There has been recent interest in the use of mild hypothermia (30-35 degrees C) in the treatment of cerebral ischemia and stroke. The purpose of this project is to define optimal parameters in which hypothermia can be applied in animal models of focal cerebral ischemia. Using an intraluminal suture occlusion model of stroke in the rat, a series of experiments will be performed to determine the optimal depth and duration of hypothermia which provides maximal reduction in infarct size as well as avoiding systemic complications. Additional questions that will be addressed will include the extent to which hypothermia can be delayed and still offer protection as well as whether the protective effects are permanent. This project will then investigate the use of diffusion- weighted MRI (DWI) in characterizing ischemic stroke in response to alterations in temperature. Since it is known that diffusion is affected by temperature changes, experiments relating the apparent diffusion coefficient and various temperatures will be performed. After establishing this relationship in normal animals, experiments will be conducted to characterize the diffusion changes seen with hypothermia and focal ischemia. The time course of diffusion changes and infarct size will be studied as well as the potential of DWI as a predictor of infarct severity. To examine the feasibility of hypothermia in a potential clinical setting, hypothermia will be used in conjunction with a thrombolytic agent in a rabbit model of thromboembolic stroke. The time course of ischemia and response to treatment with hypothermia and thrombolysis will be monitored using sequential diffusion and perfusion MRIs. The final years of this grant will focus on mechanisms that may explain the protective effect of hypothermia. Cerebral blood flow may be an important factor in its protective effect and will be studied using perfusion MRI techniques as well as established laboratory methods. Other parameters such as blood brain barrier integrity, edema and inflammatory cell infiltration will be measured at various temperatures. The knowledge gained from this project will have direct implications in the treatment of ischemic stroke in humans as well as the prophylactic use of hypothermia in both medical and surgical patients.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08NS001860-04
Application #
2750779
Study Section
NST-2 Subcommittee (NST)
Program Officer
Jacobs, Tom P
Project Start
1995-09-30
Project End
2000-07-31
Budget Start
1998-08-01
Budget End
1999-07-31
Support Year
4
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Stanford University
Department
Neurology
Type
Schools of Medicine
DUNS #
800771545
City
Stanford
State
CA
Country
United States
Zip Code
94305
Yenari, Midori A; Iwayama, Satoshi; Cheng, Danye et al. (2002) Mild hypothermia attenuates cytochrome c release but does not alter Bcl-2 expression or caspase activation after experimental stroke. J Cereb Blood Flow Metab 22:29-38
Yenari, M A; Dumas, T C; Sapolsky, R M et al. (2001) Gene therapy for treatment of cerebral ischemia using defective herpes simplex viral vectors. Neurol Res 23:543-52
Phillips, R G; Monje, M L; Giuli, L C et al. (2001) Gene therapy effectiveness differs for neuronal survival and behavioral performance. Gene Ther 8:579-85
Maier, C M; Sun, G H; Kunis, D et al. (2001) Delayed induction and long-term effects of mild hypothermia in a focal model of transient cerebral ischemia: neurological outcome and infarct size. J Neurosurg 94:90-6
Yenari, M A; Dumas, T C; Sapolsky, R M et al. (2001) Gene therapy for treatment of cerebral ischemia using defective herpes simplex viral vectors. Ann N Y Acad Sci 939:340-57
Yenari, M A; Giffard, R G (2001) Ischemic vulnerability of primary murine microglial cultures. Neurosci Lett 298:5-8
Lee, J E; Yenari, M A; Sun, G H et al. (2001) Differential neuroprotection from human heat shock protein 70 overexpression in in vitro and in vivo models of ischemia and ischemia-like conditions. Exp Neurol 170:129-39
Yenari, M A; Minami, M; Sun, G H et al. (2001) Calbindin d28k overexpression protects striatal neurons from transient focal cerebral ischemia. Stroke 32:1028-35
Yenari, M A; Sun, G H; Kunis, D M et al. (2001) L-selectin inhibition does not reduce injury in a rabbit model of transient focal cerebral ischemia. Neurol Res 23:72-8
Yenari, M A; Onley, D; Hedehus, M et al. (2000) Diffusion- and perfusion-weighted magnetic resonance imaging of focal cerebral ischemia and cortical spreading depression under conditions of mild hypothermia. Brain Res 885:208-19

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