Alba Vieites-Prado1, Ramón Iglesias-Rey1, Héctor Fernández-Susavila1, Andrés da Silva-Candal1, Emilio Rodríguez-Castro1, Olli H J Gröhn1, Sven Wellmann1, Tomás Sobrino1, José Castillo2, Francisco Campos2. 1. From the Clinical Neurosciences Research Laboratory, Clinical University Hospital, Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Spain (A.V.-P., R.I.-R., H.F.-S., A.d.S.-C., E.R.-C., T.S., J.C., F.C.); Department of Neurobiology, AI Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio (O.H.J.G.); and Division of Neonatology, University of Basel Children's Hospital (UKBB), Switzerland (S.W.). 2. From the Clinical Neurosciences Research Laboratory, Clinical University Hospital, Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Spain (A.V.-P., R.I.-R., H.F.-S., A.d.S.-C., E.R.-C., T.S., J.C., F.C.); Department of Neurobiology, AI Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio (O.H.J.G.); and Division of Neonatology, University of Basel Children's Hospital (UKBB), Switzerland (S.W.). jose.castillo.sanchez@sergas.es francisco.campos.perez@sergas.es.
Abstract
BACKGROUND AND PURPOSE: Hypothermia is potentially the most effective protective therapy for brain ischemia; however, its use is limited because of serious side effects. Although focal hypothermia (FH) has a significantly lower stress profile than systemic hypothermia (SH), its efficacy in ischemia has been poorly studied. We aimed to compare the therapeutic effects of each treatment on various short- and long-term clinically relevant end points. METHODS: Sprague-Dawley rats were subjected to transient (45 minutes) occlusion of the middle cerebral artery. One hour after arterial reperfusion, animals were randomly assigned to groups for treatment with SH or FH (target temperature: 32°C) for 4 or 24 hours. Lesion volume, edema, functional recovery, and histological markers of cellular injury were evaluated for 1 month after ischemic injury. Effects of SH and FH on cerebral temperature were also analyzed for the first time by magnetic resonance thermometry, an approach that combines spectroscopy with gradient-echo-based phase mapping. RESULTS: Both therapeutic approaches reduced ischemic lesion volume (P<0.001), although a longer FH treatment (24 hours) was required to achieve similar protective effects to those induced by 4 hours of SH. In addition, magnetic resonance thermometry demonstrated that systemic hypothermia reduced whole-brain temperature, whereas FH primarily reduced the temperature of the ischemic region. CONCLUSIONS: Focal brain hypothermia requires longer cooling periods to achieve the same protective efficacy as SH. However, FH mainly affects the ischemic region, and therefore represents a promising and nonstressful alternative to SH.
BACKGROUND AND PURPOSE:Hypothermia is potentially the most effective protective therapy for brain ischemia; however, its use is limited because of serious side effects. Although focal hypothermia (FH) has a significantly lower stress profile than systemic hypothermia (SH), its efficacy in ischemia has been poorly studied. We aimed to compare the therapeutic effects of each treatment on various short- and long-term clinically relevant end points. METHODS:Sprague-Dawley rats were subjected to transient (45 minutes) occlusion of the middle cerebral artery. One hour after arterial reperfusion, animals were randomly assigned to groups for treatment with SH or FH (target temperature: 32°C) for 4 or 24 hours. Lesion volume, edema, functional recovery, and histological markers of cellular injury were evaluated for 1 month after ischemic injury. Effects of SH and FH on cerebral temperature were also analyzed for the first time by magnetic resonance thermometry, an approach that combines spectroscopy with gradient-echo-based phase mapping. RESULTS: Both therapeutic approaches reduced ischemic lesion volume (P<0.001), although a longer FH treatment (24 hours) was required to achieve similar protective effects to those induced by 4 hours of SH. In addition, magnetic resonance thermometry demonstrated that systemic hypothermia reduced whole-brain temperature, whereas FH primarily reduced the temperature of the ischemic region. CONCLUSIONS: Focal brain hypothermia requires longer cooling periods to achieve the same protective efficacy as SH. However, FH mainly affects the ischemic region, and therefore represents a promising and nonstressful alternative to SH.
Authors: Paulo Ávila-Gómez; María Pérez-Mato; Pablo Hervella; Antonio Dopico-López; Andrés da Silva-Candal; Ana Bugallo-Casal; Sonia López-Amoedo; María Candamo-Lourido; Tomás Sobrino; Ramón Iglesias-Rey; José Castillo; Francisco Campos Journal: J Clin Med Date: 2022-02-11 Impact factor: 4.241
Authors: Héctor Fernández-Susavila; Ramón Iglesias-Rey; Antonio Dopico-López; María Pérez-Mato; Tomás Sobrino; José Castillo; Francisco Campos Journal: Dis Model Mech Date: 2017-12-19 Impact factor: 5.758
Authors: Paulo Ávila-Gómez; Alba Vieites-Prado; Antonio Dopico-López; Saima Bashir; Héctor Fernández-Susavila; Carme Gubern; María Pérez-Mato; Clara Correa-Paz; Ramón Iglesias-Rey; Tomás Sobrino; Alejandro Bustamante; Sven Wellmann; Joan Montaner; Joaquín Serena; José Castillo; Pablo Hervella; Francisco Campos Journal: Brain Commun Date: 2020-06-04
Authors: R Iglesias-Rey; M Rodríguez-Yáñez; S Arias; M Santamaría; E Rodríguez-Castro; I López-Dequidt; P Hervella; T Sobrino; F Campos; J Castillo Journal: Eur J Neurol Date: 2018-06-15 Impact factor: 6.089
Authors: Ramón Iglesias-Rey; Andres da Silva-Candal; Manuel Rodríguez-Yáñez; Ana Estany-Gestal; Uxía Regueiro; Elena Maqueda; Paulo Ávila-Gómez; José Manuel Pumar; José Castillo; Tomás Sobrino; Francisco Campos; Pablo Hervella Journal: Transl Stroke Res Date: 2021-06-24 Impact factor: 6.829