Longitudinal in vivo intrinsic optical imaging of cortical blood perfusion and tissue damage in focal photothrombosis stroke model

Discovery of orally bioavailable phenyltetrazolium derivatives for the acute treatment and the secondary prevention of ischemic stroke

The potential for secondary stroke prevention, which can significantly reduce the risk of recurrent strokes by almost 90%, underscores its critical importance. N-butylphthalide (NBP) has emerged as a promising treatment for acute cerebral ischemia, yet its efficacy for secondary stroke prevention is hindered by inadequate pharmacokinetic properties. This study, driven by a comprehensive structural analysis, the iterative process of structure optimization culminated in the identification of compound B4, which demonstrated exceptional neuroprotective efficacy and remarkable oral exposure and oral bioavailability. Notably, in an in vivo transient middle cerebral artery occlusion (tMCAO) model, B4 substantially attenuated infarct volumes, surpassing the effectiveness of NBP. While oral treatment with B4 exhibited stronger prevention potency than NBP in photothrombotic (PT) model. In summary, compound B4, with its impressive oral bioavailability and potent neuroprotective effects, offers promise for both acute ischemic stroke treatment and secondary stroke prevention.

Sex-Specific Acute Cerebrovascular Responses to Photothrombotic Stroke in Mice

Mechanisms underlying cerebrovascular stroke outcomes are poorly understood, and the effects of biological sex on cerebrovascular regulation post-stroke have yet to be fully comprehended. Here, we explore the overlapping roles of gonadal sex hormones and rho-kinase (ROCK), two important modulators of cerebrovascular tone, on the acute cerebrovascular response to photothrombotic (PT) focal ischemia in mice. Male mice were gonadectomized and female mice were ovariectomized to remove gonadal hormones, whereas control ("intact") animals received a sham surgery prior to stroke induction. Intact wild-type (WT) males showed a delayed drop in cerebral blood flow (CBF) compared with intact WT females, whereby maximal CBF drop was observed 48 h following stroke. Gonadectomy in males did not alter this response. However, ovariectomy in WT females produced a "male-like" phenotype. Intact Rock2+/- males also showed the same phenotypic response, which was not altered by gonadectomy. Alternatively, intact Rock2+/- females showed a significant difference in CBF values compared with intact WT females, displaying higher CBF values immediately post-stroke and showing a maximal CBF drop 48 h post-stroke. This pattern was not altered by ovariectomy. Altogether, these data illustrate sex differences in acute CBF responses to PT stroke, which seem to involve gonadal female sex hormones and ROCK2. Overall, this study provides a framework for exploring sex differences in acute CBF responses to focal ischemic stroke in mice.

Wearable optical coherence tomography angiography probe for freely moving mice

Optical coherence tomography (OCT) is an emerging optical imaging technology that holds great potential in medical and biological applications. Apart from its conventional ophthalmic uses, it has found extensive applications in studying various brain activities and disorders in anesthetized/restricted rodents, with a particular focus on visualizing brain blood vessel morphology and function. However, developing a compact wearable OCT probe for studying the brain activity/disorders in freely moving rodents is challenging due to the requirements for stability and lightweight design. Here, we report a robust wearable OCT probe, which, to the best of our knowledge, is the first wearable OCT angiography probe capable of long-term monitoring of mouse brain blood flow. This wearable imaging probe has a maximum scanning speed of 76 kHz, with a 12 µm axial resolution, 5.5 µm lateral resolution, and a large field of view (FOV) of 4 mm × 4 mm. It offers easy assembly and stable imaging, enabling it to capture brain vessels in freely moving rodents. We tested this probe to monitor cerebral hemodynamics for up to 4 hours during the acute ischemic phase after photothrombotic stroke in mice, highlighting the reliability and long-term stability of our probe. This work contributes to the advancement of wearable biomedical imaging.

Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations

Among the high prevalence of cerebrovascular diseases nowadays, acute ischemic stroke stands out, representing a significant worldwide health issue with important socio-economic implications. Prompt diagnosis and intervention are important milestones for the management of this multifaceted pathology, making understanding the various stroke-onset symptoms crucial. A key role in acute ischemic stroke management is emphasizing the essential role of a multi-disciplinary team, therefore, increasing the efficiency of recognition and treatment. Neuroimaging and neuroradiology have evolved dramatically over the years, with multiple approaches that provide a higher understanding of the morphological aspects as well as timely recognition of cerebral artery occlusions for effective therapy planning. Regarding the treatment matter, the pharmacological approach, particularly fibrinolytic therapy, has its merits and challenges. Endovascular thrombectomy, a game-changer in stroke management, has witnessed significant advances, with technologies like stent retrievers and aspiration catheters playing pivotal roles. For select patients, combining pharmacological and endovascular strategies offers evidence-backed benefits. The aim of our comprehensive study on acute ischemic stroke is to efficiently compare the current therapies, recognize novel possibilities from the literature, and describe the state of the art in the interdisciplinary approach to acute ischemic stroke. As we aspire for holistic patient management, the emphasis is not just on medical intervention but also on physical therapy, mental health, and community engagement. The future holds promising innovations, with artificial intelligence poised to reshape stroke diagnostics and treatments. Bridging the gap between groundbreaking research and clinical practice remains a challenge, urging continuous collaboration and research.

Target ischemic stroke model creation method using photoacoustic microscopy with simultaneous vessel monitoring and dynamic photothrombosis induction

The ischemic stroke animal model evaluates the efficacy of reperfusion and neuroprotective strategies for ischemic injuries. Various conventional methods have been reported to induce the ischemic models; however, controlling specific neurological deficits, mortality rates, and the extent of the infarction is difficult as the size of the affected region is not precisely controlled. In this paper, we report a single laser-based localized target ischemic stroke model development method by simultaneous vessel monitoring and photothrombosis induction using photoacoustic microscopy (PAM), which has minimized the infarct size at precise location with high reproducibility. The proposed method has significantly reduced the infarcted region by illuminating the precise localization. The reproducibility and validity of suggested method have been demonstrated through repeated experiments and histological analyses. These results demonstrate that our method can provide the ischemic stroke model closest to the clinical pathology for brain ischemia research from inducement, occurrence mechanisms to the recovery process.

Research and application advances in rehabilitation assessment of stroke

Stroke has a high incidence and disability rate, and rehabilitation is an effective means to reduce the disability rate of patients. To systematize rehabilitation assessment, which is the foundation for rehabilitation therapy, we summarize the assessment methods commonly used in research and clinical applications, including the various types of stroke rehabilitation scales and their applicability, and related biomedical detection technologies, including surface electromyography (sEMG), motion analysis systems, transcranial magnetic stimulation (TMS), magnetic resonance imaging (MRI), and combinations of different techniques. We also introduce some assessment techniques that are still in the experimental phase, such as the prospective application of artificial intelligence (AI) with optical correlation tomography (OCT) in stroke rehabilitation. This review provides a useful bibliography for the assessment of not only the severity of stroke injury, but also the therapeutic effects of stroke rehabilitation, and establishes a solid base for the future development of stroke rehabilitation skills.

Determination of significant parameters in remote ischemic postconditioning for ischemic stroke in experimental models: A systematic review and meta-analysis study

Objectives

To systematically review studies using remote ischemia postconditioning (RIPostC) for ischemic stroke in experimental models and obtain factors that significantly influence treatment outcomes.

Materials and Methods

Peer‐reviewed studies were identified and selected based on the eligibility criteria, followed by extraction of data on potentially influential factors related to model preparation, postconditioning, and measure time based on outcome measures including infarct size, neurological scales, and cell tests with autophagy, apoptosis, normal‐neuron, and damaged‐neuron counting. Then, all data were preprocessed, grouped, and meta‐analyzed with the indicator of the standardized mean difference.

Results

Fifty‐seven studies with 224 experiments (91 for infarct size, 92 for neurological scales, and 41 for cell‐level tests) were included. There was little statistical difference between different model preparations, treated body parts, number of treatments, and sides. And treatment effect was generally a positive correlation with the duration of conditioning time to stroke onset with exceptions at some time points. Based on infarct size, the number of cycles per treatment, duration of occlusion, and release per cycle showed significant differences. Combined with the effect sizes by other measures, the occlusion/release duration of 8–10 min per cycle is better than 5 min, and three cycles per treatment were most frequently used with good effects. Effect also varied when measuring at different times, showing statistical differences in infarct size and most neurological scales. RIPostC is confirmed as an effective therapeutic intervention for ischemic stroke, while the RIPostC‐mediated autophagy level being activated or inhibited remained conflicting.

Conclusions

Conditioning time, number of cycles per treatment, duration of occlusion, and release per cycle were found to influence the treatment effects of RIPostC significantly. More studies on the relevant influential factors and autophagy mechanisms are warranted.

A Long-Term Clearing Cranial Window for Longitudinal Imaging of Cortical and Calvarial Ischemic Injury through the Intact Skull

Skull is a reservoir for supplying immune cells that mediate brain immune surveillance. However, during intravital optical imaging of brain, conventional cranial windows requiring skull thinning or removal disrupt brain immunity integrity. Here, a novel long-term clearing cranial window (LCCW) based on the intact skull, dedicated to chronic skull transparency maintenance, is proposed. It significantly improves optical imaging resolution and depth, by which the cortical and calvarial vascular injury and regeneration processes after ischemic injury are longitudinally monitored in awake mice. Results show that calvarial blood vessels recover earlier than the cortex. And the transcriptome analysis reveals that gene expression patterns and immune cells abundances exist substantial differences between brain and skull after ischemic injury, which may be one of the causes for the time lag between their vascular recovery. These findings bring great enlightenment to vascular regeneration and reconstruction. Moreover, LCCW provides a minimally invasive approach for imaging the brain and skull bone marrow.

Optical clearing imaging assisted evaluation of urokinase thrombolytic therapy on cerebral vessels with different sizes

Ischemic stroke is caused by occlusion of the blood vessels in the brain, where intravenous thrombolytic therapy is the most effective treatment. Urokinase is a commonly used drug for intravenous thrombolytic therapy, while the effect of vessel size has not been thoroughly studied on urokinase. In this work, using the thrombin-combined photothrombosis model and craniotomy-free skull optical clearing window, we studied the recanalization of different cortical vessels after urokinase treatment. The results demonstrated that, compared to small vessels in distal middle cerebral artery (MCA) and large MCA, urokinase has the best therapeutic effect on secondary branches of MCA. This study holds potential to provide references for the clinical applications of urokinase.

Spatio-temporal analysis of EEG features during consciousness recovery in patients with disorders of consciousness

OBJECTIVE

As consciousness recovery is not only dynamic but also involves interactions between various brain regions, elucidating the mechanism of recovery requires tracking cortical activity in spatio-temporal dimensions.

METHODS

We tracked the cortical activities of 40 patients (mean age: 54.38 years; 28 males; 21 patients with minimally conscious states) with disorders of consciousness, and collected a total of 156 electroencephalographic signals. We investigated the longitudinal changes in EEG nonlinear dynamic features (i.e., approximate entropy, sample entropy, and Lempel-Ziv complexity) and relative wavelet energy along with consciousness recovery.

RESULTS

Global EEG features showed a non-monotonic trend during consciousness recovery (P < 0.05). When the level of consciousness of patients was transferred to a minimally conscious state from an unresponsive wakefulness syndrome/ vegetative state, an inflection point appeared in the EEG features. The EEG feature change trends between the injured and uninjured areas were dissimilar (P < 0.05). Importantly, the degree of dissimilarity increased non-monotonically across the levels of consciousness (P < 0.05).

CONCLUSIONS

EEG recovery was non-monotonic and dissimilar in spatio-temporal dimensions, with an inflection point.

SIGNIFICANCE

These findings further clarify the process of consciousness recovery and provide assistance in exploring the mechanism of consciousness recovery.

Longitudinal cortex-wide monitoring of cerebral hemodynamics and oxygen metabolism in awake mice using multi-parametric photoacoustic microscopy

Multi-parametric photoacoustic microscopy (PAM) has emerged as a promising new technique for high-resolution quantification of hemodynamics and oxygen metabolism in the mouse brain. In this work, we have extended the scope of multi-parametric PAM to longitudinal, cortex-wide, awake-brain imaging with the use of a long-lifetime (24 weeks), wide-field (5 × 7 mm²), light-weight (2 g), dual-transparency (i.e., light and ultrasound) cranial window. Cerebrovascular responses to the window installation were examined in vivo, showing a complete recovery in 18 days. In the 22-week monitoring after the recovery, no dura thickening, skull regrowth, or changes in cerebrovascular structure and function were observed. The promise of this technique was demonstrated by monitoring vascular and metabolic responses of the awake mouse brain to ischemic stroke throughout the acute, subacute, and chronic stages. Side-by-side comparison of the responses in the ipsilateral (injury) and contralateral (control) cortices shows that despite an early recovery of cerebral blood flow and an increase in microvessel density, a long-lasting deficit in cerebral oxygen metabolism was observed throughout the chronic stage in the injured cortex, part of which proceeded to infarction. This longitudinal, functional-metabolic imaging technique opens new opportunities to study the chronic progression and therapeutic responses of neurovascular diseases.

Assessment of tissue-specific changes in structure and function induced by in vivo skin/skull optical clearing techniques

BACKGROUND OBJECTIVES

Newly developed in vivo skin and skull optical clearing techniques can greatly improve the optical imaging performance, showing great advantages and clinical prospects. However, there is a poor understanding of in vivo optical clearing-induced changes in the skin and skull.

MATERIALS AND METHODS

Here, we employed in vivo skin/skull optical clearing techniques to improve the optical coherence tomography (OCT) imaging quality. And we also used polarization-sensitive OCT to monitor the dynamic changes in the polarization characteristics of the skin and skull during in vivo optical clearing processes. Two-photon imaging was used to evaluate changes in tissue barrier function and structure. Additionally, Raman spectra were employed for assessing the changes of each component in the skin and skull before and after optical clearing treatment.

RESULTS

The results indicated that the polarization states of the skin and skull were altered with the usages of optical clearing agents. And the barrier permeability and collagen fiber distribution of them became disordered. Furthermore, the Raman spectra of tissue demonstrated that the applications of in vivo tissue optical clearing methods could lead to the reduction of proteins, lipids, and inorganic salts in these two organs. Interestingly, after recovery treatment, the structure and function of the skin and skull could almost recover to the initial states.

CONCLUSION

In vivo tissue optical clearing can lead to changes in the structure and function of tissue, which was reversible to some extent. This study plays an important role in revealing the underlying mechanisms of tissue optical clearing techniques; moreover, it is conducive to the development and optimization of a novel in vivo tissue optical clearing approaches in future.

A Stretchable and Transparent Electrode Based on PEGylated Silk Fibroin for In Vivo Dual-Modal Neural-Vascular Activity Probing

Transparent electrodes that form seamless contact and enable optical interrogation at the electrode-brain interface are potentially of high significance for neuroscience studies. Silk hydrogels can offer an ideal platform for transparent neural interfaces owing to their superior biocompatibility. However, conventional silk hydrogels are too weak and have difficulties integrating with highly conductive and stretchable electronics. Here, a transparent and stretchable hydrogel electrode based on poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) and PEGylated silk protein is reported. PEGylated silk protein with poly(ethylene glycol) diglycidyl ether (PEGDE) improves the Young's modulus to 1.51-10.73 MPa and the stretchability to ≈400% from conventional silk hydrogels (<10 kPa). The PEGylated silk also helps form a robust interface with PEDOT:PSS thin film, making the hydrogel electrode synergistically incorporate superior stretchability (≈260%), stable electrical performance (≈4 months), and a low sheet resistance (≈160 ± 56 Ω sq^-1 ). Finally, the electrode facilitates efficient electrical recording, and stimulation with unobstructed optical interrogation and rat-brain imaging are demonstrated. The highly transparent and stretchable hydrogel electrode offers a practical tool for neuroscience and paves the way for a harmonized tissue-electrode interface.

Noninvasive OCT angiography-based blood attenuation measurements correlate with blood glucose level in the mouse retina

In this study, we investigated the correlation of the blood optical attenuation coefficient (OAC) and the blood glucose concentration (BGC). The blood OAC was measured in mouse retina in vivo by analyzing the depth attenuation of backscattered light under the guidance of OCT angiography (OCTA) vascular mapping, and then its correlation to the BGC was further investigated. The optical attenuation of the blood components presented a more reliable correlation to BGC than that of the background tissues. The arteries and veins presented a blood OAC change of ∼0.05-0.07 mm^-1 per 10 mg/dl and a significant (P < 0.001) elevation of blood OAC in diabetic mice was observed. Furthermore, different kinds of vessels also presented different performances. The veins had a higher correlation coefficient (R=0.86) between the measured blood OAC and BGC than that of the arteries (R=0.73). Besides, the blood OAC changes of the specific vessels occur without any obvious change in the vascular morphology in the retina. The blood OAC-BGC correlation suggests a concept of non-invasive OCTA-based glucometry, allowing a fast assessment of the blood glucose of specific vessels with superior motion immunity. A direct glucometry of the retina would be helpful for accurately monitoring the progression of diabetic retinopathy.

Three-dimensional remodeling of functional cerebrovascular architecture and gliovascular unit in leptin receptor-deficient mice

The cerebrovascular sequelae of diabetes render victims more susceptible to ischemic stroke, vascular cognitive impairment, and Alzheimer's disease. However, limited knowledge exists on the progressive changes in cerebrovascular structure and functional remodeling in type 2 diabetes. To ascertain the impact of diabetes on whole-brain cerebrovascular perfusion, leptin-receptor-deficient mice were transcardially injected with tomato-lectin before sacrifice. The whole brain was clarified by the Fast free-of-acrylamide clearing tissue technique. Functional vascular anatomy of the cerebrum was visualized by light-sheet microscopy, followed by analysis in Imaris software. We observed enhanced neovascularization in adult db/db mice, characterized by increased branch level and loop structures. Microvascular hypoperfusion was initially detected in juvenile db/db mice, suggesting early onset of insufficient microcirculation. Furthermore, gliovascular unit remodeling was verified by loss of pericytes and overactivation of microglia and astrocytes in adult diabetic mice. However, the integrity of the blood-brain barrier (BBB) was fundamentally preserved, as shown by a lack of extravasation of IgG into the brain parenchyma. In summary, we, for the first time, reveal that functional cerebrovascular remodeling occurs as early as four weeks in db/db mice and the deficit in gliovascular coupling may play a role in cerebral hypoperfusion before BBB breakdown in 16-week-old db/db mice.

Tissue Optical Clearing for Biomedical Imaging: From In Vitro to In Vivo

Tissue optical clearing technique provides a prospective solution for the application of advanced optical methods in life sciences. This chapter firstly gives a brief introduction to mechanisms of tissue optical clearing techniques, from the physical mechanism to chemical mechanism, which is the most important foundation to develop tissue optical clearing methods. During the past years, in vitro and in vivo tissue optical clearing methods were developed. In vitro tissue optical clearing techniques, including the solvent-based clearing methods and the hydrophilic reagents-based clearing methods, combined with labeling technique and advanced microscopy, can be applied to image 3D microstructure of tissue blocks or whole organs such as brain and spinal cord with high resolution. In vivo skin or skull optical clearing, promise various optical imaging techniques to detect cutaneous or cortical cell and vascular structure and function without surgical window.

Design and optimization of line-field optical coherence tomography at visible wavebands

Parallel line-field Fourier-domain optical coherence tomography (LF-FDOCT) has emerged to enable relatively higher speeds than the conventional FDOCT system. In the LF-FDOCT, one B-scan is captured at a time instead of scanning the beam to acquire hundreds of A-scans. On the other hand, spectroscopic OCT using the visible waveband provides absorption information over multiple wavelengths at each voxel. This information of spectral absorption enables quantitative measurement of blood oxygenation, voxel by voxel. Here, we presented the design and optimization of a LF-FDOCT system at the visible waveband (520-620 nm), especially using a generic Camera Link area sensor (2048 × 1088 pixels). To optimize the axial resolution and depth of imaging volume, we simulated various parameters and found that two Nyquist optima can exist, the origin and implication of which has been discussed. As a result, our system acquired 1088 A-scans in parallel at the camera's frame rate of 281 frame per second, achieving an equivalent rate of over 300,000 A-scan/s, while minimizing sacrifice in the point spread function (2.8 × 3.1 × 3.2 µm³, x × y × z) and the field of view (750 × 750 × 750 µm³). As an example of application, we presented high-speed imaging of blood oxygenation in the rodent brain cortex.

Design and optimization of line-field optical coherence tomography at visible wavebands

Parallel line-field Fourier-domain optical coherence tomography (LF-FDOCT) has emerged to enable relatively higher speeds than the conventional FDOCT system. In the LF-FDOCT, one B-scan is captured at a time instead of scanning the beam to acquire hundreds of A-scans. On the other hand, spectroscopic OCT using the visible waveband provides absorption information over multiple wavelengths at each voxel. This information of spectral absorption enables quantitative measurement of blood oxygenation, voxel by voxel. Here, we presented the design and optimization of a LF-FDOCT system at the visible waveband (520-620 nm), especially using a generic Camera Link area sensor (2048 × 1088 pixels). To optimize the axial resolution and depth of imaging volume, we simulated various parameters and found that two Nyquist optima can exist, the origin and implication of which has been discussed. As a result, our system acquired 1088 A-scans in parallel at the camera's frame rate of 281 frame per second, achieving an equivalent rate of over 300,000 A-scan/s, while minimizing sacrifice in the point spread function (2.8 × 3.1 × 3.2 µm³, x × y × z) and the field of view (750 × 750 × 750 µm³). As an example of application, we presented high-speed imaging of blood oxygenation in the rodent brain cortex.

Principles and requirements for stroke recovery science

The disappointing results in bench-to-bedside translation of neuroprotective strategies caused a certain shift in stroke research towards enhancing the endogenous recovery potential of the brain. One reason for this focus on recovery is the much wider time window for therapeutic interventions which is open for at least several months. Since recently two large clinical studies using d-amphetamine or fluoxetine, respectively, to enhance post-stroke neurological outcome failed again it is a good time for a critical reflection on principles and requirements for stroke recovery science. In principal, stroke recovery science deals with all events from the molecular up to the functional and behavioral level occurring after brain ischemia eventually ending up with any measurable improvement of various clinical parameters. A detailed knowledge of the spontaneously occurring post-ischemic regeneration processes is the indispensable prerequisite for any therapeutic approaches aiming to modify these responses to enhance post-stroke recovery. This review will briefly illuminate the molecular mechanisms of post-ischemic regeneration and the principle possibilities to foster post-stroke recovery. In this context, recent translational approaches are analyzed. Finally, the principal and specific requirements and pitfalls in stroke recovery research as well as potential explanations for translational failures will be discussed.

Improvement of Decorrelation-Based OCT Angiography by an Adaptive Spatial-Temporal Kernel in Monitoring Stimulus-Evoked Hemodynamic Responses

Complex decorrelation-based OCT angiography (OCTA) has the potential for monitoring hemodynamic activities in a label-free, high-resolution, and quantitative manner. To improve the measurement dynamic range and uncertainty of blood flow, an adaptive spatial-temporal (ST) kernel was proposed for decorrelation estimation and it was validated through a theoretical simulation and experimental measurements. The ensemble size in the decorrelation computation was effectively enlarged by collecting samples of the phasor pair in both the spatial and temporal dimensions. The spatial sub-kernel size was adaptively changed to suppress the influence of bulk motion in the temporal dimension by solving a maximum entropy model. Using the flow phantom, it was observed that the decorrelation dynamic range presented an increase of ~49% and the uncertainty exhibited a decrease of ~40% and ~38% in the saturation and background limits, respectively. In monitoring the stimulus-evoked hemodynamic response, the extended dynamic range enabled an improvement of ~180% in the separability between different stimulation modes. Furthermore, the suppressed uncertainty and motion artifacts allowed a reliable temporal analysis of the hemodynamic response. The proposed adaptive ST-kernel will greatly promote the development of decorrelation-based quantitative OCTA in hemodynamic studies.

Longitudinal in-vivo OCM imaging of glioblastoma development in the mouse brain

We present in-vivo imaging of the mouse brain using custom made Gaussian beam optical coherence microscopy (OCM) with 800nm wavelength. We applied new instrumentation to longitudinal imaging of the glioblastoma (GBM) tumor microvasculature in the mouse brain. We have introduced new morphometric biomarkers that enable quantitative analysis of the development of GBM. We confirmed quantitatively an intensive angiogenesis in the tumor area between 3 and 14 days after GBM cells injection confirmed by considerably increased of morphometric parameters. Moreover, the OCM setup revealed heterogeneity and abnormality of newly formed vessels.

Structural and Functional Remodeling of the Brain Vasculature Following Stroke

Maintenance of cerebral blood vessel integrity and regulation of cerebral blood flow ensure proper brain function. The adult human brain represents only a small portion of the body mass, yet about a quarter of the cardiac output is dedicated to energy consumption by brain cells at rest. Due to a low capacity to store energy, brain health is heavily reliant on a steady supply of oxygen and nutrients from the bloodstream, and is thus particularly vulnerable to stroke. Stroke is a leading cause of disability and mortality worldwide. By transiently or permanently limiting tissue perfusion, stroke alters vascular integrity and function, compromising brain homeostasis and leading to widespread consequences from early-onset motor deficits to long-term cognitive decline. While numerous lines of investigation have been undertaken to develop new pharmacological therapies for stroke, only few advances have been made and most clinical trials have failed. Overall, our understanding of the acute and chronic vascular responses to stroke is insufficient, yet a better comprehension of cerebrovascular remodeling following stroke is an essential prerequisite for developing novel therapeutic options. In this review, we present a comprehensive update on post-stroke cerebrovascular remodeling, an important and growing field in neuroscience, by discussing cellular and molecular mechanisms involved, sex differences, limitations of preclinical research design and future directions.

In vivo noninvasive measurement of spatially resolved corneal elasticity in human eyes using Lamb wave optical coherence elastography

Current elastography techniques are limited in application to accurately assess spatially resolved corneal elasticity in vivo for human eyes. The air-puff optical coherence elastography (OCE) with an eye motion artifacts correction algorithm is developed to distinguish the in vivo cornea vibration from the eye motion and visualize the Lamb wave propagation clearly in healthy subjects. Based on the Lamb wave model, the phase velocity dispersion curve in the high-frequency is calculated to obtain spatially resolved corneal elasticity accurately with high repeatability. It is found that the corneal elasticity has regional variations and is correlated with intraocular pressure, which suggests that the method has the potential to provide noninvasive measurement of spatially resolved corneal elasticity in clinical practice.

Apoptosis regulation in the penumbra after ischemic stroke: expression of pro- and antiapoptotic proteins

Ischemic stroke is the leading cause of human disability and mortality in the world. The main problem in stroke therapy is the search of efficient neuroprotector capable to rescue neurons in the potentially salvageable transition zone (penumbra), which is expanding after brain damage. The data on molecular mechanisms of penumbra formation and expression of diverse signaling proteins in the penumbra during first 24 h after ischemic stroke are discussed. Two basic features of cell death regulation in the ischemic penumbra were observed: (1) both apoptotic and anti-apoptotic proteins are simultaneously over-expressed in the penumbra, so that the fate of individual cells is determined by the balance between these opposite tendencies. (2) Similtaneous and concerted up-regulation in the ischemic penumbra of proteins that execute apoptosis (caspases 3, 6, 7; Bcl-10, SMAC/DIABLO, AIF, PSR), signaling proteins that regulate different apoptosis pathways (p38, JNK, DYRK1A, neurotrophin receptor p75); transcription factors that control expression of various apoptosis regulation proteins (E2F1, p53, c-Myc, GADD153); and proteins, which are normally involved in diverse cellular functions, but stimulate apoptosis in specific situations (NMDAR2a, Par4, GAD65/67, caspase 11). Hence, diverse apoptosis initiation and regulation pathways are induced simultaneously in penumbra from very different initial positions. Similarly, various anti-apoptotic proteins (Bcl-x, p21/WAF-1, MDM2, p63, PKBα, ERK1, RAF1, ERK5, MAKAPK2, protein phosphatases 1α and MKP-1, estrogen and EGF receptors, calmodulin, CaMKII, CaMKIV) are upregulated. These data provide an integral view of neurodegeneration and neuroprotection in penumbra. Some discussed proteins may serve as potential targets for anti-stroke therapy.

Automatic 3D adaptive vessel segmentation based on linear relationship between intensity and complex-decorrelation in optical coherence tomography angiography

Background

Vascular quantitative metrics have been widely used in the preclinical studies and clinical applications (e.g., the diagnosis and treatment of port wine stain, PWS), which require accurate vessel segmentation. An automatic 3D adaptive vessel segmentation is in need for a reproducible and objective quantification of the optical coherence tomography angiography (OCTA) image.

Methods

Human skin imaging was performed with a lab-built optical coherence tomography (OCT) system. Rather than separately applying the conventional 2-step (intensity and binarization) thresholding in the decorrelation-contrast OCTA, we proposed a 3D adaptive threshold using the linear relationship between the local intensity and complex-decorrelation which was termed as inverse SNR-decorrelation (ID) threshold. Furthermore, the ID threshold was automatically determined by defining a binary image similarity (BISIM) index as the feedback and searching the ID threshold with the minimal BISIM value. The proposed ID-BISIM threshold was applied to the acquired OCTA skin images for further vessel quantification.

Results

The proposed ID-BISIM threshold enabled a 3D adaptive binarization and presented superior sensitivity and specificity in vessel segmentation over conventional 2-step thresholding method in the decorrelation-contrast OCTA and a 37-65% improvement of the Youden's index in human skin experiments. The 3D binarization enabled a depth-resolved vessel skeleton and enhanced the differentiation of the overlapping vessels in the depth direction. Using ID-BISIM, the quantitative OCTA image presented a significant increase of vessel diameter index (P=0.0015) and vessel area density (VAD) (P=0.0485) as well as a significant decrease of vessel complexity index (VCI) (P=0.0094) in PWS lesion skin compared with normal skin.

Conclusions

The proposed ID-BISIM method enables an automatic 3D adaptive vessel segmentation with enhanced performance in quantitative OCTA. The vascular quantitative metrics would be a useful tool for improving the diagnosis and the treatment of PWS.

In vivo brain imaging with multimodal optical coherence microscopy in a mouse model of thromboembolic photochemical stroke

We used a new multimodal imaging system that combines optical coherence microscopy and brightfield microscopy. Using this in vivo brain monitoring approach and cranial window implantation, we three-dimensionally visualized the vascular network during thrombosis, with high temporal (18 s) and spatial (axial, 2.5    μ m ; lateral, 2.2    μ m ) resolution. We used a modified mouse model of photochemical thromboembolic stroke in order to more accurately parallel human stroke. Specifically, we applied green laser illumination to focally occlude a branch of the middle cerebral artery. Despite the recanalization of the superficial arteries at 24 h after stroke, no blood flow was detected in the small vessels within deeper regions. Moreover, after 24 h of stroke progression, scattering signal enhancement was observed within the stroke region. We also evaluated the infarct extent and shape histologically. In summary, we present a novel approach for real-time mouse brain monitoring and ischemic variability analysis. This multimodal imaging method permits the analysis of thrombosis progression and reperfusion. Additionally and importantly, the system could be used to study the effect of poststroke drug treatments on blood flow in small arteries and capillaries of the brain.

Correlation of optical attenuation coefficient estimated using optical coherence tomography with changes in astrocytes and neurons in a chronic photothrombosis stroke model

The optical attenuation coefficient (OAC) estimated using optical coherence tomography (OAC-OCT) offers a label-free 3D mapping of tissue infarction, but the physiological origin of the OAC contrast remains unclear. For effectively suppressing OAC fluctuations, we propose a hybrid (wavelength/angle) division multiplexing (HDM) method, which improved the OAC contrast by 70.7% in tissue phantoms. To test the feasibility of OAC-based infarction detection, triphenyltetrazolium chloride (TTC) staining was performed on fresh ex vivo brain slices, and the TTC-defined infarction was used as the ground truth. Sharp OAC contrast was observed between the TTC-defined infarction (1.09 mm-1) and normal tissue (0.79 mm-1). The OAC infarction spatially matched well with the TTC-defined infarction. To further explore the physiological origin of OAC contrast in ischemic stroke at the cellular level, the dynamic changes in OAC were measured in the rat cortex in vivo over 3 weeks after photothrombosis (PT) occlusion and found significantly correlated with the changes in astrocytes and neurons acquired with ex vivo hematoxylin and eosin (HE), glial fibrillary acidic protein (GFAP), and NeuN staining. These results suggest that OAC imaging enables non-invasive infarction detection and its contrast might originate from the changes in astrocytes and neurons in the chronic PT stroke model. The cellular responses revealed by in vivo OAC imaging would be essential for evaluating treatments and even developing novel therapies.

Increased Sample Entropy in EEGs During the Functional Rehabilitation of an Injured Brain

Complex nerve remodeling occurs in the injured brain area during functional rehabilitation after a brain injury; however, its mechanism has not been thoroughly elucidated. Neural remodeling can lead to changes in the electrophysiological activity, which can be detected in an electroencephalogram (EEG). In this paper, we used EEG band energy, approximate entropy (ApEn), sample entropy (SampEn), and Lempel-Ziv complexity (LZC) features to characterize the intrinsic rehabilitation dynamics of the injured brain area, thus providing a means of detecting and exploring the mechanism of neurological remodeling during the recovery process after brain injury. The rats in the injury group (n = 12) and sham group (n = 12) were used to record the bilateral symmetrical EEG on days 1, 4, and 7 after a unilateral brain injury in awake model rats. The open field test (OFT) experiments were performed in the following three groups: an injury group, a sham group, and a control group (n = 10). An analysis of the EEG data using the energy, ApEn, SampEn, and LZC features demonstrated that the increase in SampEn was associated with the functional recovery. After the brain injury, the energy values of the delta1 bands on day 4; the delta2 bands on days 4 and 7; the theta, alpha, and beta bands and the values of ApEn, SampEn, and LZC of the cortical EEG signal on days 1, 4 and 7 were significantly lower in the injured brain area than in the non-injured area. During the process of recovery for the injured brain area, the values of the beta bands, ApEn, and SampEn of the injury group increased significantly, and gradually became equal to the value of the sham group. The improvement in the motor function of the model rats significantly correlated with the increase in SampEn. This study provides a method based on EEG nonlinear features for measuring neural remodeling in injured brain areas during brain function recovery. The results may aid in the study of neural remodeling mechanisms.

Monitoring Acute Stroke Progression: Multi-Parametric OCT Imaging of Cortical Perfusion, Flow, and Tissue Scattering in a Mouse Model of Permanent Focal Ischemia

Cerebral ischemic stroke causes injury to brain tissue characterized by a complex cascade of neuronal and vascular events. Imaging during the early stages of its development allows prediction of tissue infarction and penumbra so that optimal intervention can be determined in order to salvage brain function impairment. Therefore, there is a critical need for novel imaging techniques that can characterize brain injury in the earliest phases of the ischemic stroke. This paper examined optical coherence tomography (OCT) for imaging acute injury in experimental ischemic stroke in vivo. Based on endogenous optical scattering signals provided by OCT imaging, we have developed a single, integrated imaging platform enabling the measurement of changes in blood perfusion, blood flow, erythrocyte velocity, and light attenuation within a cortical tissue, during focal cerebral ischemia in a mouse model. During the acute phase (from 5 min to the first few hours following the blood occlusion), the multi-parametric OCT imaging revealed multiple hemodynamic and tissue scattering responses in vivo, including cerebral blood flow deficits, capillary non-perfusion, displacement of penetrating vessels, and increased light attenuation in the cortical tissue at risk that are spatially correlated with the infarct core, as determined by postmortem staining with triphenyltetrazolium chloride. The use of multi-parametric OCT imaging may aid in the comprehensive evaluation of ischemic lesions during the early stages of stroke, thereby providing essential knowledge for guiding treatment decisions.