Goursaud Suzanne, Martinez de Lizarrondo Sara, Grolleau François, Chagnot Audrey, Agin Véronique, Maubert Eric, Gauberti Maxime, Vivien Denis, Ali Carine, Gakuba Clément
CHU de Caen Normandie, Service de Réanimation Médicale, Caen, France.
Normandie University, UNICAEN, INSERM, U1237, PhIND ≪ Physiopathology and Imaging of Neurological Disorders ≫, Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France.
Front Cardiovasc Med. 2021 Nov 15;8:752769. doi: 10.3389/fcvm.2021.752769. eCollection 2021.
Delayed cerebral ischemia (DCI) is one of the main prognosis factors for disability after aneurysmal subarachnoid hemorrhage (SAH). The lack of a consensual definition for DCI had limited investigation and care in human until 2010, when a multidisciplinary research expert group proposed to define DCI as the occurrence of cerebral infarction (identified on imaging or histology) associated with clinical deterioration. We performed a systematic review to assess whether preclinical models of SAH meet this definition, focusing on the combination of noninvasive imaging and neurological deficits. To this aim, we searched in PUBMED database and included all rodent SAH models that considered cerebral ischemia and/or neurological outcome and/or vasospasm. Seventy-eight publications were included. Eight different methods were performed to induce SAH, with blood injection in the being the most widely used ( = 39, 50%). Vasospasm was the most investigated SAH-related complication ( = 52, 67%) compared to cerebral ischemia ( = 30, 38%), which was never investigated with imaging. Neurological deficits were also explored ( = 19, 24%). This systematic review shows that no preclinical SAH model meets the 2010 clinical definition of DCI, highlighting the inconsistencies between preclinical and clinical standards. In order to enhance research and favor translation to humans, pertinent SAH animal models reproducing DCI are urgently needed.
迟发性脑缺血（DCI）是动脉瘤性蛛网膜下腔出血（SAH）后导致残疾的主要预后因素之一。在2010年之前，由于缺乏对DCI的共识性定义，人类对此的研究和治疗受到限制。当时，一个多学科研究专家组提议将DCI定义为与临床病情恶化相关的脑梗死（通过影像学或组织学确定）的发生。我们进行了一项系统评价，以评估SAH的临床前模型是否符合这一定义，重点关注非侵入性成像和神经功能缺损的结合。为此，我们在PubMed数据库中进行了检索，并纳入了所有考虑脑缺血和/或神经功能结局和/或血管痉挛的啮齿类SAH模型。共纳入78篇出版物。采用了八种不同的方法诱导SAH，其中向蛛网膜下腔注射血液是最常用的方法（n = 39，占50%）。与脑缺血（n = 30，占38%）相比，血管痉挛是研究最多的SAH相关并发症（n = 52，占67%），而脑缺血从未通过影像学进行研究。也对神经功能缺损进行了探索（n = 19，占24%）。这项系统评价表明，没有临床前SAH模型符合2010年DCI的临床定义，凸显了临床前和临床标准之间的不一致。为了加强研究并促进向人类的转化，迫切需要能够再现DCI的相关SAH动物模型。
