Journal
NEUROLOGY
Volume 58, Issue 6, Pages 945-952Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.58.6.945
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Funding
- NHLBI NIH HHS [HL39810] Funding Source: Medline
- NINDS NIH HHS [R01-NS38731, R29-NS32806, R01-NS37074] Funding Source: Medline
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Background: Hyperbaric oxygen therapy is considered an important stroke treatment strategy. Objective: To determine whether normobaric oxygen is neuroprotective, and, if so, what the therapeutic time window is. Methods: Experiment 1-Serial diffusion- and perfusion-weighted MRI (DWI and PWI) was performed after middle cerebral artery filament occlusion (MCAO) in rats randomized to FiO(2) 30% (normoxia) or FiO(2) 100% (hyperoxia). Experiment 2-48-hour lesion volumes were analyzed in rats subjected to 2-hour MCAO and randomized to normoxia or hyperoxia starting 15, 30, or 45 minutes after MCAO and ending 15 minutes after reperfusion. Results: Experiment I-Lesion apparent diffusion coefficient (ADC) values were persistently low in normoxic animals. In hyperoxia-treated rats, ADC values in cortical border zones showed progressive recovery from 66 +/- 3% of contralateral before hyperoxia, to 104 +/- 20% at similar to2 hours. Striatal ADC values showed early but ill-sustained improvement. ADC lesion volumes increased progressively in the normoxia group. In the hyperoxia group, ADC lesion volumes tended to decrease after starting hyperoxia; however, lesions later increased in size, and 2-hour lesion volumes were not significantly different from baseline. PWI showed stable right MCA hypoperfusion in all animals. Experiment 2-Hyperoxia within 30 minutes significantly reduced total and cortical lesion volumes at 48 hours after stroke. Striatal lesion volumes were significantly reduced in the hyperoxia-15 group. Conclusion: In rats subjected to transient stroke, 100% oxygen administered within 30 minutes salvages ischemic brain tissue, especially in the cerebral cortex. Reducing the time to treatment enhances the degree of neuroprotection.
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