Early Thalamocortical Reperfusion Leads to Neurologic Recovery in a Rodent Cardiac Arrest Model.
Early Thalamocortical Reperfusion Leads to Neurologic Recovery in a Rodent Cardiac Arrest Model.
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DOI：
10.1007/s12028-021-01432-9
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发表时间：
2022-08
影响因子：
3.5
通讯作者：
中科院分区：
文献类型：
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作者：
脑血流量（CBF）在心脏骤停（CA）复苏后神经功能恢复中起重要作用。然而，不同脑区CBF恢复的变化及其与自主循环恢复（ROSC）后神经功能恢复的相关性尚未得到表征。本研究旨在探讨复苏后局部脑再灌注特征对神经功能恢复的预测作用。12只成年雄性Wistar大鼠，其中10只从7分钟窒息CA中复苏，2只作为健康对照（HC）。通过伪连续动脉自旋标记磁共振成像（MRI）评估大脑皮层、海马、丘脑、脑干和小脑中CBF的动态变化，从ROSC后60分钟开始至156分钟（或自发觉醒时间）。在ROSC后24小时，盲法检查者使用神经功能缺损量表（NDS）评估结局。rCBF和神经功能恢复之间的相关性进行了研究。发现所有CA后动物在ROSC后60- 156分钟内无反应，与HC相比，rCBF降低24 - 42%。在ROSC后60- 156分钟时间窗内的rCBF分析显示，海马和丘脑的rCBF恢复与更好的神经功能结局呈正相关（分别为rs=0.82，p=0.004和rs=0.73，p<0.001）。在唤醒前96分钟内，丘脑和皮层rCBF与神经功能恢复呈正相关（分别为rs=0.80，p<0.001和rs=0.65，p<0.001）;丘脑rCBF阈值高于50.84 ml/100 g/min时，可预测良好的神经功能结局（HC的34%）（AUC=0.96），而皮质rCBF阈值高于60.43 ml/100 g/min（HC的38%）（AUC=0.88）。早期MRI分析显示，ROSC后丘脑、海马和皮质的早期rCBF恢复与24小时的神经功能结局呈正相关。我们的研究结果表明，新的翻译见解的区域再灌注和时间窗口，可能是至关重要的神经恢复，并保证进一步验证。
Cerebral blood flow (CBF) plays an important role in neurological recovery after cardiac arrest (CA) resuscitation. However, variation of CBF recovery in distinct brain regions and its correlation with neurologic recovery after return of spontaneous circulation (ROSC) have not been characterized. This study aimed to investigate the characteristics of regional cerebral reperfusion following resuscitation in predicting neurological recovery. Twelve adult male Wistar rats were studied, 10 resuscitated from 7-min asphyxial CA and 2 uninjured rats as healthy control (HC). Dynamic changes in CBF in cerebral cortex, hippocampus, thalamus, brainstem and cerebellum were assessed by pseudo-continuous arterial spin-labeling magnetic resonance imaging (MRI), starting at 60-min after ROSC to 156-min (or time to spontaneous arousal). A blinded examiner evaluated outcomes using neurologic deficit scale (NDS) at 24-h post-ROSC. Correlations between rCBF and neurological recovery were undertaken. All post-CA animals were found to be nonresponsive during the 60- to 156-min post-ROSC, with reductions in rCBF by 24 to 42% versus HC. Analyses of rCBF during the post-ROSC time window from 60- to 156-min showed the rCBF recovery of hippocampus and thalamus were positively associated with better neurological outcomes (rs=0.82, p=0.004 and rs=0.73, p<0.001, respectively). During 96 minutes before arousal, thalamic and cortical rCBF exhibited positive correlations with neurological recovery (rs=0.80, p<0.001 and rs=0.65, p<0.001, respectively); for predicting a favorable neurological outcome, the thalamic rCBF threshold was above 50.84 ml/100g/min (34% of HC) (AUC=0.96), while the cortical rCBF threshold was above 60.43 ml/100g/min (38% of HC) (AUC=0.88). Early MRI analyses showed early rCBF recovery in thalamus, hippocampus and cortex post-ROSC was positively correlated with neurological outcomes at 24-h. Our findings suggest new translational insights into the regional reperfusion and the time-window that may be critical in neurological recovery and warrant further validation.
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影响因子：
5.3
作者：
Forgacs PB;Frey HP;Velazquez A;Thompson S;Brodie D;Moitra V;Rabani L;Park S;Agarwal S;Falo MC;Schiff ND;Claassen J
通讯作者：
Claassen J
影响因子：
1.6
作者：
Jang, Sung Ho;Hyun, Yi Ji;Lee, Han Do
通讯作者：
Lee, Han Do
影响因子：
8.3
作者：
Fisher M;Feuerstein G;Howells DW;Hurn PD;Kent TA;Savitz SI;Lo EH;STAIR Group
通讯作者：
STAIR Group
使用ASL-MRI，在大鼠中，进入脑血流与心室纤颤后的脑血流的全球和区域差异。
影响因子：
6.5
作者：
Drabek T;Foley LM;Janata A;Stezoski J;Hitchens TK;Manole MD;Kochanek PM
通讯作者：
Kochanek PM
影响因子：
6.5
作者：
Geocadin, RG;Sherman, DL;Hanley, DF
通讯作者：
Hanley, DF