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Treatment temperature and insult severity influence the neuroprotective effects of therapeutic hypothermia

Research output: Contribution to journalArticle

Original languageEnglish
Article number23430
Number of pages12
JournalScientific Reports
Volume6
DOIs
DateAccepted/In press - 22 Feb 2016
DatePublished (current) - 21 Mar 2016

Abstract

Therapeutic hypothermia (HT) is standard care for moderate and severe neonatal hypoxic-ischaemic encephalopathy (HIE), the leading cause of permanent brain injury in term newborns. However, the optimal temperature for HT is still unknown, and few preclinical studies have compared multiple HT treatment temperatures. Additionally, HT may not benefit infants with severe encephalopathy. In a neonatal rat model of unilateral hypoxia-ischaemia (HI), the effect of five different HT temperatures was investigated after either moderate or severe injury. At postnatal-day seven, rat pups underwent moderate or severe HI followed by 5 h at normothermia (37 °C), or one of five HT temperatures: 33.5 °C, 32 °C, 30 °C, 26 °C, and 18 °C. One week after treatment, neuropathological analysis of hemispheric and hippocampal area loss, and CA1 hippocampal pyramidal neuron count, was performed. After moderate injury, a significant reduction in hemispheric and hippocampal loss on the injured side, and preservation of CA1 pyramidal neurons, was seen in the 33.5 °C, 32 °C, and 30 °C groups. Cooling below 33.5 °C did not provide additional neuroprotection. Regardless of treatment temperature, HT was not neuroprotective in the severe HI model. Based on these findings, and previous experience translating preclinical studies into clinical application, we propose that milder cooling should be considered for future clinical trials.

    Research areas

  • Neonatal brain damage, Neurophysiology, Stroke

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    Rights statement: This is the final published version of the article (version of record). It first appeared online via Nature Publishing Group at http://dx.doi.org/ 10.1038/srep23430.

    Final published version, 1 MB, PDF document

    Licence: CC BY

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