK
| | - Yanjun Zeng
- b Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University , Beijing , China
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23
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Zhao B, Zou CJ, Zhou P. Delayed administration IL-1β neutralizing antibody improves cognitive function after transient global ischemia in rats. Behav Brain Res 2016; 303:53-60. [DOI: 10.1016/j.bbr.2016.01.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 01/06/2016] [Accepted: 01/10/2016] [Indexed: 12/23/2022]
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24
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Tiwari YV, Jiang Z, Sun Y, Du F, Rodriguez P, Shen Q, Duong TQ. Effects of stroke severity and treatment duration in normobaric hyperoxia treatment of ischemic stroke. Brain Res 2016; 1635:121-9. [PMID: 26826010 PMCID: PMC4779399 DOI: 10.1016/j.brainres.2016.01.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 01/15/2016] [Accepted: 01/19/2016] [Indexed: 11/26/2022]
Abstract
In order to improve clinical trial design and translation of normobaric oxygen (NBO) treatment of ischemic stroke, NBO treatment parameters need to be better understood. This study investigated NBO treatment efficacy at two different stroke severities and two NBO treatment durations in rats. For the 60-min middle cerebral artery occlusion (MCAO), NBO treatment for 25 min and 150 min were studied. For the 90-min MCAO, NBO treatment for 55 min and 150 min were studied. Cerebral blood flow (CBF), apparent diffusion coefficients (ADC) and T2 MRI were acquired during occlusion prior to treatment, after reperfusion, and 48h after MCAO. The effects of NBO treatment on lesion volumes, and CBF, ADC and T2 of ischemic core, perfusion-diffusion mismatch and normal tissue were analyzed longitudinally. The major findings were: i) NBO treatment was effective in both groups of stroke severities, salvaging similar percentage of initial abnormal ADC tissue, and ii) NBO treatments continued after reperfusion were more beneficial than NBO treatment during occlusion alone for both MCAO groups. These findings underscore the importance of the effects of NBO duration and stroke severity on treatment outcomes.
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Affiliation(s)
- Yash Vardhan Tiwari
- Research Imaging Institute, University of Texas Health Science Center, 8403 Floyd Curl Dr, San Antonio, TX 78229, USA; Department of Biomedical Engineering, University of Texas, San Antonio, TX, USA
| | - Zhao Jiang
- Research Imaging Institute, University of Texas Health Science Center, 8403 Floyd Curl Dr, San Antonio, TX 78229, USA
| | - Yuhao Sun
- Research Imaging Institute, University of Texas Health Science Center, 8403 Floyd Curl Dr, San Antonio, TX 78229, USA
| | - Fang Du
- Research Imaging Institute, University of Texas Health Science Center, 8403 Floyd Curl Dr, San Antonio, TX 78229, USA
| | - Pavel Rodriguez
- Research Imaging Institute, University of Texas Health Science Center, 8403 Floyd Curl Dr, San Antonio, TX 78229, USA
| | - Qiang Shen
- Research Imaging Institute, University of Texas Health Science Center, 8403 Floyd Curl Dr, San Antonio, TX 78229, USA
| | - Timothy Q Duong
- Research Imaging Institute, University of Texas Health Science Center, 8403 Floyd Curl Dr, San Antonio, TX 78229, USA.
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25
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Liu JM, Wu PF, Rao J, Zhou J, Shen ZC, Luo H, Huang JG, Liang X, Long LH, Xie QG, Jiang FC, Wang F, Chen JG. ST09, a Novel Thioester Derivative of Tacrine, Alleviates Cognitive Deficits and Enhances Glucose Metabolism in Vascular Dementia Rats. CNS Neurosci Ther 2016; 22:220-9. [PMID: 26813743 DOI: 10.1111/cns.12495] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 10/30/2015] [Accepted: 11/18/2015] [Indexed: 01/31/2023] Open
Abstract
AIMS Chemical entities containing mercapto group have been increasingly attractive in the therapy of central nerve system (CNS) diseases. In the recent study, we screened a series of mercapto-tacrine derivatives with synergistic neuropharmacological profiles in vitro. METHODS We investigated the effect and mechanism of ST09, a thioester derivative of tacrine containing a potential mercapto group, on the vascular dementia (VaD) model of rat induced by bilateral common carotid arteries occlusion (2-VO). RESULTS ST09 and its active metabolite ST10 retained excellent inhibition on acetylcholinesterase (AChE) activity. ST09 significantly attenuated the 2-VO-induced impairment in spatial acquisition performance and inhibited the 2-VO-induced rise of AChE activity. In the VaD model, ST09 attenuated the oxidative stress and decreased the apoptosis in the cortex and hippocampus. Compared with donepezil, ST09 exhibited a better effect on the regeneration of free thiols in 2-VO rats. Interestingly, ST09, not donepezil, greatly improved glucose metabolism in various brain regions of 2-VO rats using functional imaging of (18) F-labeled fluoro-deoxyglucose (FDG) positron emission tomography (PET). CONCLUSIONS ST09 may serve as a more promising agent for the therapy of VaD than tacrine owing to the introduction of a potential mercapto group into the parent skeleton.
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Affiliation(s)
- Jian-Min Liu
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng-Fei Wu
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,The Key Laboratory for Drug Target Researches and Pharmacodynamic Evaluation of Hubei Province, Wuhan, China.,Laboratory of Neuropsychiatric Diseases, The Institute of Brain Research, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Rao
- Department of Pharmaceutics, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Zhou
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zu-Cheng Shen
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Han Luo
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-Geng Huang
- Department of Pharmaceutics, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao Liang
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
| | - Li-Hong Long
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,The Key Laboratory for Drug Target Researches and Pharmacodynamic Evaluation of Hubei Province, Wuhan, China.,Laboratory of Neuropsychiatric Diseases, The Institute of Brain Research, Huazhong University of Science and Technology, Wuhan, China
| | - Qing-Guo Xie
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
| | - Feng-Chao Jiang
- Department of Medicinal Chemistry, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Wang
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,The Key Laboratory for Drug Target Researches and Pharmacodynamic Evaluation of Hubei Province, Wuhan, China.,Laboratory of Neuropsychiatric Diseases, The Institute of Brain Research, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-Guo Chen
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,The Key Laboratory for Drug Target Researches and Pharmacodynamic Evaluation of Hubei Province, Wuhan, China.,Laboratory of Neuropsychiatric Diseases, The Institute of Brain Research, Huazhong University of Science and Technology, Wuhan, China.,The Collaborative Innovation Center for Brain Science, Wuhan, China
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Ejaz S, Emmrich JV, Sitnikov SL, Hong YT, Sawiak SJ, Fryer TD, Aigbirhio FI, Williamson DJ, Baron JC. Normobaric hyperoxia markedly reduces brain damage and sensorimotor deficits following brief focal ischaemia. Brain 2016; 139:751-64. [PMID: 26767570 DOI: 10.1093/brain/awv391] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 11/16/2015] [Indexed: 01/02/2023] Open
Abstract
'True' transient ischaemic attacks are characterized not only clinically, but also radiologically by a lack of corresponding changes on magnetic resonance imaging. During a transient ischaemic attack it is assumed that the affected tissue is penumbral but rescued by early spontaneous reperfusion. There is, however, evidence from rodent studies that even brief focal ischaemia not resulting in tissue infarction can cause extensive selective neuronal loss associated with long-lasting sensorimotor impairment but normal magnetic resonance imaging. Selective neuronal loss might therefore contribute to the increasingly recognized cognitive impairment occurring in patients with transient ischaemic attacks. It is therefore relevant to consider treatments to reduce brain damage occurring with transient ischaemic attacks. As penumbral neurons are threatened by markedly constrained oxygen delivery, improving the latter by increasing arterial O2 content would seem logical. Despite only small increases in arterial O2 content, normobaric oxygen therapy experimentally induces significant increases in penumbral O2 pressure and by such may maintain the penumbra alive until reperfusion. Nevertheless, the effects of normobaric oxygen therapy on infarct volume in rodent models have been conflicting, although duration of occlusion appeared an important factor. Likewise, in the single randomized trial published to date, early-administered normobaric oxygen therapy had no significant effect on clinical outcome despite reduced diffusion-weighted imaging lesion growth during therapy. Here we tested the hypothesis that normobaric oxygen therapy prevents both selective neuronal loss and sensorimotor deficits in a rodent model mimicking true transient ischaemic attack. Normobaric oxygen therapy was applied from the onset and until completion of 15 min distal middle cerebral artery occlusion in spontaneously hypertensive rats, a strain representative of the transient ischaemic attack-prone population. Whereas normoxic controls showed normal magnetic resonance imaging but extensive cortical selective neuronal loss associated with microglial activation (present both at Day 14 in vivo and at Day 28 post-mortem) and marked and long-lasting sensorimotor deficits, normobaric oxygen therapy completely prevented sensorimotor deficit (P < 0.02) and near-completely Day 28 selective neuronal loss (P < 0.005). Microglial activation was substantially reduced at Day 14 and completely prevented at Day 28 (P = 0.002). Our findings document that normobaric oxygen therapy administered during ischaemia nearly completely prevents the neuronal death, microglial inflammation and sensorimotor impairment that characterize this rodent true transient ischaemic attack model. Taken together with the available literature, normobaric oxygen therapy appears a promising therapy for short-lasting ischaemia, and is attractive clinically as it could be started at home in at-risk patients or in the ambulance in subjects suspected of transient ischaemic attack/early stroke. It may also be a straightforward adjunct to reperfusion therapies, and help prevent subtle brain damage potentially contributing to long-term cognitive and sensorimotor impairment in at-risk populations.
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Affiliation(s)
- Sohail Ejaz
- 1 Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, UK
| | - Julius V Emmrich
- 1 Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, UK 2 Department of Neurology, Charité - Universitätsmedizin Berlin, Germany
| | - Sergey L Sitnikov
- 1 Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, UK
| | - Young T Hong
- 3 Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, UK
| | - Stephen J Sawiak
- 3 Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, UK
| | - Tim D Fryer
- 3 Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, UK
| | - Franklin I Aigbirhio
- 3 Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, UK
| | - David J Williamson
- 3 Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, UK
| | - Jean-Claude Baron
- 1 Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, UK 4 INSERM U894, Hôpital Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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27
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Garbuzova-Davis S, Haller E, Williams SN, Haim ED, Tajiri N, Hernandez-Ontiveros DG, Frisina-Deyo A, Boffeli SM, Sanberg PR, Borlongan CV. Compromised blood-brain barrier competence in remote brain areas in ischemic stroke rats at the chronic stage. J Comp Neurol 2015; 522:3120-37. [PMID: 24610730 DOI: 10.1002/cne.23582] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/28/2014] [Accepted: 03/05/2014] [Indexed: 12/14/2022]
Abstract
Stroke is a life-threatening disease leading to long-term disability in stroke survivors. Cerebral functional insufficiency in chronic stroke might be due to pathological changes in brain areas remote from the initial ischemic lesion, i.e., diaschisis. Previously, we showed that the damaged blood-brain barrier (BBB) was involved in subacute diaschisis. The present study investigated BBB competence in chronic diaschisis by using a transient middle cerebral artery occlusion (tMCAO) rat model. Our results demonstrated significant BBB damage mostly in the ipsilateral striatum and motor cortex in rats at 30 days after tMCAO. The BBB alterations were also determined in the contralateral hemisphere via ultrastructural and immunohistochemical analyses. Major BBB pathological changes in contralateral remote striatum and motor cortex areas included 1) vacuolated endothelial cells containing large autophagosomes, 2) degenerated pericytes displaying mitochondria with cristae disruption, 3) degenerated astrocytes and perivascular edema, 4) Evans blue extravasation, and 5) appearance of parenchymal astrogliosis. Discrete analyses of striatal and motor cortex areas revealed significantly higher autophagosome accumulation in capillaries of ventral striatum and astrogliosis in dorsal striatum in both cerebral hemispheres. These widespread microvascular alterations in ipsilateral and contralateral brain hemispheres suggest persistent and/or continued BBB damage in chronic ischemia. The pathological changes in remote brain areas likely indicate chronic ischemic diaschisis, which should be considered in the development of treatment strategies for stroke.
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Affiliation(s)
- Svitlana Garbuzova-Davis
- Center of Excellence for Aging and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, 33612; Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, 33612; Department of Molecular Pharmacology and Physiology, University of South Florida, Morsani College of Medicine, Tampa, Florida, 33612; Department of Pathology and Cell Biology, University of South Florida, Morsani College of Medicine, Tampa, Florida, 33612
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28
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Huang CH, Shih YYI, Siow TY, Hsu YH, Chen CCV, Lin TN, Jaw FS, Chang C. Temporal assessment of vascular reactivity and functionality using MRI during postischemic proangiogenenic vascular remodeling. Magn Reson Imaging 2015; 33:903-10. [PMID: 25944092 DOI: 10.1016/j.mri.2015.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 03/13/2015] [Accepted: 04/26/2015] [Indexed: 11/18/2022]
Abstract
Postischemic angiogenesis is an important recovery mechanism. Both arteries and veins are upregulated during angiogenesis, but eventually there are more angiogenic veins than arteries in terms of number and length. It is critical to understand how the veins are modulated after ischemia and then transitioned into angiogenic vessels during the proangiogenic stage to finally serve as a restorative strength to the injured area. Using a rat model of transient focal cerebral ischemia, the hypercapnic blood oxygen level-dependent (BOLD) response was used to evaluate vascular reactivity, while the hyperoxic BOLD and tissue oxygen level-dependent (TOLD) responses were used to evaluate the vascular functionality at 1, 3, and 7days after ischemia. Vessel-like venous signals appeared on R2* maps on days 3 and 7, but not on day 1. The large hypercapnic BOLD responses on days 3 and 7 indicated that these areas have high vascular reactivity. The temporal correlation between vascular reactivity and the immunoreactivity to desmin and VEGF further indicates that the integrity of vascular reactivity is associated with the pericyte coverage as regulated by the VEGF level. Vascular functionality remained low on days 1, 3, and 7, as reflected by the small hyperoxic BOLD and large hyperoxic TOLD responses, indicating the low oxygen consumption of the ischemic tissues. These functional changes in proangiogenic veins may be critical for angiogenesis.
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Affiliation(s)
- Chien-Hsiang Huang
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Yen-Yu Ian Shih
- Experimental Neuroimaging Laboratory, Department of Neurology and Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, USA
| | - Tiing-Yee Siow
- Department of Medical Imaging and Intervention, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Yi-Hua Hsu
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Chiao-Chi V Chen
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Teng-Nan Lin
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
| | - Chen Chang
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan.
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29
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Ejaz S, Williamson DJ, Jensen-Kondering U, Ahmed T, Sawiak SJ, Baron JC. What is the Optimal Duration of Middle-Cerebral Artery Occlusion Consistently Resulting in Isolated Cortical Selective Neuronal Loss in the Spontaneously Hypertensive Rat? Front Neurol 2015; 6:64. [PMID: 25859239 PMCID: PMC4374627 DOI: 10.3389/fneur.2015.00064] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 03/11/2015] [Indexed: 12/03/2022] Open
Abstract
Introduction and objectives: Selective neuronal loss (SNL) in the reperfused penumbra may impact clinical recovery and is thus important to investigate. Brief proximal middle cerebral artery occlusion (MCAo) results in predominantly striatal SNL, yet cortical damage is more relevant given its behavioral implications and that thrombolytic therapy mainly rescues the cortex. Distal temporary MCAo (tMCAo) does target the cortex, but the optimal occlusion duration that results in isolated SNL has not been determined. In the present study, we assessed different distal tMCAo durations looking for consistently pure SNL. Methods: Microclip distal tMCAo (md-tMCAo) was performed in ~6-month old male spontaneously hypertensive rats (SHRs). We previously reported that 45 min md-tMCAo in SHRs results in pan-necrosis in the majority of subjects. Accordingly, three shorter MCAo durations were investigated here in decremental succession, namely 30, 22, and 15 min (n = 3, 3, and 7 subjects, respectively). Recanalization was confirmed by MR angiography just prior to brain collection at 28 days and T2-weighted MRI was obtained for characterization of ischemic lesions. NeuN, OX42, and GFAP immunohistochemistry appraised changes in neurons, microglia, and astrocytes, respectively. Ischemic lesions were categorized into three main types: (1) pan-necrosis; (2) partial infarction; and (3) SNL. Results: Pan-necrosis or partial infarction was present in all 30 min and 22 min subjects, but not in the 15 min group (p < 0.001), in which isolated cortical SNL was consistently present. MRI revealed characteristic hyperintense abnormalities in all rats with pan-necrosis or partial infarction, but no change in any 15 min subject. Conclusion: We found that 15 min distal MCAo consistently resulted in pure cortical SNL, whereas durations equal or longer than 22 min consistently resulted in infarcts. This model may be of use to study the pathophysiology of cortical SNL and its prevention by appropriate interventions.
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Affiliation(s)
- Sohail Ejaz
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge , Cambridge , UK
| | - David J Williamson
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, Addenbrooke's Hospital, University of Cambridge , Cambridge , UK
| | - Ulf Jensen-Kondering
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge , Cambridge , UK
| | - Tahir Ahmed
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge , Cambridge , UK
| | - Steve J Sawiak
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, Addenbrooke's Hospital, University of Cambridge , Cambridge , UK
| | - Jean-Claude Baron
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge , Cambridge , UK ; INSERM U 894, Université Paris Descartes , Paris , France
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Ejaz S, Emmrich JV, Sawiak SJ, Williamson DJ, Baron JC. Cortical selective neuronal loss, impaired behavior, and normal magnetic resonance imaging in a new rat model of true transient ischemic attacks. Stroke 2015; 46:1084-92. [PMID: 25669312 DOI: 10.1161/strokeaha.114.007581] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE New-definition transient ischemic attacks (TIAs) are frequent but difficult to diagnose because magnetic resonance imaging (MRI)-negative by definition. However, hidden underlying cell damage might be present and account for the reported long-lasting cognitive impairment after TIAs. Most prior rodent models of true TIA targeted the striatum or have not been fully characterized. Here we present the MRI, behavioral, and quantitative cell changes characterizing a new rodent model of true TIA targeting the more behaviorally relevant cerebral cortex. METHODS Fifteen-minute distal middle cerebral artery occlusion was performed in 29 spontaneously hypertensive rats allowed to survive for 7 to 60 days. Behavior was assessed serially using both global neurological and fine sensorimotor tests. Diffusion- and T2-weighted MRI was obtained 20 min postreperfusion and again 7 to 60 days later, and then changes in neurons and microglia were quantified across the middle cerebral artery territory using immunohistochemistry. RESULTS No MRI changes or pan-necrosis were observed at any time point, but patchy cortical selective neuronal loss affected 28/29 rats, regardless of survival interval, together with topographically congruent microglial activation that gradually declined over time. The Neuroscore was unchanged, but there was marked contralateral sensorimotor impairment, still recovering by day 28. CONCLUSIONS Our new rodent model mimicking true cortical TIA is characterized by normal MRI, but consistent cortical selective neuronal loss and microglial activation and long-lasting sensorimotor deficits. By causing selective neuronal loss, TIAs and silent microemboli might affect neuronal reserve, thereby increasing long-term cognitive impairment risk. Selective neuronal loss and microglial activation might represent novel therapeutic targets that could be detectable in vivo after TIAs using appropriate imaging tracers.
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Affiliation(s)
- Sohail Ejaz
- From the Stroke Research Group, Department of Clinical Neurosciences (S.E., J.V.E., J.-C.B.), and Wolfson Brain Imaging Centre, Department of Clinical Neurosciences (S.J.S., D.J.W.), University of Cambridge; Department of Neurology, Charité-Universitätsmedizin Berlin, Germany (J.V.E.); and INSERM U894, Centre Hospitalier Sainte-Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.)
| | - Julius V Emmrich
- From the Stroke Research Group, Department of Clinical Neurosciences (S.E., J.V.E., J.-C.B.), and Wolfson Brain Imaging Centre, Department of Clinical Neurosciences (S.J.S., D.J.W.), University of Cambridge; Department of Neurology, Charité-Universitätsmedizin Berlin, Germany (J.V.E.); and INSERM U894, Centre Hospitalier Sainte-Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.)
| | - Stephen J Sawiak
- From the Stroke Research Group, Department of Clinical Neurosciences (S.E., J.V.E., J.-C.B.), and Wolfson Brain Imaging Centre, Department of Clinical Neurosciences (S.J.S., D.J.W.), University of Cambridge; Department of Neurology, Charité-Universitätsmedizin Berlin, Germany (J.V.E.); and INSERM U894, Centre Hospitalier Sainte-Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.)
| | - David J Williamson
- From the Stroke Research Group, Department of Clinical Neurosciences (S.E., J.V.E., J.-C.B.), and Wolfson Brain Imaging Centre, Department of Clinical Neurosciences (S.J.S., D.J.W.), University of Cambridge; Department of Neurology, Charité-Universitätsmedizin Berlin, Germany (J.V.E.); and INSERM U894, Centre Hospitalier Sainte-Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.)
| | - Jean-Claude Baron
- From the Stroke Research Group, Department of Clinical Neurosciences (S.E., J.V.E., J.-C.B.), and Wolfson Brain Imaging Centre, Department of Clinical Neurosciences (S.J.S., D.J.W.), University of Cambridge; Department of Neurology, Charité-Universitätsmedizin Berlin, Germany (J.V.E.); and INSERM U894, Centre Hospitalier Sainte-Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.).
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Emmrich JV, Ejaz S, Neher JJ, Williamson DJ, Baron JC. Regional distribution of selective neuronal loss and microglial activation across the MCA territory after transient focal ischemia: quantitative versus semiquantitative systematic immunohistochemical assessment. J Cereb Blood Flow Metab 2015; 35:20-7. [PMID: 25352044 PMCID: PMC4294404 DOI: 10.1038/jcbfm.2014.181] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/10/2014] [Accepted: 09/30/2014] [Indexed: 11/09/2022]
Abstract
Histopathologic assessment in transient middle cerebral artery occlusion (MCAo) rodent models generally lacks comprehensiveness and exposes to interobserver bias. Here we compared a novel quantitative assessment of regional infarction, selective neuronal loss (SNL) and microglial activation (MA) across the MCA territory to a previously published semiquantitative visual protocol. NeuN and OX42 immunohistochemistry was applied after either 15 or 45 minutes distal MCAo to maximize SNL and infarction, respectively. Survival times varied from 28 to 60 days to cover potential biases such as delayed tissue shrinkage. Damage was assessed using a template of 44 cytoarchitectonic regions of interest (ROIs) mapped onto a subset of digitized coronal sections spanning the MCA territory. For each ROI were obtained a semiquantitative visually determined index of histopathologic changes (method 1), and lpsilateral/contralesional ratios of remaining neurons and activated microglia cell counts (method 2). There was excellent agreement between the two methods for 28-day survival for both MCAo durations, whereas method 2 more sensitively detected subtle SNL and MA at 45 days and 60 days after 15-minute MCAo. Thus the visual method is accurate for usual degrees of ischemic damage, but absolute cell quantification is superior to detect subtle changes and should therefore be preferred in brief MCAo models, although requires optimal staining quality.
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Affiliation(s)
- Julius V Emmrich
- 1] Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, Cambridge, UK [2] Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sohail Ejaz
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, Cambridge, UK
| | - Jonas J Neher
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | - David J Williamson
- 1] Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, Cambridge, UK [2] Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Jean-Claude Baron
- 1] Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, Cambridge, UK [2] INSERM U894, Hôpital Sainte-Anne, Université Paris Descartes/Sorbonne Paris Cité, Paris, France
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Ansar S, Chatzikonstantinou E, Wistuba-Schier A, Mirau-Weber S, Fatar M, Hennerici MG, Meairs S. Characterization of a new model of thromboembolic stroke in C57 black/6J mice. Transl Stroke Res 2014; 5:526-33. [PMID: 24347404 PMCID: PMC4092233 DOI: 10.1007/s12975-013-0315-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 11/18/2013] [Accepted: 11/29/2013] [Indexed: 11/29/2022]
Abstract
This study characterizes a new model of thromboembolic stroke of the middle cerebral artery in C57 black/6J mice, thus offering an opportunity to use the model for studying ischemic stroke in transgenic mice. Thromboembolic stroke was induced by local injection of either 1.5 or 3.0 UI of thrombin directly into the right MCA of C57 black/6J mice. Cerebral blood flow (CBF) velocity was measured continuously by laser Doppler flowmetry, which allowed documentation of both MCA occlusion and of spontaneous recanalization. After 24 h, all animals were euthanized. Cryosections were cut at 400-μm intervals and silver stained with the high-contrast method for volumetric assessment of infarct size. Interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), caspase-3 and hsp 70 protein levels were investigated by immunofluorescence. Thrombin injection resulted in clot formation in all animals. Cortical infarction occurred in 63% of the mice while 37% had a spontaneous MCA recanalization during the first 20 min following thrombin injection. In cases of successful MCA occlusion with consequent infarction, the clot was stable up to 2 h after formation. Subsequently, 20% recanalized spontaneously. Infarctions were restricted to the cortex with a mean lesion volume of 36 ± 5 for 1.5 UI and 56 ± 8 for 3.0 UI thrombin. Protein levels of IL-6, TNF-α, caspase-3, and hsp 70 were significantly increased after MCAO. The results demonstrate that the mouse thromboembolic stroke model produces cortical infarctions of consistent size in C57 black/6J mice, which is dependent upon the amount of thrombin used for clot formation. Spontaneous MCA recanalization occurs after 2 h of ischemia in 20% of mice. Thus, the thromboembolic model is an applicable stroke model for C57 black/6J mice, which mimics many of the features of human stroke, including spontaneous recanalization. However, strain differences between Swiss and C57 black/6J mice must be taken into account when using the model.
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Affiliation(s)
- Saema Ansar
- Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Eva Chatzikonstantinou
- Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Anja Wistuba-Schier
- Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Silvia Mirau-Weber
- Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Marc Fatar
- Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Michael G. Hennerici
- Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Stephen Meairs
- Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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Ejaz S, Anwar K, Ashraf M. MRI and neuropathological validations of the involvement of air pollutants in cortical selective neuronal loss. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2014; 21:3351-3362. [PMID: 24234816 DOI: 10.1007/s11356-013-2294-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 10/24/2013] [Indexed: 05/28/2023]
Abstract
Vehicles are a major source of air pollution, especially particulate matter (PM) pollution, throughout the world and auto-rickshaws are considered main contributors to this air pollution. PM, in addition to causing respiratory and cardiovascular disorders, has potential to gain access to the brain and could induce neuroinflammation leading to different neurological disorders. Therefore, in the current project, MRI and immunohistochemistry techniques were adopted to ascertain the neurotoxic potential of the chronic exposure to different PM generated by two-stroke auto-rickshaws (TSA), four-stroke auto-rickshaws (FSA), and aluminum sulfate (AS) solution in rats. The results highlighted that all treated groups followed a pattern of dose-dependent increase in pure cortical neuronal loss, selective neuronal loss (SNL), nuclear pyknosis, karyolysis, and karyorrhexis. Mild to moderate areas of penumbra were also observed with increase in the population of activated microglia and astrocytes, while no alteration in the intensities of T2W MRI signals was perceived in any group. When comparing the findings, TSA possess more neurotoxic potential than FSA and AS, which could be associated with increased concentration of certain elements in TSA emissions. The study concludes that chronic exposure to PM from TSA, FSA, and AS solutions produces diverse neuropathies in the brain, which may lead to different life-threatening neurological disorders like stroke, Alzheimer's, and Parkinson's disorders. Government and environmental agencies should take serious notice of this alarming situation, and immediate steps should be implemented to improve the standards of PM emissions from auto-rickshaws.
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Canazza A, Minati L, Boffano C, Parati E, Binks S. Experimental models of brain ischemia: a review of techniques, magnetic resonance imaging, and investigational cell-based therapies. Front Neurol 2014; 5:19. [PMID: 24600434 PMCID: PMC3928567 DOI: 10.3389/fneur.2014.00019] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 02/06/2014] [Indexed: 01/17/2023] Open
Abstract
Stroke continues to be a significant cause of death and disability worldwide. Although major advances have been made in the past decades in prevention, treatment, and rehabilitation, enormous challenges remain in the way of translating new therapeutic approaches from bench to bedside. Thrombolysis, while routinely used for ischemic stroke, is only a viable option within a narrow time window. Recently, progress in stem cell biology has opened up avenues to therapeutic strategies aimed at supporting and replacing neural cells in infarcted areas. Realistic experimental animal models are crucial to understand the mechanisms of neuronal survival following ischemic brain injury and to develop therapeutic interventions. Current studies on experimental stroke therapies evaluate the efficiency of neuroprotective agents and cell-based approaches using primarily rodent models of permanent or transient focal cerebral ischemia. In parallel, advancements in imaging techniques permit better mapping of the spatial-temporal evolution of the lesioned cortex and its functional responses. This review provides a condensed conceptual review of the state of the art of this field, from models and magnetic resonance imaging techniques through to stem cell therapies.
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Affiliation(s)
- Alessandra Canazza
- Cerebrovascular Diseases Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta" , Milan , Italy
| | - Ludovico Minati
- Scientific Department, Fondazione IRCCS Istituto Neurologico "Carlo Besta" , Milan , Italy ; Brighton and Sussex Medical School , Brighton , UK
| | - Carlo Boffano
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta" , Milan , Italy
| | - Eugenio Parati
- Cerebrovascular Diseases Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta" , Milan , Italy
| | - Sophie Binks
- Brighton and Sussex Medical School , Brighton , UK ; Brighton and Sussex University Hospitals NHS Trust , Brighton , UK
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Present status and future challenges of electroencephalography- and magnetic resonance imaging-based monitoring in preclinical models of focal cerebral ischemia. Brain Res Bull 2014; 102:22-36. [PMID: 24462642 DOI: 10.1016/j.brainresbull.2014.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 01/07/2014] [Accepted: 01/14/2014] [Indexed: 12/16/2022]
Abstract
Animal models are useful tools for better understanding the mechanisms underlying neurological deterioration after an ischemic insult as well as subsequent evolution of changes and recovery of functions. In response to the updated requirements for preclinical investigations of stroke to include relevant functional measurement techniques and biomarker endpoints, we here review the state of knowledge on application of some translational electrophysiological and neuroimaging methods, and in particular, electroencephalography monitoring and magnetic resonance imaging in rodent models of ischemic stroke. This may lead to improvement of diagnostic methods and identification of new therapeutic targets, which would considerably advance the translational value of preclinical stroke research.
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36
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Ansar S, Chatzikonstantinou E, Thiagarajah R, Tritschler L, Fatar M, Hennerici MG, Meairs S. Pro-inflammatory mediators and apoptosis correlate to rt-PA response in a novel mouse model of thromboembolic stroke. PLoS One 2014; 9:e85849. [PMID: 24465746 PMCID: PMC3896417 DOI: 10.1371/journal.pone.0085849] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 10/21/2013] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND A recent study suggests that patients with persistent occlusion of the middle cerebral artery (MCA) following treatment with recombinant tissue plasminogen activator (rt-PA) have better outcomes than patients with MCA occlusion not receiving rt-PA. We performed a study to elucidate possible mechanisms of this finding in a new model of thromboembolic stroke closely mimicking human pathophysiology. METHODS Thromboembolic stroke was induced by local injection of thrombin directly into the right MCA of C57 black/6J mice. Rt-PA was administered 20 and 40 min after clot formation. The efficiency of rt-PA to induce thrombolysis was measured by laser Doppler. After 24 h, all animals were euthanized and interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase (MMP)-9, Caspase-3, hsp 32 and hsp 70 protein levels were investigated by immunofluorescence. Presence of hemorrhage was verified and infarct volume was measured using histology. RESULTS Thrombin injection resulted in clot formation giving rise to cortical brain infarction. Early rt-PA treatment starting at 20 min after the clot formation resulted in 100% recanalization. However, rt-PA-induced thrombolysis dissolved the clot in only 38% of the animals when administered 40 min after clot formation. Protein levels of IL-6, TNF-α, MMP-9, Caspase-3, hsp 32 and hsp 70 were increased after MCAO, whereas treatment with rt-PA attenuated the expressions of inflammatory markers in those animals where the thrombolysis was successful. In addition, the infarct size was significantly reduced with rt-PA treatment compared to non-treated MCAO, regardless of whether MCA thrombolysis was successful. CONCLUSIONS The present study demonstrates a clear correlation of the protein expression of inflammatory mediators, apoptosis and stress genes with the recanalization data after rt-PA treatment. In this model rt-PA treatment decreases the infarct size regardless of whether vessel recanalization is successful.
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Affiliation(s)
- Saema Ansar
- Department of Neurology, University Medicine Mannheim, Heidelberg University, Heidelberg, Germany
| | - Eva Chatzikonstantinou
- Department of Neurology, University Medicine Mannheim, Heidelberg University, Heidelberg, Germany
| | - Rushani Thiagarajah
- Department of Neurology, University Medicine Mannheim, Heidelberg University, Heidelberg, Germany
| | - Laurent Tritschler
- Department of Neurology, University Medicine Mannheim, Heidelberg University, Heidelberg, Germany
| | - Marc Fatar
- Department of Neurology, University Medicine Mannheim, Heidelberg University, Heidelberg, Germany
| | - Michael G. Hennerici
- Department of Neurology, University Medicine Mannheim, Heidelberg University, Heidelberg, Germany
| | - Stephen Meairs
- Department of Neurology, University Medicine Mannheim, Heidelberg University, Heidelberg, Germany
- * E-mail:
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Selective neuronal loss in ischemic stroke and cerebrovascular disease. J Cereb Blood Flow Metab 2014; 34:2-18. [PMID: 24192635 PMCID: PMC3887360 DOI: 10.1038/jcbfm.2013.188] [Citation(s) in RCA: 169] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 01/23/2023]
Abstract
As a sequel of brain ischemia, selective neuronal loss (SNL)-as opposed to pannecrosis (i.e. infarction)-is attracting growing interest, particularly because it is now detectable in vivo. In acute stroke, SNL may affect the salvaged penumbra and hamper functional recovery following reperfusion. Rodent occlusion models can generate SNL predominantly in the striatum or cortex, showing that it can affect behavior for weeks despite normal magnetic resonance imaging. In humans, SNL in the salvaged penumbra has been documented in vivo mainly using positron emission tomography and (11)C-flumazenil, a neuronal tracer validated against immunohistochemistry in rodent stroke models. Cortical SNL has also been documented using this approach in chronic carotid disease in association with misery perfusion and behavioral deficits, suggesting that it can result from chronic or unstable hemodynamic compromise. Given these consequences, SNL may constitute a novel therapeutic target. Selective neuronal loss may also develop at sites remote from infarcts, representing secondary 'exofocal' phenomena akin to degeneration, potentially related to poststroke behavioral or mood impairments again amenable to therapy. Further work should aim to better characterize the time course, behavioral consequences-including the impact on neurological recovery and contribution to vascular cognitive impairment-association with possible causal processes such as microglial activation, and preventability of SNL.
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Daadi MM, Hu S, Klausner J, Li Z, Sofilos M, Sun G, Wu JC, Steinberg GK. Imaging neural stem cell graft-induced structural repair in stroke. Cell Transplant 2013; 22:881-92. [PMID: 23044338 DOI: 10.3727/096368912x656144] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Stem cell therapy ameliorates motor deficits in experimental stroke model. Multimodal molecular imaging enables real-time longitudinal monitoring of infarct location, size, and transplant survival. In the present study, we used magnetic resonance imaging (MRI) and positron emission tomography (PET) to track the infarct evolution,tissue repair, and the fate of grafted cells. We genetically engineered embryonic stem cell-derived neural stem cells (NSCs) with a triple fusion reporter gene to express monomeric red fluorescence protein and herpes simplex virus-truncated thymidine kinase for multimodal molecular imaging and SPIO labeled for MRI. The infarct size as well as fate and function of grafted cells were tracked in real time for 3 months using MRI and PET. We report that grafted NSCs reduced the infarct size in animals with less than 0.1 cm(3) initial infarct in a dose-dependent manner, while larger stroke was not amenable to such beneficial effects. PET imaging revealed increased metabolic activity in grafted animals and visualized functioning grafted cells in vivo. Immunohistopathological analysis demonstrated that, after a 3-month survival period, grafted NSCs dispersed in the stroke-lesioned parenchyma and differentiated into neurons, astrocytes, and oligodendrocytes. Longitudinal multimodal imaging provides insights into time course dose-dependent interactions between NSC grafts and structural changes in infarcted tissue.
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Affiliation(s)
- Marcel M Daadi
- Department of Neurosurgery, Stanford Stroke Center and Stanford Institute for Neuro-Innovationand Translational Neurosciences, Stanford, CA, USA.
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Dijkhuizen RM. Imaging neuronal loss and recovery in compromised but viable brain tissue. Brain 2013; 136:1689-91. [DOI: 10.1093/brain/awt119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Carrera E, Jones PS, Morris RS, Alawneh J, Hong YT, Aigbirhio FI, Fryer TD, Carpenter TA, Warburton EA, Baron JC. Is neural activation within the rescued penumbra impeded by selective neuronal loss? Brain 2013; 136:1816-29. [DOI: 10.1093/brain/awt112] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Brain connectivity plasticity in the motor network after ischemic stroke. Neural Plast 2013; 2013:924192. [PMID: 23738150 PMCID: PMC3655657 DOI: 10.1155/2013/924192] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 04/07/2013] [Indexed: 01/06/2023] Open
Abstract
The motor function is controlled by the motor system that comprises a series of cortical and subcortical areas interacting via anatomical connections. The motor function will be disturbed when the stroke lesion impairs either any of these areas or their connections. More and more evidence indicates that the reorganization of the motor network including both areas and their anatomical and functional connectivity might contribute to the motor recovery after stroke. Here, we review recent studies employing models of anatomical, functional, and effective connectivity on neuroimaging data to investigate how ischemic stroke influences the connectivity of motor areas and how changes in connectivity relate to impaired function and functional recovery. We suggest that connectivity changes constitute an important pathophysiological aspect of motor impairment after stroke and important mechanisms of motor recovery. We also demonstrate that therapeutic interventions may facilitate motor recovery after stroke by modulating the connectivity among the motor areas. In conclusion, connectivity analyses improved our understanding of the mechanisms of motor recovery after stroke and may help to design hypothesis-driven treatment strategies and sensitive measures for outcome prediction in stroke patients.
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42
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Stroke neuroprotection: targeting mitochondria. Brain Sci 2013; 3:540-60. [PMID: 24961414 PMCID: PMC4061853 DOI: 10.3390/brainsci3020540] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 04/08/2013] [Accepted: 04/09/2013] [Indexed: 11/17/2022] Open
Abstract
Stroke is the fourth leading cause of death and the leading cause of long-term disability in the United States. Blood flow deficit results in an expanding infarct core with a time-sensitive peri-infarct penumbra that is considered salvageable and is the primary target for treatment strategies. The only current FDA-approved drug for treating ischemic stroke is recombinant tissue plasminogen activator (rt-PA). However, this treatment is limited to within 4.5 h of stroke onset in a small subset of patients. The goal of this review is to focus on mitochondrial-dependent therapeutic agents that could provide neuroprotection following stroke. Dysfunctional mitochondria are linked to neurodegeneration in many disease processes including stroke. The mechanisms reviewed include: (1) increasing ATP production by purinergic receptor stimulation, (2) decreasing the production of ROS by superoxide dismutase, or (3) increasing antioxidant defenses by methylene blue, and their benefits in providing neuroprotection following a stroke.
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Albach FN, Brunecker P, Usnich T, Villringer K, Ebinger M, Fiebach JB, Nolte CH. Complete Early Reversal of Diffusion-Weighted Imaging Hyperintensities After Ischemic Stroke Is Mainly Limited to Small Embolic Lesions. Stroke 2013; 44:1043-8. [DOI: 10.1161/strokeaha.111.676346] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Case reports have demonstrated complete early reversal of hyperintensities on diffusion-weighted imaging (DWI) after clinically diagnosed stroke. We aimed to investigate systematically the rate and characteristics of reversible diffusion hyperintensities (RDHs) in the first week after stroke.
Methods—
Patients with clinical diagnosis of an acute cerebrovascular event and evidence of ischemia on DWI were included. MRI scans were performed on admission, on the following day, and 4 to 7 days after onset of symptoms with DWI and fluid-attenuated inversion recovery. Baseline and follow-up DWIs were coregistered and examined for individual RDHs. Characteristics of patients and of hyperintensities associated with early reversal were identified.
Results—
We included 153 patients with a median National Institutes of Health Stroke Scale score of 4 (interquartile range, 2–8). In 3 patients (2%), MR images normalized completely. Thirty-seven patients (24%) displayed individual RDHs. Of 611 initial DWI hyperintensities, 97 (16%) reversed. Thirteen percent of the RDHs had corresponding abnormalities on fluid-attenuated inversion recovery images at the third measurement. Median size of the RDHs was 0.029 mL (interquartile range, 0.013–0.055). RDHs were associated with a multiple infarct pattern (odds ratio, 22.1; 95% confidence interval, 4.5–109.7) and symptomatic carotid stenosis (odds ratio, 5.5; 95% confidence interval, 1.4–21.5). Fifty-nine percent of the patients with RDHs had new additional lesions on follow-up DWI. RDHs were not associated with functional improvement on the National Institutes of Health Stroke Scale score.
Conclusions—
In this population of mainly minor to moderate stroke patients, complete normalization of MR images was rare. Complete reversal of individual DWI hyperintensities was limited to very small lesions and mostly occurred in embolic stroke patients.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00715533.
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Affiliation(s)
- Fredrik N. Albach
- From the Department of Neurology (F.N.A., T.U., M.E., C.H.N.) and Center for Stroke Research Berlin (P.B., K.V., M.E., J.B.F., C.H.N.), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Peter Brunecker
- From the Department of Neurology (F.N.A., T.U., M.E., C.H.N.) and Center for Stroke Research Berlin (P.B., K.V., M.E., J.B.F., C.H.N.), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tatiana Usnich
- From the Department of Neurology (F.N.A., T.U., M.E., C.H.N.) and Center for Stroke Research Berlin (P.B., K.V., M.E., J.B.F., C.H.N.), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Kersten Villringer
- From the Department of Neurology (F.N.A., T.U., M.E., C.H.N.) and Center for Stroke Research Berlin (P.B., K.V., M.E., J.B.F., C.H.N.), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Ebinger
- From the Department of Neurology (F.N.A., T.U., M.E., C.H.N.) and Center for Stroke Research Berlin (P.B., K.V., M.E., J.B.F., C.H.N.), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jochen B. Fiebach
- From the Department of Neurology (F.N.A., T.U., M.E., C.H.N.) and Center for Stroke Research Berlin (P.B., K.V., M.E., J.B.F., C.H.N.), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christian H. Nolte
- From the Department of Neurology (F.N.A., T.U., M.E., C.H.N.) and Center for Stroke Research Berlin (P.B., K.V., M.E., J.B.F., C.H.N.), Charité Universitätsmedizin Berlin, Berlin, Germany
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Ejaz S, Williamson DJ, Ahmed T, Sitnikov S, Hong YT, Sawiak SJ, Fryer TD, Aigbirhio FI, Baron JC. Characterizing infarction and selective neuronal loss following temporary focal cerebral ischemia in the rat: a multi-modality imaging study. Neurobiol Dis 2012; 51:120-32. [PMID: 23146994 DOI: 10.1016/j.nbd.2012.11.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 10/05/2012] [Accepted: 11/01/2012] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Current models dictate that, depending on occurrence of early reperfusion, the ischemic penumbra either undergoes or escapes infarction (i.e., "pan-necrosis"). However, tissue outcome following temporary middle-cerebral artery occlusion (tMCAo) in rodents can also include selective neuronal loss (SNL), which even if subtle may impede functional recovery. In order to explore the pathophysiology of ischemic stroke, determine potential therapeutic targets and monitor effects of therapy, in vivo imaging surrogates of these varied histopathological outcomes applicable in the clinical setting would be useful. Although hyperintense signal on T(2)-weighted MRI in the chronic post-stroke stage is considered a reliable surrogate of tissue infarction, SNL is not associated with T(2)W abnormal signal. In the clinical setting, the neuron-specific PET ligand (11)C-flumazenil (FMZ) has been used to identify both pan-necrosis and peri-infarct SNL, but this inference has not been histopathological confirmed so far. Here we investigated the late tissue sequelae of tMCAo in the rodent using in vivo T(2)W MRI and FMZ-PET against post mortem immunohistochemistry as gold standard. METHODS Adult spontaneously hypertensive rats (SHRs) underwent 45 min distal-clip middle-cerebral artery occlusion and, 28 days later, FMZ-PET and T(2)W-MRI, immediately followed by immunohistochemistry for neuronal loss (NeuN), activated microglia and astrocytosis. Based on standard histopathological definitions, ischemic lesions were classified into pan-necrosis, partial infarction or SNL. NeuN changes and FMZ binding across the whole hemisphere were quantified in the same set of 44 regions-of-interest according to previously validated protocols; linear regressions between these two measures were carried out both within and across subjects. RESULTS Both cortical pan-necrosis/partial infarction and SNL were present in all rats except one, where SNL was isolated and extensive. Infarction/partial infarction, but not SNL, was associated with T(2)W hyperintense signals and cortical atrophy. In contrast, FMZ binding was decreased in all types of lesions including SNL, in proportion with NeuN staining intensity both within (p<0.05 to <0.001) and across (p<0.001) subjects, including the subject that showed pure SNL (p=0.01). CONCLUSION This novel study revealed three main facts: i) long-term histopathological cortical changes following 45 min tMCAo in SHRs included all three of SNL, partial infarction and frank infarction; ii) T2W MRI showed conspicuous high signal lesions for complete or partial infarction, but no changes for SNL; and iii) FMZ-PET was sensitive to all three types of tMCAo-induced histopathological changes, including isolated SNL, suggesting it is a valid surrogate for the histological sequelae of focal cerebral ischemia. In addition, the finding of almost universal completed cortical infarction at 28 days differed from our previous findings at 14-day survival using the same model and rat strain, where SNL was the almost exclusive outcome, possibly representing delayed infarct maturation. Prospective studies are needed to investigate this interesting possibility.
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Affiliation(s)
- Sohail Ejaz
- Stroke Research Group, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
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Usnich T, Albach FN, Brunecker P, Fiebach JB, Nolte CH. Incidence of New Diffusion-Weighted Imaging Lesions Outside the Area of Initial Hypoperfusion Within 1 Week After Acute Ischemic Stroke. Stroke 2012; 43:2654-8. [DOI: 10.1161/strokeaha.112.655993] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
New diffusion-weighted imaging (DWI) lesions are common in patients with acute ischemic stroke. The pathophysiology of these new lesions is unclear. We differentiated new DWI lesions outside the area of initial hypoperfusion from those confined to the area of initial hypoperfusion.
Methods—
Patients with acute stroke underwent 3 MRI examinations: on admission, on the next day, and 4 to 7 days after symptom onset. Patients were included if a perfusion deficit was present on the initial scan. Lesions on DWI images were delineated manually. Coregistered DWI images were analyzed visually for new hyperintensities. In reference to the perfusion maps (mean transit time), patients were classified as having “outside lesions” if new DWI lesions were outside or both outside and inside the area of the initial perfusion deficit or “inside lesions” if new DWI lesions were completely inside.
Results—
We enrolled 164 patients. Thirty-eight patients (23%) had outside lesions and 34 patients (21%) had inside lesions. In multivariable regression analysis, new outside lesions were significantly associated with symptomatic carotid stenosis, multiple index lesions pattern, and high low-density lipoprotein levels. New inside lesions were significantly associated with (spontaneous or thrombolytic) vessel recanalization, multiple index lesions pattern, and low low-density lipoprotein levels.
Conclusion—
Outside and inside lesions represent different pathophysiological entities. More specifically patients with outside lesions may have an increased risk for subsequent cerebrovascular events.
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Affiliation(s)
- Tatiana Usnich
- From the Department of Neurology, Charite Benjamin Franklin Campus, Berlin, Germany (T.U., F.N.A., C.H.N.); and the Center for Stroke Research Berlin (CSB), Charité–Universitätsmedizin Berlin, Berlin, Germany (P.B., J.B.F., C.H.N.)
| | - Fredrik N. Albach
- From the Department of Neurology, Charite Benjamin Franklin Campus, Berlin, Germany (T.U., F.N.A., C.H.N.); and the Center for Stroke Research Berlin (CSB), Charité–Universitätsmedizin Berlin, Berlin, Germany (P.B., J.B.F., C.H.N.)
| | - Peter Brunecker
- From the Department of Neurology, Charite Benjamin Franklin Campus, Berlin, Germany (T.U., F.N.A., C.H.N.); and the Center for Stroke Research Berlin (CSB), Charité–Universitätsmedizin Berlin, Berlin, Germany (P.B., J.B.F., C.H.N.)
| | - Jochen B. Fiebach
- From the Department of Neurology, Charite Benjamin Franklin Campus, Berlin, Germany (T.U., F.N.A., C.H.N.); and the Center for Stroke Research Berlin (CSB), Charité–Universitätsmedizin Berlin, Berlin, Germany (P.B., J.B.F., C.H.N.)
| | - Christian H. Nolte
- From the Department of Neurology, Charite Benjamin Franklin Campus, Berlin, Germany (T.U., F.N.A., C.H.N.); and the Center for Stroke Research Berlin (CSB), Charité–Universitätsmedizin Berlin, Berlin, Germany (P.B., J.B.F., C.H.N.)
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Functional MRI and diffusion tensor imaging of brain reorganization after experimental stroke. Transl Stroke Res 2012; 3:36-43. [PMID: 22408692 PMCID: PMC3284658 DOI: 10.1007/s12975-011-0143-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 12/23/2011] [Accepted: 12/27/2011] [Indexed: 11/27/2022]
Abstract
The potential of the adult brain to reorganize after ischemic injury is critical for functional recovery and provides a significant target for therapeutic strategies to promote brain repair. Despite the accumulating evidence of brain plasticity, the interaction and significance of morphological and physiological modifications in post-stroke brain tissue remain mostly unclear. Neuroimaging techniques such as functional MRI (fMRI) and diffusion tensor imaging (DTI) enable in vivo assessment of the spatial and temporal pattern of functional and structural changes inside and outside ischemic lesion areas. This can contribute to the elucidation of critical aspects in post-stroke brain remodeling. Task/stimulus-related fMRI, resting-state fMRI, or pharmacological MRI enables direct or indirect measurement of neuronal activation, functional connectivity, or neurotransmitter system responses, respectively. DTI allows estimation of the structural integrity and connectivity of white matter tracts. Together, these MRI methods provide an unprecedented means to (a) measure longitudinal changes in tissue structure and function close by and remote from ischemic lesion areas, (b) evaluate the organizational profile of neural networks after stroke, and (c) identify degenerative and restorative processes that affect post-stroke functional outcome. Besides, the availability of MRI in clinical institutions as well as research laboratories provides an optimal basis for translational research on stroke recovery. This review gives an overview of the current status and perspectives of fMRI and DTI applications to study brain reorganization in experimental stroke models.
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Duong TQ. Multimodal MRI of experimental stroke. Transl Stroke Res 2011; 3:8-15. [PMID: 24323751 DOI: 10.1007/s12975-011-0140-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 12/01/2011] [Accepted: 12/05/2011] [Indexed: 10/14/2022]
Abstract
Stroke is the fourth leading cause of death and the leading cause of long-term disability in USA. Brain imaging data from experimental stroke models and stroke patients have shown that there is often a gradual progression of potentially reversible ischemic injury toward infarction. Reestablishing tissue perfusion and/or treating with neuroprotective drugs in a timely fashion are expected to salvage some ischemic tissues. Diffusion-weighted imaging based on magnetic resonance imaging (MRI) in which contrast is based on water motion can detect ischemic injury within minutes after onsets, whereas computed tomography and other imaging modalities fail to detect stroke injury for at least a few hours. Along with quantitative perfusion imaging, the perfusion-diffusion mismatch which approximates the ischemic penumbra could be imaged noninvasively. This review describes recent progresses in the development and application of multimodal MRI and image analysis techniques to study ischemic tissue at risk in experimental stroke in rats.
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Affiliation(s)
- Timothy Q Duong
- Research Imaging Institute, Departments of Ophthalmology, Radiology and Physiology, University of Texas Health Science Center, 8403 Floyd Curl Dr, San Antonio, TX, 78229, USA,
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Cheung JS, Wang X, Zhe Sun P. Magnetic resonance characterization of ischemic tissue metabolism. Open Neuroimag J 2011; 5:66-73. [PMID: 22216079 PMCID: PMC3245409 DOI: 10.2174/1874440001105010066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 02/23/2011] [Accepted: 03/13/2011] [Indexed: 11/22/2022] Open
Abstract
Magnetic resonance imaging (MRI) and spectroscopy (MRS) are versatile diagnostic techniques capable of characterizing the complex stroke pathophysiology, and hold great promise for guiding stroke treatment. Particularly, tissue viability and salvageability are closely associated with its metabolic status. Upon ischemia, ischemic tissue metabolism is disrupted including altered metabolism of glucose and oxygen, elevated lactate production/accumulation, tissue acidification and eventually, adenosine triphosphate (ATP) depletion and energy failure. Whereas metabolism impairment during ischemic stroke is complex, it may be monitored non-invasively with magnetic resonance (MR)-based techniques. Our current article provides a concise overview of stroke pathology, conventional and emerging imaging and spectroscopy techniques, and data analysis tools for characterizing ischemic tissue damage.
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Affiliation(s)
- Jerry S Cheung
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
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Brain irradiation improves focal cerebral ischemia recovery in aged rats. J Neurol Sci 2011; 306:143-53. [DOI: 10.1016/j.jns.2011.02.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 01/21/2011] [Accepted: 02/28/2011] [Indexed: 12/14/2022]
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Affiliation(s)
- Dae-Yul Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College Medicine, Korea
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