Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts 02129, USA.
J Cereb Blood Flow Metab. 2012 Sep;32(9):1800-9. doi: 10.1038/jcbfm.2012.87. Epub 2012 Jun 27.
Studies suggest that neuroprotective effects of normobaric oxygen (NBO) therapy in acute stroke are partly mediated by hemodynamic alterations. We investigated cerebral hemodynamic effects of repeated NBO exposures. Serial magnetic resonance imaging (MRI) was performed in Wistar rats subjected to focal ischemic stroke. Normobaric oxygen-induced functional cerebral blood volume (fCBV) responses were analyzed. All rats had diffusion-weighted MRI (DWI) lesions within larger perfusion deficits, with DWI lesion expansion after 3 hours. Functional cerebral blood volume responses to NBO were spatially and temporally heterogeneous. Contralateral healthy tissue responded consistently with vasoconstriction that increased with time. No significant responses were evident in the acute DWI lesion. In hypoperfused regions surrounding the acute DWI lesion, tissue that remained viable until the end of the experiment showed relative preservation of mean fCBV at early time points, with some rats showing increased fCBV (vasodilation); however, these regions later exhibited significantly decreased fCBV (vasoconstriction). Tissue that became DWI abnormal by study-end initially showed marginal fCBV changes that later became moderate fCBV reductions. Our results suggest that a reverse-steal hemodynamic effect may occur in peripheral ischemic zones during NBO treatment of focal stroke. In addition, CBV responses to NBO challenge may have potential as an imaging marker to distinguish ischemic core from salvageable tissues.
研究表明,常压氧(NBO)治疗急性中风的神经保护作用部分是通过血液动力学改变介导的。我们研究了重复 NBO 暴露对脑血流动力学的影响。在局灶性缺血性中风的 Wistar 大鼠中进行了连续磁共振成像(MRI)。分析了常压氧诱导的功能性脑血容量(fCBV)反应。所有大鼠在较大的灌注缺损范围内均有弥散加权 MRI(DWI)病变,在 3 小时后 DWI 病变扩大。NBO 的功能性脑血流反应在空间和时间上均存在异质性。对侧健康组织始终表现为收缩,且随时间增加而增加。在急性 DWI 病变中未见明显反应。在急性 DWI 病变周围的低灌注区域,在实验结束时仍存活的组织在早期表现出平均 fCBV 的相对保留,一些大鼠表现出 fCBV 增加(血管扩张);然而,这些区域后来表现出明显的 fCBV 减少(血管收缩)。在研究结束时最初表现出边缘 fCBV 变化的 DWI 异常组织后来表现出中等程度的 fCBV 减少。我们的结果表明,在局灶性中风的 NBO 治疗期间,可能会在周边缺血区域发生反向窃血的血液动力学效应。此外,CBV 对 NBO 挑战的反应可能有潜力成为一种成像标志物,以区分缺血核心和可挽救的组织。