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Mastej EJ, Leppert MH, Poisson S, Ritchey Z, Barry M, Rundek T, Liebeskind DS, Mirsky D, Bernard TJ, Stence NV. Thalamic Volume Loss Is Greater in Children Than in Adults Following Middle Cerebral Artery Territory Arterial Ischemic Stroke. J Child Neurol 2022; 37:882-888. [PMID: 36069041 PMCID: PMC9560991 DOI: 10.1177/08830738221118807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Younger stroke patients may suffer worse outcomes than older patients; however, the extent to which age at stroke impacts remote areas of the brain remains unclear. The objective of this study was to determine thalamic volume changes ipsilateral to middle cerebral artery territory strokes based on age at acute ischemic stroke onset. Methods: Acute ischemic stroke patients <9 years, 9-18 years, and >18 years old were retrospectively recruited from a large quaternary care system. Each subject underwent an acute (<72 hours from AIS) and chronic (>90 days) magnetic resonance imaging (MRI) scan. Manual thalamic segmentation was performed. Results: Younger and older children had significantly greater stroke-side thalamic volume loss compared to adults (48.2%, P = .022; 40.7%, P = .044, respectively). Conclusions: Stroke-side thalamic volumes decreased across the age spectrum but to a greater degree in pediatric patients. This observation can affect functional and cognitive outcomes post stroke and warrants further research.
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Affiliation(s)
- Emily J. Mastej
- Computational Bioscience Program, University of Colorado Anschutz, Aurora, CO
| | - Michelle H. Leppert
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO
| | - Sharon Poisson
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO
| | - Zak Ritchey
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO
| | - Megan Barry
- Section of Child Neurology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
| | - David S. Liebeskind
- Department of Neurology, University of California Los Angeles, Los Angeles, CA
| | - David Mirsky
- Department of Radiology, Children’s Hospital Colorado, Medicine, Aurora, CO
| | - Timothy J. Bernard
- Section of Child Neurology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Nicholas V. Stence
- Department of Radiology, Children’s Hospital Colorado, Medicine, Aurora, CO
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Orfila JE, Dietz RM, Rodgers KM, Dingman A, Patsos OP, Cruz-Torres I, Grewal H, Strnad F, Schroeder C, Herson PS. Experimental pediatric stroke shows age-specific recovery of cognition and role of hippocampal Nogo-A receptor signaling. J Cereb Blood Flow Metab 2020; 40:588-599. [PMID: 30762478 PMCID: PMC7026845 DOI: 10.1177/0271678x19828581] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Ischemic stroke is a leading cause of death worldwide and clinical data suggest that children may recover from stroke better than adults; however, supporting experimental data are lacking. We used our novel mouse model of experimental juvenile ischemic stroke (MCAO) to characterize age-specific cognitive dysfunction following ischemia. Juvenile and adult mice subjected to 45-min MCAO, and extracellular field recordings of CA1 neurons were performed to assess hippocampal synaptic plasticity changes after MCAO, and contextual fear conditioning was performed to evaluate memory and biochemistry used to analyze Nogo-A expression. Juvenile mice showed impaired synaptic plasticity seven days after MCAO, followed by full recovery by 30 days. Memory behavior was consistent with synaptic impairments and recovery after juvenile MCAO. Nogo-A expression increased in ipsilateral hippocampus seven days after MCAO compared to contralateral and sham hippocampus. Further, inhibition of Nogo-A receptors reversed MCAO-induced synaptic impairment in slices obtained seven days after juvenile MCAO. Adult MCAO-induced impairment of LTP was not associated with increased Nogo-A. This study demonstrates that stroke causes functional impairment in the hippocampus and recovery of behavioral and synaptic function is more robust in the young brain. Nogo-A receptor activity may account for the impairments seen following juvenile ischemic injury.
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Affiliation(s)
- James E Orfila
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.,Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert M Dietz
- Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Krista M Rodgers
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.,Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - Andra Dingman
- Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Olivia P Patsos
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.,Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ivelisse Cruz-Torres
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.,Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - Himmat Grewal
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.,Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - Frank Strnad
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.,Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - Christian Schroeder
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.,Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - Paco S Herson
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.,Neuronal Injury & Plasticity Program, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Pharmacology, University of Colorado School of Medicine, Aurora, CO, USA
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