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Chapter Fifty - Neuroprotection

from Treatment

Published online by Cambridge University Press:  13 December 2022

Louis R. Caplan  and
Aishwarya Aggarwal
Louis R. Caplan
Affiliation:
Beth Israel Deaconess Medical Centre
Aishwarya Aggarwal
Affiliation:
John F. Kennedy Medical Center
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Summary

Lives of great men all remind us

We can make our lives sublime,

And, departing, leave behind us

Footprints on the sands of time.

—Henry Wadsworth Longfellow
The history of neuroprotection might start on a cold winter day with the tale of Ann Green, a young serving girl found guilty of having a child out of wedlock, allegedly fathered by a member of the English aristocracy. She was hanged at Carfax, Oxford, one December morning in 1650 [1]. At the execution she was clearly hypothermic, and likely hypoglycemic. Rendered unconscious, the body was taken down and conveyed from the site of public execution to the lodgings of Thomas Willis. In preparation for her dissection, and to confirm she was dead, Willis’s technician stomped on her chest and unexpectedly revived her. She recovered over several hours, leaving no discernible neurological damage. Despite a period of anoxia and a transient global ischemic insult, her recovery was because of prompt reperfusion assisted by the then unknown but later discovered neuroprotective properties of hypothermia and hypoglycemia, accounting for her impressive neurological outcome.

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Stories of Stroke
Key Individuals and the Evolution of Ideas
 , pp. 478 - 490
Publisher: Cambridge University Press
Print publication year: 2022

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References

Notes and References

Breathnach, CS, Moynihan, JB. Intensive care 1650: The revival of Anne Greene (c. 1628–59). J. Med. Biogr. 2009;17:35–38.Google Scholar
Drake, CG, Barr, HW, Coles, JC, Gergely, NF. The use of extracorporeal circulation and profound hypothermia in the treatment of ruptured intracranial aneurysm. J. Neurosurg. 1964;21:575–581.Google ScholarGoogle Scholar
Bernard, SA, Gray, TW, Buist, MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N. Engl. J. Med. 2002;346:557–563.Google ScholarGoogle Scholar
van der Worp, HB, de Haan, P, Morrema, E, Kalkman, CJ. Methodological quality of animal studies on neuroprotection in focal cerebral ischaemia. J. Neurol. 2005;252:1108–1114.Google Scholar
Spielmeyer, W. Zur pathogenese örtlich elektiver grehirnveränderungen. Zeitschrift für die gesamte Neurologie und Psychiatrie 1925;99:756–776.Google Scholar
Pulsinelli, WA, Brierley, JB, Plum, F. Temporal profile of neuronal damage in a model of transient forebrain ischemia. Ann. Neurol. 1982;11:491–498.Google Scholar
Diemer, NH, Jorgensen, MB, Johansen, FF, Sheardown, M, Honore, T. Protection against ischemic hippocampal CA1 damage in the rat with a new non-NMDA antagonist, NBQX. Acta Neurol. Scand. 1992;86:45–49.Google ScholarGoogle Scholar
Ito, U, Spatz, M, Walker, JT Jr, Klatzo, I. Experimental cerebral ischemia in Mongolian gerbils. I. Light microscopic observations. Acta Neuropathol. 1975;32:209–223.Google ScholarGoogle Scholar
Petito, CK, Feldmann, E, Pulsinelli, WA, Plum, F. Delayed hippocampal damage in humans following cardiorespiratory arrest. Neurology 1987;37:1281–1286.Google Scholar
Paulson, OB, Hossman, K-A, Ingvar, M, Sokoloff, L. In memoriam: Bo K. Siesjö, 1930–2013. J. Cereb. Blood Flow Metab. 2014;34(1):1.Google ScholarGoogle Scholar
Posner, JB. Fred Plum, MD (1924–2010). Arch. Neurol. 2010;67(11):1409–1410.Google Scholar
Branston, NM, Symon, L, Crockard, HA, Pasztor, E. Relationship between the cortical evoked potential and local cortical blood flow following acute middle cerebral artery occlusion in the baboon. Exp. Neurol. 1974;45:195–208.Google ScholarGoogle Scholar
Symon, LN, Branston, M, Strong, AJ, Hope, TD. The concepts of thresholds of ischaemia in relation to brain structure and function. J. Clin. Pathol. Suppl. (R. Coll. Pathol.) 1977;11:149–154.Google Scholar
Baron, JC. Mapping the ischaemic penumbra with PET: Implications for acute stroke treatment. Cerebrovasc. Dis. 1999;9:193–201.Google ScholarGoogle ScholarGoogle Scholar
Ginsberg, MD, Busto, R. Rodent models of cerebral ischemia. Stroke 1989;20:1627–1642.Google ScholarGoogle Scholar
Brown, AW, Brierley, JB. The earliest alterations in rat neurones and astrocytes after anoxia-ischaemia. Acta Neuropathol. 1973;23:9–22.Google ScholarGoogle Scholar
Abe, K, Aoki, M, Kawagoe, J, et al. Ischemic delayed neuronal death: A mitochondrial hypothesis. Stroke 1995;26:1478–1489.Google Scholar
Dirnagl, U, Simon, RP, Hallenbeck, JM. Ischemic tolerance and endogenous neuroprotection. Trends Neurosci. 2003;26:248–254.Google ScholarGoogle Scholar
Chamorro, A, Lo, EH, Renù, A, van Leyden, K, Lyden, P. The future of neuroprotection in stroke. J. Neurol. Neurosurg. Psychiatry 2021;92(2):129–135.CrossRefGoogle ScholarPubMed
Krams, MK, Lees, R, Hacke, W, Grieve, AP, Orgogozo, JM, Ford, GA, and ASTIN study investigators. Acute Stroke Therapy by Inhibition of Neutrophils (ASTIN): An adaptive dose-response study of UK-279,276 in acute ischemic stroke. Stroke 2003;34:2543–2548.Google Scholar
Hall, CN, Reynell, C, Gesslein, B, et al. Capillary pericytes regulate cerebral blood flow in health and disease. Nature 2014;508:55–60.Google Scholar
Rothman, SM, Olney, JW. Glutamate and the pathophysiology of hypoxic-ischemic brain damage. Ann. Neurol. 1986;19:105–111.Google Scholar
Choi, DW, Rothman, SM. The role of glutamate neurotoxicity in hypoxic-ischemic neuronal death. Annu. Rev. Neurosci. 1990;13:171–182.Google Scholar
Simon, RP, Swan, JH, Griffiths, T, Meldrum, BS. Blockade of N-methyl-D-aspartate receptors may protect against ischemic damage in the brain. Science 1984;226:850–852.Google Scholar
Gill, R, Foster, AC, Woodruff, GN. Systemic administration of MK-801 protects against ischemia-induced hippocampal neurodegeneration in the gerbil. J. Neurosci. 1987;7:3343–3349.Google Scholar
Buchan, A, Pulsinelli, WA. Hypothermia but not the N-methyl-D-aspartate antagonist, MK-801, attenuates neuronal damage in gerbils subjected to transient global ischemia. J. Neurosci. 1990;10:311–316.Google Scholar
Nellgard, B, Wieloch, T. Cerebral protection by AMPA- and NMDA-receptor antagonists administered after severe insulin-induced hypoglycemia. Exp. Brain Res. 1992;92:259–266.CrossRefGoogle ScholarPubMed
Takizawa, S, Hogan, M, Hakim, AM. The effects of a competitive NMDA receptor antagonist (CGS-19755) on cerebral blood flow and pH in focal ischemia. J. Cereb. Blood Flow Metab. 1991;11:786–793.Google ScholarGoogle Scholar
Sheardown, MJ, Suzdak, PD, Nordholm, L. AMPA, but not NMDA, receptor antagonism is neuroprotective in gerbil global ischaemia, even when delayed 24 h. Eur. J. Pharmacol. 1993;236:347–353.Google ScholarGoogle Scholar
Siesjo, BK, Agardh, CD, Bengtsson, F. Free radicals and brain damage. Cerebrovasc. Brain Metab. Rev. 1989;1:165–211.Google Scholar
Lees, KR, Zivin, JA, Ashwood, T, et al. for the Stroke-Acute Ischemic NXY Treatment (SAINT I) Trial Investigators. NXY-059 for acute ischemic stroke. N. Engl. J. Med. 2006;354:588–600.Google Scholar
Shuaib, A, Lees, KR, Lyden, P et al., and Saint Il Trial Investigators. NXY-059 for the treatment of acute ischemic stroke. N. Engl. J. Med. 2007;357:562–571.Google Scholar
Belayev, L, Liu, Y, Zhao, W, Busto, R, Ginsberg, MD. Human albumin therapy of acute ischemic stroke: Marked neuroprotective efficacy at moderate doses and with a broad therapeutic window. Stroke 2001;32:553–560.CrossRefGoogle ScholarPubMed
Martin, RH, Yeatts, SD, Hill, MD, et al. and ALIAS Parts 1 and 2 and Nett Investigators. ALIAS (Albumin in Acute Ischemic Stroke) trials: Analysis of the combined data from parts 1 and 2. Stroke 2016;47:2355–2359.Google Scholar
Shuaib, A, Bornstein, NM, Diener, HC, et al. and Sentis trial investigators. Partial aortic occlusion for cerebral perfusion augmentation: Safety and efficacy of NeuroFlo in Acute Ischemic Stroke trial. Stroke 2011;42:1680–1690.Google Scholar
Fisher, M, Feuerstein, G, Howells, DW, et al. STAIR Group. Update of the stroke therapy academic industry roundtable preclinical recommendations. Stroke 2009;40(6):2244–2250.CrossRefGoogle ScholarPubMed
Hill, MD, Goyal, M, Menon, BK, et al. and Escape-Na Investigators. Efficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): A multicentre, double-blind, randomised controlled trial. Lancet 2020;395:878–887.Google Scholar
Hill, MD, Martin, RH, Mikulis, D, et al. and ENACT trial investigators. Safety and efficacy of NA-1 in patients with iatrogenic stroke after endovascular aneurysm repair (ENACT): A phase 2, randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2012;11:942–950.Google Scholar
Karnatovskaia, LV, Wartenberg, KE, Freeman, WD. Therapeutic hypothermia for neuroprotection: History, mechanisms, risks, and clinical applications. Neurohospitalist 2014;4:153–163.Google Scholar
Bigelow, WG, Lindsay, WK, Greenwood, WF. Hypothermia, its possible role in cardiac surgery: An investigation of factors governing survival in dogs at low body temperatures. Ann. Surg. 1950;132:849–866.Google Scholar
van der Worp, HB, Sena, ES, Donnan, GA, Howells, DW, Macleod, MR. Hypothermia in animal models of acute ischaemic stroke: A systematic review and meta-analysis. Brain 2007;130:3063–3074.Google Scholar
De Georgia, MA, Krieger, DW, Abou-Chebl, A, et al. Cooling for Acute Ischemic Brain Damage (COOL AID): A feasibility trial of endovascular cooling. Neurology 2004;63:312–317.CrossRefGoogle Scholar
Hemmen, TM, Raman, R, Guluma, KZ, et al. and ICTuS-L Investigators. Intravenous thrombolysis plus hypothermia for acute treatment of ischemic stroke (ICTuS-L): Final results. Stroke 2010;41:2265–2270.CrossRefGoogle ScholarPubMed
Horn, CM, Sun, CH, Nogueira, RG, et al. Endovascular Reperfusion and Cooling in Cerebral Acute Ischemia (ReCCLAIM I). J. Neurointerv. Surg. 2014;6:91–95.Google Scholar
Lyden, P, Hemmen, T, Grotta, J, et al. and collaborators. Results of the ICTuS 2 Trial (Intravascular Cooling in the Treatment of Stroke 2). Stroke 2016;47:2888–2895.CrossRefGoogle ScholarPubMed
van der Worp, HB, Macleod, MR, Bath, PMW, et al. and the EuroHYP-1 Investigators. Therapeutic hypothermia for acute ischaemic stroke: Results of a European multicentre, randomised, phase III clinical trial. Eur. Stroke J. 2019;4:254–262.Google Scholar
Lougheed, WM, Kahn, DS. Circumvention of anoxia during arrest of cerebral circulation for intracranial surgery. J. Neurosurg. 1955;12:226–239.Google Scholar
Schwartz, AE, Stone, JG, Finck, AD, et al. Isolated cerebral hypothermia by single carotid artery perfusion of extracorporeally cooled blood in baboons. Neurosurgery 1996;39:577–581; discussion 81–82.Google ScholarPubMed

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