Department of Physiology, Anatomy and Microbiology and Centre for Cardiovascular Biology and Disease Research, School of Life Sciences (S.R.Z., H.A.K., M.A.E., G.R.D., C.G.S.), La Trobe University, Bundoora, Victoria, Australia.
Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Pharmacology (S.R.Z., H.A.K., H.X.C., S.L., M.A.E., G.R.D., C.G.S.), Monash University, Clayton, Victoria, Australia.
Stroke. 2021 Nov;52(11):3661-3669. doi: 10.1161/STROKEAHA.121.036500. Epub 2021 Oct 8.
Preclinical stroke studies endeavor to model the pathophysiology of clinical stroke, assessing a range of parameters of injury and impairment. However, poststroke pathology is complex and variable, and associations between diverse parameters may be difficult to identify within the usual small study designs that focus on infarct size.
We have performed a retrospective large-scale big data analysis of records from 631 C57BL/6 mice of either sex in which the middle cerebral artery was occluded by 1 of 5 surgeons either transiently for 1 hour followed by 23-hour reperfusion (transient middle cerebral artery occlusion [MCAO]; n=435) or permanently for 24 hours without reperfusion (permanent MCAO; n=196). Analyses included a multivariate linear mixed model with random intercept for different surgeons as a random effect to reduce type I and type II errors and a generalized ordinal regression model for ordinal data when random effects are low.
Analyses indicated that brain edema volume was associated with infarct volume at 24 hours (β, 0.52 [95% CI, 0.45–0.59]) and was higher after permanent MCAO than after transient MCAO (P<0.05). A more severe clinical score was associated with a greater infarct volume but not with the animal’s age or edema volume. Further, a more severe clinical score was observed for a given brain infarct volume after transient MCAO versus permanent MCAO. Remarkably the animal’s age, which corresponded with the period of young adulthood (6–40 weeks; equivalent to ≈18–35 years in humans), was positively associated with severity of lung infection (β, 0.65 [95% CI, 0.42–0.88]) and negatively with spleen weight (β, −0.36 [95% CI, −0.63 to −0.09]).
Large-scale analysis of preclinical stroke data can provide researchers in our field with insight into relationships between variables not possible if individual studies are analyzed in isolation and has identified hypotheses for future study.
临床前卒中研究致力于模拟临床卒中的病理生理学,评估损伤和损伤程度的一系列参数。然而,卒中后病理复杂且多变,在通常专注于梗死面积的小型研究设计中,不同参数之间的关联可能难以识别。
我们对 631 只 C57BL/6 雌雄小鼠的记录进行了回顾性的大规模大数据分析,其中 5 位外科医生中的 1 位将大脑中动脉短暂性闭塞 1 小时,然后再进行 23 小时再灌注(短暂性大脑中动脉闭塞[MCAO];n=435)或永久性闭塞 24 小时无再灌注(永久性 MCAO;n=196)。分析包括随机截距的多元线性混合模型,以不同外科医生为随机效应,以减少 I 型和 II 型错误,以及当随机效应较低时用于有序数据的广义有序回归模型。
分析表明,脑水肿体积与 24 小时的梗死体积相关(β,0.52[95%CI,0.45-0.59]),永久性 MCAO 后高于短暂性 MCAO(P<0.05)。更严重的临床评分与更大的梗死体积相关,但与动物的年龄或水肿体积无关。此外,在给定的脑梗死体积后,与永久性 MCAO 相比,短暂性 MCAO 观察到更严重的临床评分。值得注意的是,动物的年龄与青年期(6-40 周;相当于人类的 18-35 岁)相对应,与肺部感染的严重程度呈正相关(β,0.65[95%CI,0.42-0.88]),与脾脏重量呈负相关(β,-0.36[95%CI,-0.63 至-0.09])。
对临床前卒中数据的大规模分析可以为我们领域的研究人员提供有关变量之间关系的见解,如果单独分析单个研究则不可能获得这些见解,并为未来的研究提出了假设。