Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Department of Neurology, Auckland City Hospital, Auckland, New Zealand.
J Cereb Blood Flow Metab. 2022 Nov;42(11):2058-2065. doi: 10.1177/0271678X221107988. Epub 2022 Jun 16.
Active conductive head cooling is a simple and non-invasive intervention that may slow infarct growth in ischemic stroke. We investigated the effect of active conductive head cooling on brain temperature using whole brain echo-planar spectroscopic imaging. A cooling cap (WElkins Temperature Regulation System, 2nd Gen) was used to administer cooling for 80 minutes to healthy volunteers and chronic stroke patients. Whole brain echo-planar spectroscopic imaging scans were obtained before and after cooling. Brain temperature was estimated using the Metabolite Imaging and Data Analysis System software package, which allows voxel-level temperature calculations using the chemical shift difference between metabolite (N-acetylaspartate, creatine, choline) and water resonances. Eleven participants (six healthy volunteers, five post-stroke) underwent 80 ± 5 minutes of cooling. The average temperature of the coolant was 1.3 ± 0.5°C below zero. Significant reductions in brain temperature (ΔT = -0.9 ± 0.7°C, P = 0.002), and to a lesser extent, rectal temperature (ΔT = -0.3 ± 0.1°C, P = 0.03) were observed. Exploratory analysis showed that the occipital lobes had the greatest reduction in temperature (ΔT = -1.5 ± 1.2°C, P = 0.002). Regions of infarction had similar temperature reductions to the contralateral normal brain. Future research could investigate the feasibility of head cooling as a potential neuroprotective strategy in patients being considered for acute stroke therapies.
主动传导性头部冷却（active conductive head cooling）是一种简单且非侵入性的干预措施，可能会减缓缺血性中风的梗塞生长。我们使用全脑回波平面波谱成像（whole brain echo-planar spectroscopic imaging）来研究主动传导性头部冷却对大脑温度的影响。冷却帽（WElkins Temperature Regulation System，2 代）用于在 80 分钟内向健康志愿者和慢性中风患者施予冷却。在冷却前后获得全脑回波平面波谱成像扫描。使用代谢物成像和数据分析系统软件包（Metabolite Imaging and Data Analysis System software package）估计脑温，该软件包允许使用代谢物（N-乙酰天冬氨酸、肌酸、胆碱）和水共振之间的化学位移差异进行体素级别的温度计算。11 名参与者（6 名健康志愿者，5 名中风后）接受了 80±5 分钟的冷却。冷却剂的平均温度比零度低 1.3±0.5°C。观察到大脑温度（ΔT=-0.9±0.7°C，P=0.002）和直肠温度（ΔT=-0.3±0.1°C，P=0.03）有显著降低。探索性分析表明，枕叶的温度降低最大（ΔT=-1.5±1.2°C，P=0.002）。梗塞区域的温度降低与对侧正常大脑相似。未来的研究可以调查头部冷却作为急性中风治疗患者潜在神经保护策略的可行性。
