Early evolution and recovery from excitotoxic injury in the neonatal rat brain: a study combining magnetic resonance imaging, electrical impedance, and histology

Using MRI to predict the fate of excitotoxic lesions in rats

Excitotoxic lesions are frequently used to assess the role of cerebral structures in cognitive processes in rodents. However, the precise site and extent of these lesions remain unknown without histological verifications. Using a 7-Teslas MRI system and a T2-weighted turbo-RARE sequence, MR images were acquired at several time points following NMDA lesions (1h, 6h, 24h, 48h, 1 week and 2 weeks). NMDA infusions into the parenchyma induced a clear and delineable hyperintense signal from 1h up to 1-week post-surgery. Hyperintensity volumes were compared with NeuN and Cresyl violet histological quantifications of the lesion magnitude. NMDA-induced hypersignal is observed as soon as 1h post-injection and is a reliable estimate of the presence (or absence) of a lesion. Compared to NeuN, Cresyl violet staining underestimates the extent of the lesion in significant proportions. The MRI hyperintensity generated by NMDA instillation into the parenchyma can be used as a powerful tool to confirm the diffusion of the drug into the cerebral tissue, to ascertain the locus of injection and predict with a high success rate the fate of NMDA lesions as soon as 1h post-surgery. This approach could be very useful in a large variety of lesion studies in rodents.

Sustained diffusion reversal with in-bore reperfusion in monkey stroke models: Confirmed by prospective magnetic resonance imaging

Although early diffusion lesion reversal after recanalization treatment of acute ischaemic stroke has been observed in clinical settings, the reversibility of lesions observed by diffusion-weighted imaging remains controversial. Here, we present consistent observations of sustained diffusion lesion reversal after transient middle cerebral artery occlusion in a monkey stroke model. Seven rhesus macaques were subjected to endovascular transient middle cerebral artery occlusion with in-bore reperfusion confirmed by repeated prospective diffusion-weighted imaging. Early diffusion lesion reversal was defined as lesion reversal at 3 h after reperfusion. Sustained diffusion lesion reversal was defined as the difference between the ADC-derived pre-reperfusion maximal ischemic lesion volume (ADC_{D-P Match}) and the lesion on 4-week follow-up FLAIR magnetic resonance imaging. Diffusion lesions were spatiotemporally assessed using a 3-D voxel-based quantitative technique. The ADC_{D-P Match} was 9.7 ± 6.0% (mean ± SD) and the final infarct was 1.2-6.0% of the volume of the ipsilateral hemisphere. Early diffusion lesion reversal and sustained diffusion lesion reversal were observed in all seven animals, and the calculated percentages compared with their ADC_{D-P Match} ranged from 8.3 to 51.9% (mean ± SD, 26.9 ± 15.3%) and 41.7-77.8% (mean ± SD, 65.4 ± 12.2%), respectively. Substantial sustained diffusion lesion reversal and early reversal were observed in all animals in this monkey model of transient focal cerebral ischaemia.

Sex differences in the effect of progesterone after controlled cortical impact in adolescent mice: a preliminary study

OBJECT

While progesterone has been well studied in experimental models of adult traumatic brain injury (TBI), it has not been evaluated in pediatric models. The study of promising interventions in pediatric TBI is important because children have the highest public health burden of such injuries. Therapies that are beneficial in adults may not necessarily be effective in the pediatric population. The purpose of this study was to evaluate whether progesterone treatment improves outcomes in an experimental model of pediatric TBI.

METHODS

The authors determined whether progesterone administered after controlled cortical impact (CCI) improves functional and histopathological outcomes in 4-week-old mice. Both male and female mice (58 mice total) were included in this study, as the majority of prior studies have used only male and/or reproductively senescent females. Mice were randomized to treatment with progesterone or vehicle and to CCI injury or sham injury. Motor (wire grip test) and memory (Morris water maze) testing were performed to determine the effect of progesterone on TBI. Lesion volume was also assessed.

RESULTS

Compared with their vehicle-treated counterparts, the progesterone-treated CCI-injured male mice had improved motor performance (p < 0.001). In contrast, progesterone-treated CCI-injured female mice had a worse performance than their vehicle-treated counterparts (p = 0.001). Progesterone treatment had no effect on spatial memory performance or lesion volume in injured male or female mice.

CONCLUSIONS

These data suggest a sex-specific effect of progesterone treatment after CCI in adolescent mice and could inform clinical trials in children.

The unique features of traumatic brain injury in children. review of the characteristics of the pediatric skull and brain, mechanisms of trauma, patterns of injury, complications, and their imaging findings--part 2

Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children. The unique biomechanical, hemodynamical, and functional characteristics of the developing brain and the age-dependent variance in trauma mechanisms result in a wide range of age specific traumas and patterns of brain injuries. Detailed knowledge of the main primary and secondary pediatric injuries, which enhance sensitivity and specificity of diagnosis, will guide therapy and may give important information about the prognosis. In recent years, anatomical but also functional imaging methods have revolutionized neuroimaging of pediatric TBI. The purpose of this article is (1) to comprehensively review frequent primary and secondary brain injuries and (2) to give a short overview of two special types of pediatric TBI: birth related and nonaccidental injuries.

Pediatric traumatic brain injury: quo vadis?

In this review, five questions serve as the framework to discuss the importance of age-related differences in the pathophysiology and therapy of traumatic brain injury (TBI). The following questions are included: (1) Is diffuse cerebral swelling an important feature of pediatric TBI and what is its etiology? (2) Is the developing brain more vulnerable than the adult brain to apoptotic neuronal death after TBI and, if so, what are the clinical implications? (3) If the developing brain has enhanced plasticity versus the adult brain, why are outcomes so poor in infants and young children with severe TBI? (4) What contributes to the poor outcomes in the special case of inflicted childhood neurotrauma and how do we limit it? (5) Should both therapeutic targets and treatments of pediatric TBI be unique? Strong support is presented for the existence of unique biochemical, molecular, cellular and physiological facets of TBI in infants and children versus adults. Unique therapeutic targets and enhanced therapeutic opportunities, both in the acute phase after injury and in rehabilitation and regeneration, are suggested.

Nuclear magnetic resonance (NMR) measurement of the apparent diffusion coefficient (ADC) of tissue water and its relationship to cell volume changes in pathological states

Diffusion-weighted nuclear magnetic resonance (NMR) imaging (DWI) is sensitive to the random translational motion of water molecules due to Brownian motion. Although the mechanism is still not completely understood, the cellular swelling that accompanies cell membrane depolarization results in a reduction in the net displacement of diffusing water molecules and thus a concomitant reduction in the apparent diffusion coefficient (ADC) of tissue water. Cerebral regions of reduced ADC appear hyperintense in a DWI and this technique has been used extensively to study acute stroke. In addition to cerebral ischemia, reductions in the ADC of cerebral water have been observed following cortical spreading depression, ischemic depolarizations (IDs), transient ischemic attack (TIA), status epilepticus, and hypoglycemia. Although the mechanism responsible for initiating membrane depolarization varies in each case, the ensuing cell volume changes follow a similar pattern. Water ADC values are also affected by the presence and orientation of barriers to translational motion (such as cell membranes and myelin fibers) and thus NMR measures of anisotropic diffusion are sensitive to more chronic pathological states where the integrity of these structures is modified by disease. Both theoretical prediction and experimental evidence suggest that the ADC of tissue water is related to the volume fraction of the interstitial space via the electrical conductivity of the tissue. The implication is that acute neurological disorders that exhibit electrical conductivity changes should also exhibit ADC changes that are detectable by DWI. A qualitative correlation between electrical conductivity and the ADC of water has been demonstrated in a number of animal model studies and the results indicate that reduced ADC values are associated with reductions in the extracellular volume fraction and increased extracellular tortuosity. The close relationship between ADC changes and cell volume changes in various pathological states suggests that NMR measurements are also sensitive to chemical communication between cells through the extracellular space (i.e., extrasynaptic or volume transmission, VT).

[Cerebral oedema in children compared to cerebral oedema in adults]

About 50% of deaths, in the pediatric population between 1-15 years of age, are due to trauma. This high mortality rate, associated with the frequent sequelae, leading sometimes to severe handicaps, constitutes a major problem for public health in the developed countries. Pediatric trauma has some particularities, due to anatomic and physiologic differences, and to specific injury mechanisms. In a busy traumatology center, a child will be admitted daily in the emergency department with head trauma injury. The anaesthesiologist must have a complete understanding of the pathophysiology involved in this clinical presentation if one wishes to develop a practical knowledge of initial management of such patients. Traumatic brain injury may have intracranial and systemic effects that combine to give global cerebral ischaemia.

Exogenous anandamide protects rat brain against acute neuronal injury in vivo

The endocannabinoid anandamide [N-arachidonoylethanolamine (AEA)] is thought to function as an endogenous protective factor of the brain against acute neuronal damage. However, this has never been tested in an in vivo model of acute brain injury. Here, we show in a longitudinal pharmacological magnetic resonance imaging study that exogenously administered AEA dose-dependently reduced neuronal damage in neonatal rats injected intracerebrally with the Na(+)/K(+)-ATPase inhibitor ouabain. At 15 min after injury, AEA (10 mg/kg) administered 30 min before ouabain injection reduced the volume of cytotoxic edema by 43 +/- 15% in a manner insensitive to the cannabinoid CB(1) receptor antagonist SR141716A. At 7 d after ouabain treatment, 64 +/- 24% less neuronal damage was observed in AEA-treated (10 mg/kg) rats compared with control animals. Coadministration of SR141716A prevented the neuroprotective actions of AEA at this end point. In addition, (1) no increase in AEA and 2-arachidonoylglycerol levels was detected at 2, 8, or 24 hr after ouabain injection; (2) application of SR141716A alone did not increase the lesion volume at days 0 and 7; and (3) the AEA-uptake inhibitor, VDM11, did not affect the lesion volume. These data indicate that there was no endogenous endocannabinoid tone controlling the acute neuronal damage induced by ouabain. Although our data seem to question a possible role of the endogenous cannabinoid system in establishing a brain defense system in our model, AEA may be used as a structural template to develop neuroprotective agents.

Application of magnetic resonance to animal models of cerebral ischemia

The present review has been compiled to highlight the role of magnetic resonance imaging (MRI) and MR spectroscopy (MRS) for the investigation of cerebral ischemia in the animal experimental field of basic research. We have focused on stroke investigations analyzing the pathomechanisms of the disease evolution and on new advances in both nuclear MR (NMR) methodology or genetic engineering of transgenic animals for the study of complex molecular relationships and causes of the disease. Furthermore, we have tried to include metabolic and genetic aspects, as well as the application of functional imaging, for the investigation of the disturbance or restitution of functional brain activation under pathological conditions as relates to controlled animal experiments.

CT and MRI in the diagnosis of acute stroke and their role in thrombolysis

Thrombolysis is an effective but potential deleterious therapy and should therefore be limited to patients with acute intracerebral vessel occlusion and salvageable tissue. MRI currently develops towards the new diagnostic standard for the selection of stroke patients eligible for acute thrombolytic treatment and acute stroke studies. Diffusion- and perfusion-weighed MRI provides diagnostic information not available from the neurological assessments or from CCT and conventional spin-echo MRI. As high-speed DWI and PWI protocols become standardized, a 15-minute integrated stroke protocol of employing echo-planar imaging (EPI) can be outinely performed in the setting of acute clinical stroke. The combination of these MR techniques is suitable to define tissue at risk of infarction that is potentially salvageable brain tissue (an estimate of the ischemic penumbra) and may respond to early recanalization even beyond 3 hours after stroke onset. The extension of the therapeutic window for thrombolytic therapy towards 6 hours in a subpopulation of acute stroke patients might open the way for the successful reperfusion therapy in more stroke patients.

Neuroprotection by Delta9-tetrahydrocannabinol, the main active compound in marijuana, against ouabain-induced in vivo excitotoxicity

Excitotoxicity is a paradigm used to explain the biochemical events in both acute neuronal damage and in slowly progressive, neurodegenerative diseases. Here, we show in a longitudinal magnetic resonance imaging study that Delta(9)-tetrahydrocannabinol (Delta(9)-THC), the main active compound in marijuana, reduces neuronal injury in neonatal rats injected intracerebrally with the Na(+)/K(+)-ATPase inhibitor ouabain to elicit excitotoxicity. In the acute phase Delta(9)-THC reduced the volume of cytotoxic edema by 22%. After 7 d, 36% less neuronal damage was observed in treated rats compared with control animals. Coadministration of the CB(1) cannabinoid receptor antagonist SR141716 prevented the neuroprotective actions of Delta(9)-THC, indicating that Delta(9)-THC afforded protection to neurons via the CB(1) receptor. In Delta(9)-THC-treated rats the volume of astrogliotic tissue was 36% smaller. The CB(1) receptor antagonist did not block this effect. These results provide evidence that the cannabinoid system can serve to protect the brain against neurodegeneration.

Excitatory amino acid concentrations in ventricular cerebrospinal fluid after severe traumatic brain injury in infants and children: the role of child abuse

BACKGROUND

Excitotoxicity is an important mechanism in secondary neuronal injury after traumatic brain injury (TBI). Excitatory amino acids (EAAs) are increased in cerebrospinal fluid (CSF) in adults after TBI; however, studies in pediatric head trauma are lacking. We hypothesized that CSF glutamate, aspartate, and glycine would be increased after TBI in children and that these increases would be associated with age, child abuse, poor outcome, and cerebral ischemia.

METHODS

EAAs were measured in 66 CSF samples from 18 children after severe TBI. Control samples were obtained from 19 children who received lumbar punctures to rule out meningitis.

RESULTS

Peak and mean CSF glycine and peak CSF glutamate levels were increased versus control values. Subgroups of patients with TBI were compared by using univariate regression analysis. Massive increases in CSF glutamate were found in children <4 years old and in child abuse victims. Increased CSF glutamate and glycine were associated with poor outcome. A trend toward an association between high glutamate concentration and ischemic blood flow was observed.

CONCLUSIONS

CSF EAAs are increased in infants and children with severe TBI. Young age and child abuse were associated with extremely high CSF glutamate concentrations after TBI. A possible role for excitotoxicity after pediatric TBI is supported.

Temporal evolution of 3-nitropropionic acid-induced neurodegeneration in the rat brain by T2-weighted, diffusion-weighted, and perfusion magnetic resonance imaging

An appropriate detecting technique is necessary for the early detection of neurodegenerative diseases. 3-Nitropropionic acid-intoxicated rats serve as the animal model for one neurodegenerative disease, Huntington's disease. Non-invasive diffusion- and T2-weighted magnetic resonance imaging were applied to study temporal evolution and spatial distribution of brain lesions which were produced by intravenous injection of 3-nitropropionic acid in rats. Lesions in the striatum, hippocampus, and corpus callosum but not in the cortex were observed 3 and 4.5 h after 3-nitropropionic acid injection (30 mg/kg) on the diffusion- and T2-weighted images, respectively (n = 6). The results demonstrated that the diffusion-weighted imaging is not only superior to T2-weighted imaging in detecting onset of 3-nitropropionic acid-induced excitotoxic brain damage but also differentiates lesion and non-lesion areas with better spatial resolution than T2-weighted imaging. Additionally, to correlate structural alterations with pathophysiological conditions, dynamic susceptibility contrast magnetic resonance imaging was performed before and 4 h after 3-nitropropionic acid administration (n = 8). The relative cerebral blood volume was significantly elevated in the striatum (P < 0.001) but not in the cortex after 3-nitropropionic acid administration. The changes in regional relative cerebral blood volume were well correlated to the changes in signal intensities in the corresponding areas on the diffusion- and T2-weighted images. The combined structural and functional information in this study may provide new insights and therapeutic strategies in treating neurodegenerative diseases.

Enhanced ornithine decarboxylase activity is associated with attenuated rate of damage evolution and reduction of infarct volume in transient middle cerebral artery occlusion in the rat

Ornithine decarboxylase (ODC) transgenic and alpha-difluoromethyl ornithine (DFMO)-treated rats were exposed to transient middle cerebral occlusion (MCAO) to examine the role of intraischaemic ODC-activity on the evolution of ischaemia-reperfusion damage. Magnetic resonance imaging (MRI) data show that the damage develops slower in ODC transgenic than in DFMO-treated rats, which is not caused by a difference in perfusion. Furthermore, infarct volumes are smaller in the former animals one day later. These data support the idea of endogenous neuroprotective action of ODC.

Unilateral hypoxic-ischemic injury in the neonatal rat brain evaluated by in vivo MRI. Correlation with histopathology and neuroprotection by MK-801

RATIONALE AND OBJECTIVES

MRI was used for the in vivo evaluation of unilateral hypoxic-ischemic brain injury and the evaluation of MK-801 in the neonatal rat.

METHODS

T2-weighted scans were obtained during the acute phase of HI injury and 3 months later. Histology was performed to correlate MRI signal changes with pathology. Finally, the effectiveness of MK-801 to limit brain injury was regionally assessed in vivo using T2-weighted MRI.

RESULTS

Injury visualized by MRI at 72 hours after hypoxia correlated strongly with histopathologic analysis. Transient injury was identified. MK-801 significantly reduced the lesion extent at the level of the hippocampus. Patterns of unilateral versus bilateral neonatal brain injury were found to differ.

CONCLUSIONS

The study demonstrates unique patterns of brain injury not seen in adult animal hypoxia-ischemia studies, and the sensitivity of the corpus callosum to hypoxia-ischemia. MK-801, although neuroprotective, did not offer any selective neuroprotective benefit.

Changes in the diffusion of water and intracellular metabolites after excitotoxic injury and global ischemia in neonatal rat brain

The reduction of the apparent diffusion coefficient (ADC) of brain tissue water in acute cerebral ischemia, as measured by diffusion-weighted magnetic resonance imaging, is generally associated with the development of cytotoxic edema. However, the underlying mechanism is still unknown. Our aim was to elucidate diffusion changes in the intracellular environment in cytotoxic edematous tissue. The ADC of intracellular metabolites was measured by use of diffusion-weighted 1H-magnetic resonance spectroscopy after (1) unilateral N-methyl-D-aspartate (NMDA) injection and (2) cardiac arrest-induced global ischemia in neonatal rat brain. The distinct water ADC drop early after global ischemia was accompanied by a significant reduction of the ADC of all measured metabolites (P < 0.01, n = 8). In the first hours after excitotoxic injury, the ADC of water and the metabolites taurine and N-acetylaspartate dropped significantly (P < 0.05, n = 8). At 24 and 72 hours after NMDA injection brain metabolite levels were diminished and metabolite ADC approached contralateral values. Administration of the NMDA-antagonist MK-801 1.5 hours after NMDA injection completely normalized the water ADC but not the metabolite ADC after 1 to 2 hours (n = 8). No damage was detected 72 hours later and, water and metabolite ADC had normal values (n = 8). The contribution of brain temperature changes (calculated from the chemical shift between the water and N-acetylaspartate signals) and tissue deoxygenation to ischemia-induced intracellular ADC changes was minor. These data lend support to previous suggestions that the ischemia-induced brain water ADC drop may partly be caused by reduced diffusional displacement of intracellular water, possibly involving early alterations in intracellular tortuosity, cytoplasmic streaming, or intracellular molecular interactions.

Nitric oxide mediates cerebral ischemic tolerance in a neonatal rat model of hypoxic preconditioning

Neuroprotection against cerebral ischemia can be realized if the brain is preconditioned by previous exposure to a brief period of sublethal ischemia. The present study was undertaken to test the hypothesis that nitric oxide (NO) produced from the neuronal isoform of NO synthase (NOS) serves as a necessary signal for establishing an ischemia-tolerant state in brain. A newborn rat model of hypoxic preconditioning was used, wherein exposure to sublethal hypoxia (8% oxygen) for 3 hours renders postnatal day (PND) 6 animals completely resistant to a cerebral hypoxic-ischemic insult imposed 24 hours later. Postnatal day 6 animals were treated 0.5 hour before preconditioning hypoxia with the nonselective NOS inhibitor L-nitroarginine (2 mg/kg intraperitoneally). This treatment, which resulted in a 67 to 81% inhibition of calcium-dependent constitutive NOS activity 0.5 to 3.5 hours after its administration, completely blocked preconditioning-induced protection. However, administration of the neuronal NOS inhibitor 7-nitroindazole (40 mg/kg intraperitoneally) before preconditioning hypoxia, which decreased constitutive brain NOS activity by 58 to 81%, was without effect on preconditioning-induced cerebroprotection, as was pretreatment with the inducible NOS inhibitor aminoguanidine (400 mg/kg intraperitoneally). The protective effects of preconditioning were also not blocked by treating animals with competitive [3-(2-carboxypiperazin-4-yl)propyl-1-phosphonate; 5 mg/kg intraperitoneally] or noncompetitive (MK-801; 1 mg/kg intraperitoneally) N-methyl-D-aspartate receptor antagonists prior to preconditioning hypoxia. These findings indicate that NO production and activity are critical to the induction of ischemic tolerance in this model. However, the results argue against the involvement of the neuronal NOS isoform, activated secondary to a hypoxia-induced stimulation of N-methyl-D-aspartate receptors, and against the involvement of the inducible NOS isoform, but rather suggest that NO produced by the endothelial NOS isoform is required to mediate this profound protective effect.

The influence of preischemic hyperglycemia on acute changes in brain water ADCw following focal ischemia in rats

The effect of preischemic hyperglycemia on the acute decline of brain apparent diffusion coefficient of water (ADCw) following cerebral ischemia was studied in a rat model of middle cerebral artery occlusion (MCAO). ADCw was measured by NMR with a newly developed spin-echo line-scan protocol that provides for an ADCw calculation every 15 s at a spatial resolution of 3.4 microl/pixel. A remote controlled occluding device was used to initiate ischemia from outside the magnet, allowing for continuous monitoring of ADCw before, during and after MCAO. Preischemic hyperglycemia (25-30 mM) was achieved via i.v. infusion of 50% glucose. The decline in ADCw following ischemia was analyzed to obtain three-time constants: the time from onset of ischemia to initial significant ADCw decline below baseline level (i.e., 20% of maximal decline, T0.20), the time to decline by 50% (T0.50), and the time to decline by 95% (T0.95). Mean (+/-S.D.) values for T0.20, T0.50, T0.95 were: 39.6+/-7.2, 54. 0+/-7.8, 105.0+/-15.0 s for the normoglycemic group (n=7), and 49. 2+/-33.0, 116.4+/-2.4, 351.0+/-189.0 s for the hyperglycemic group (n=6), respectively. Hyperglycemia significantly prolongs T0.50 and T0.95 but does not affect T0.20. The temporal profiles of ADCw decline following ischemia under normo- and hyperglycemia are distinctively different from the known time course of membrane depolarization under similar experimental conditions, suggesting that mechanisms other than membrane depolarization and cell swelling may contribute to changes in ADCw in cerebral ischemia.

Excitotoxic swelling occurs in oxygen and glucose deprived human cortical slices

The experimental evidence linking glutamate to ischemic neuronal injury is derived from in vitro or in vivo animal stroke models. We, therefore, developed an in vitro preparation to determine whether glutamate contributes to early neuronal swelling in oxygen and glucose deprived (OGD) human neocortical slices. In order to monitor neuronal swelling, we measured extracellular tissue resistance in brain slices by passing constant current pulses through two electrodes and recording the voltage drop between them. We verified that NMDA (30 microM) or OGD induced a rise in tissue resistance in rat neocortical slices. We then examined human neocortical slices from 11 patients undergoing resections for intractable epilepsy. Both the rodent and human neocortical slices swelled within 10 min of OGD. In both, the glutamate antagonist dizocilpine (MK-801) reduced the swelling. In the rats, MK-801 (5 microM) prolonged the latency to onset of neuronal swelling following OGD from 7.6 +/- 0.6 min (mean +/- S.E.M., n = 16) to 17.4 +/- 2.6 min (n = 6; p < 0.01). Other putative neuroprotective agents were much less effective in this paradigm. In the human slices, MK-801 again prolonged the latency to resistance increase from 8.6 +/- 0.4 min (n = 8) to 17.2 +/- 1.7 min (n = 9, p < 0.01). This is the direct demonstration that glutamate receptor activation leads to neuronal swelling in substrate deficient human brain. These results, which are similar to those obtained in the rodent brain slices, help validate the animal slices as appropriate models for the study of OGD in human brain.

Recovery of hypothalamic NMDA-induced c-fos expression following neonatal glutamate (MSG) lesions

The neonatal brain is susceptible to neurotoxic insult. In a previous report we showed that a single neonatal injection of MSG, known to cause damage in the arcuate nucleus (ARC), induces a precocious yet otherwise normal puberty in female rats. We have examined this ability of the medial basal hypothalamus (MBH) to recover from an excitotoxic insult using the immediate-early gene c-fos as a developmental marker of ARC response to glutamate receptor stimulation with N-methyl-D-aspartate (NMDA). Groups of neonatal (postnatal day (PD) 2) pups were injected with MSG, then stimulated on subsequent days (PD 3-29) with NMDA, known to induce c-fos expression in ARC. Computer-assisted densitometry was used to quantify Fos-like immunoreactivity (FLI) profiles in ARC. Pups treated neonatally with saline (PD 2) showed a robust, age-specific expression of FLI in the ARC following NMDA treatment. The FLI response was absent in the days immediately following an MSG lesion but subsequently recovered up to 75% of maximum by PD 16. Almost full recovery was seen by PD 29. We also examined the ability of the ARC to recover following chronic MSG treatment (PD 2-8), known to induce extensive hypothalamic damage. These pups displayed an unusual response to subsequent NMDA injection, consisting of 5 min cycles of hyper- and hypoactivity. Stimulation with NMDA revealed only a 50% recovery of FLI even at PD 29. In both treatment groups (acute vs. chronic MSG) the zone of recovery (i.e., reappearance of FLI) was initiated close to the third ventricle and with time radiated towards the periphery of the ARC. Some cells which reacquired FLI in the ARC following lesions presented a highly irregular condensed nuclear morphology. We conclude that the recovery of hypothalamic function (i.e., onset of puberty) after a neonatal MSG lesion is coincident with the reappearance of a normal pattern of c-fos expression in response to NMDA stimulation.

MRI measurements of water diffusion and cerebral perfusion: their relationship in a rat model of focal cerebral ischemia

The aim of this study was to examine the quantitative relationship between changes in apparent diffusion coefficient (ADC) and transverse relaxivity (delta R2*) measurements of relative perfusion deficits within the gradients of a focal ischemic insult. Sixty minutes after permanent occlusion of the middle cerebral artery, rats (n = 7) were subjected to spin echo diffusion-weighted scans followed by fast low-angle shot (FLASH) perfusion-sensitive scans. Diffusion-weighted images showed clear ischemic lesions in the affected basal ganglia and cortex. Ischemic deficits were demonstrated as a decrease in first-pass transit of injected boluses of gadodiamide. ADC maps were generated and regions of interest (ROIs) were obtained to span the range of ADC reductions from the lesion center or core to the periphery or penumbra. Corresponding ROIs from the bolus injection images were used to calculate perfusion indexes relative to contralateral levels as ratios of delta R2* integrals and ratios of delta R2* peak values. In all animals, the degree of ADC reductions was related to the degree of delta R2* perfusion deficits, ranging from severe ischemia in the core of the lesion to intermediate and moderate changes toward the lesion periphery. In the ischemic periphery, ADC reductions were linearly correlated with delta R2* peak ratios. However, no significant correlation was found between ADC reductions and delta R2* integral ratios. These data suggest that magnetic resonance measurements of ADC and delta R2* peak ratios can be used to quantitatively assess the variable gradients in focal ischemia, including potentiallyn critical areas at risk in the ischemic periphery.

Reversible, reproducible reduction of brain water apparent diffusion coefficient by cortical electroshocks

Rat brains were imaged after cortical electroshock pulse trains (1 ms pulses at 100 Hz) of varying durations (0.1-10 s), with diffusion-weighted echo planar imaging sequences at 2.0 T. The apparent water diffusion coefficient (ADC) decreased after either single or repeat electroshock trains. ADC reductions were observed within 6 s after the first shock. The size of the affected area of the brain increased in subsequent images during the 1st min after a 10-pulse (0.1 s) train, and also increased with the duration of electroshock trains. ADC reduction was reproducible in extent and time course after single 10-shock trains and was reversible. In the affected pixels the mean ADC reduction was 4% for a single shock train (0.1 s), and 7-8% for trains repeated once a minute, independent of electroshock train duration. The results indicate that neuronal activity associated with electrostimulation may be monitored with water diffusion measurements, and they may be useful for measuring the severity of seizure activity in patients with medically intractable epilepsy.

Dynamic magnetic resonance imaging and spectroscopie of experimental brain injury

This article describes the use of non-invasive magnetic resonance (MR) methods for the characterization and monitoring of the pathophysiology of experimental brain injury in laboratory animals as a function of time and treatment. The impact of MR in brain research is primarily due to its non-invasive nature, thereby enabling repeated measurements in long-term studies, and due to the type of information that it provides. MR imaging (MRI) enables the measurement of the morphology/anatomy as well as the functional status of tissues under in vivo conditions. Compared to other in vivo imaging modalities, MRI has a high spatial resolution and allows for a remarkable soft tissue differentiation. MR spectroscopy (MRS) provides information on the biochemical/metabolic status of tissues. MR methods which have proven valuable in animal studies, can be readily translated to the clinical situation where MR-based diagnosis and treatment planning play a rapidly increasing role. After a short introduction into the principles of MR, we will illustrate the remarkable versatility of MR in research on brain injury from recent animal studies. Examples will be mainly drawn from experiments on early injury in focai cerebral ischemia and from research on mechanical brain trauma and excitotoxic lesions. The article ends with a brief description of the perspectives of MR in neuropsychiatry.

Biexponential diffusion attenuation in various states of brain tissue: implications for diffusion-weighted imaging

Diffusion-weighted single voxel experiments conducted at b-values up to 1 x 10(4) smm-2 yielded biexponential signal attenuation curves for both normal and ischemic brain. The relative fractions of the rapidly and slowly decaying components (f1, f2) are f1 = 0.80 +/- 0.02, f2 = 0.17 +/- 0.02 in healthy adult rat brain and f1 = 0.90 +/- 0.02, f2 = 0.11 +/- 0.01 in normal neonatal rat brain, whereas the corresponding values for the postmortem situation are f1 = 0.69 +/- 0.02, f2 = 0.33 +/- 0.02. It is demonstrated that the changes in f1 and f2 occur simultaneously to those in the extracellular and intracellular space fractions (fex, f(in)) during: (i) cell swelling after total circulatory arrest, and (ii) the recovery from N-methyl-D-aspartate induced excitotoxic brain edema evoked by MK-801, as measured by changes in the electrical impedance. Possible reasons for the discrepancy between the estimated magnitude components and the physiological values are presented and evaluated. Implications of the biexponential signal attenuation curves for diffusion-weighted imaging experiments are discussed.

Severe transient hypoglycemia causes reversible change in the apparent diffusion coefficient of water

BACKGROUND AND PURPOSE

The aim of this study was to determine the effects of temporary severe hypoglycemia on the apparent diffusion coefficient (ADC) acquired by diffusion-weighted MRI of brain water with the use of serial multislice ADC mapping in rats. Severe hypoglycemia reduces the extracellular space volume, as does ischemia. Demonstrating a reduction of ADC with hypoglycemia should increase our understanding of the mechanisms underlying ADC changes in ischemia and other conditions.

METHODS

Fasted rats were given regular insulin (15 IU/kg IP). Rats were subjected to 15 minutes (n = 5) and 50 minutes (n = 5) of temporary severe hypoglycemia, causing a transiently isoelectric electroencephalogram (EEG). ADC mapping was performed every 30 seconds beginning at the onset of isoelectricity for 8.5 minutes. ADC maps were also obtained later during the isoelectric EEG period and 10, 20, 30, and 40 minutes after glucose infusion. Control images were obtained from a separate group of animals suffering cardiac arrest (n = 5).

RESULTS

Abnormal ADC values were not observed before the onset of cerebral isoelectricity, except for isolated areas in the cortex and periventricular regions. Cortical ADC values globally declined at the onset of EEG isoelectricity. The ADC decline spread to subcortical regions within a few minutes. During the isoelectric period, significant declines of ADC values (27% to 45%) occurred in the entire brain. Glucose infusion normalized most of the ADC changes, even after a 50-minute period of isoelectricity.

CONCLUSIONS

ADC mapping during hypoglycemia clearly demonstrates changes likely related to energy depletion. Most of these ADC declines were reversible. Hypoglycemia is a condition known to be associated with shrinkage of the extracellular space. These observations support the hypothesis that ADC reductions observed in ischemia are also related to shifts of water from the extracellular to the intracellular compartment.

The protective effect of MK-801 on infarct development over a period of 24 h as assessed by diffusion-weighted magnetic resonance imaging

Diffusion-weighted MRI has been used to investigate therapeutic intervention with MK-801 in an animal model of permanent focal cerebral ischaemia. The animals were imaged continuously for 4 h and again at 24 h following occlusion of the middle cerebral artery (MCA) allowing the development of the ischaemic lesion to be monitored continuously in the same animals. An increased DWI signal, seen as a region of hyperintensity, was detected 1 h after MCA-occlusion in the lateral cortex and caudate nucleus in both control and MK-801 (administered at a dose of 3 mg/kg i.p. 5 min post-ischaemia) treated animals. However, the volume of hemispheric and cortical hyperintensity was smaller in the MK-801-treated animals. The area of hyperintensity progressively increased in the control group over the 4 h imaging time and there was also an increase in the area of hyperintensity between 4 and 24 h. At these time points the area of hyperintensity encompassed the dorsolateral cortex and caudate nucleus. MK-801 treated animals also demonstrated some progressive increase in the area of hyperintensity between 1 and 3 h, but no significant increase in the area of hyperintensity was seen after this time. The hyperintense regions at 4 and 24 h were restricted to the so-called 'core areas' of the lesion in MK-801-treated animals. Thus, using DWI the tissue 'at risk' following ischaemia could be identified and the protective effect of therapeutic intervention demonstrated.

Reduction of excitotoxicity-induced brain damage by the competitive NMDA antagonist CGP 40116: a longitudinal study using diffusion-weighted imaging

The cerebroprotective properties of the competitive N-methyl-D-aspartate (NMDA) antagonist CGP 40116 were evaluated in a rat model of excitotoxicity-induced brain damage using direct intrastriatal injection of quinolinic acid and subsequent (5 or 45 min later) i.p. administration of the drug. Diffusion-weighted magnetic resonance imaging (DWI) was used to follow the temporal lesion growth during the acute phase (4 h) and T2-weighted MRI (T2WI) to quantify vasogenic edema extent 2 days later. For control animals, we found a rapid increase in lesion volume during the first hour followed by a moderate growth over the following hours. The DWI-visible hyperintensity was partially reversible after treatment with CGP 40116. The onset of action of CGP 40116 was immediate. The final outcome (63% reduction of lesion volume within 2-4 h post-surgery) was independent of the time of drug administration. DWI data after 4 h correlated well with those obtained by T2WI 2 days later. DWI is a valuable method for early prediction of the outcome of therapeutic interventions of excitotoxic insults.

Developmental changes in NMDA-induced cell swelling and its transition to necrosis measured with 1H magnetic resonance imaging, impedance and histology

The vulnerability of the rat brain to intracerebrally injected N-methyl-D-aspartate (NMDA) drastically changes with age. We evaluated the developmental changes in the early and late responses to NMDA using 1H magnetic resonance imaging (MRI), cortical impedance and histology. NMDA, injected in the striatum of rats at postnatal days (P) 4, 7, 10, 14 and 21, induced a significant age-dependent reduction in the apparent diffusion coefficient (ADC) of tissue water in the striatum and the cerebral cortex monitored 1 h later using diffusion-weighted MRI. The reduction in ADC amounted 65% at P4 with lower values thereafter and was about 30% at P21. NMDA similarly induced a reduction in the cortical extracellular space (by 50% at P7 and 10% at P16) as measured with impedance recordings. The progressive decrease in the effect of NMDA with brain development was also indicated by a decrease in the volume of tissue in which the changes in ADC occurred (50 mm3 at P4 and 8 mm3 at P21). The diffusion of extracellular tracer molecules Mn2+ or [3H]-(R)-alpha-amino-3-hydroxy-5-methyl-4-isoxazole proprionic acid (AMPA) injected in the striatum and monitored with T1-weighted MRI and autoradiography respectively showed a similar age dependence with the diffusion volume being twofold larger in P7 than in P21 brain. Thus restriction in diffusion during brain development may contribute to the decrease in NMDA-induced injury with age. The volume of tissue necrosis and gliosis, measured with T2-weighted MRI and histology 5 days after NMDA injection, was similar to that outlined by the ADC reduction detected soon after the insult at P4, P7 and P21. However, at P10 and P14 only 50% of the tissue showing a hyperintense signal in DW images displayed necrosis and gliosis 5 days later. This study shows that during development the early response to NMDA in terms of cytotoxic cell swelling (indicated both with impedance recordings and diffusion-weighted MRI) decreases with age. In addition, with maturation only part of the brain tissue acutely affected by NMDA does proceed into necrosis and gliosis, indicating an increased capacity of cells in the developing rat brain to survive NMDA-induced cell swelling.

Status of the neonatal rat brain after NMDA-induced excitotoxic injury as measured by MRI, MRS and metabolic imaging

Intrastriatal injection of the excitotoxin N-methyl-D-aspartate (NMDA) in neonatal rat brain resulted in an acute ipsilateral decrease of the apparent diffusion coefficient (ADC) of brain tissue water, as measured with diffusion-weighted MRI. The early diffusion changes were accompanied by only mild changes in the overall metabolic status as measured by in vivo 1H MRS and 31P MRS and metabolic imaging of brain sections. Minimal decreases in the high-energy phosphate levels and a small hemispheric acidosis were observed in the first 6 h after NMDA administration. In addition, there was very modest lactate accumulation. Twenty-four hours after the induction of the excitotoxic injury the tissue energy status was still only moderately affected, whereas an overall decrease of 1H MRS-detected brain metabolites was found. Treatment with the non-competitive NMDA-antagonist MK-801 given within 90 min after NMDA injection rapidly reversed the NMDA-induced changes in the entire ipsilateral hemisphere. The effect of the competitive NMDA-antagonist D-CPPene was restricted to the cortical areas and was accomplished on a slower time scale. Our results indicate that; (i) early excitotoxicity in the neonatal rat brain does not lead to profound changes in the metabolic status; and (ii) brain tissue water ADC changes are not necessarily associated with a metabolic energy failure.

Current concepts of brain edema. Review of laboratory investigations

Klatzo's classification of brain edema into two types, vasogenic and cytotoxic, has been in general use since 1967. The former involves overall brain swelling due to fluid entry from the vasculature because of openings in the blood-brain barrier (BBB), whereas the latter refers to cell swelling without any loss of the normal impermeability of the BBB. This review principally covers new work that identifies the intracellular swelling of astrocytes as a major form of cytotoxic edema seen in many different kinds of brain injury. The term edema should be retained because of its familiarity; however, because such intracellular swelling is usually not a response to toxins, it is suggested that the term cellular edema is preferable to cytotoxic edema. The difficulties involved in measuring cellular edema clinically are discussed, and the belief that a "pure" form of either edema is unlikely to exist. It is emphasized that the mechanisms and direct consequences of vasogenic and cellular edema are so different that the connection is mainly semantic. Studies conducted in vitro have identified several potentially damaging secondary consequences of astrocytic swelling. One of the most important of these seems likely to be the increased release of excitatory amino acids from swollen astrocytes. Potential mechanisms for inhibition of the increased release of amino acids have been identified in vitro and could prove therapeutically useful.

In vivo diffusion spectroscopy. An overview

This review describes in vivo NMR measurements of metabolite diffusion. NMR spectroscopy can employ a variety of endogenous marker molecules to obtain information on various aspects of in vivo biochemistry and biophysics from the diffusion characteristics of these markers. NMR-based metabolite diffusion data give an insight into the physico-chemical properties of the intracellular compartment and of changes therein in relation to development and pathology. Recent applications have proven that in vivo diffusion spectroscopy provides exciting opportunities to both fundamental and applied research.

The application of porous-media theory to the investigation of time-dependent diffusion in in vivo systems

Recent developments in solid-boundary porous-media theory have shown that useful structural information can be extracted from the time-dependent diffusion coefficient, D(t), of the fluid filling the interstitial space. This theoretical framework provides a basis from which to understand the results from diffusion experiments performed in other types of systems (e.g. biological). Structural information about porous media can be obtained from the short-time behavior of D(t) in the form of the ratio of the surface area to pore volume, S/V. The long-time behavior of D(t) in porous media provides an indirect measure of the macroscopic structure. In this case, the long-time diffusion coefficient, D(eff), reflects the tortuosity, T, of the medium; a property of both the connectivity of the diffusion paths and the volume fraction of the sample. Measurements of D(t) were performed in RIF-1 tumors, using both spectroscopy and imaging, and the data were used to calculate S/V and T. The results were compared with histological sections in order to correlate S/V and T with differences in tissue structure (i.e. necrotic vs non-necrotic tumor tissue). Based on spectroscopic measurements, there is a trend towards decreasing S/V and T with increasing tumor volume, consistent with the interpretation that water in necrotic tissue is experiencing relatively fewer restricting barriers (as compared to non-necrotic tumor tissue). Based on D(t) maps generated from RIF-1 tumors, D(eff), and hence T appears to be much more sensitive than S/V in differentiating between necrotic and non-necrotic tissue. In addition to characterizing diseased tissue, S/V and particularly T appear to be sensitive to structural changes that would accompany tumor treatment and should therefore provide a useful tool for monitoring the progress of therapeutic interventions.

Treatment with NMDA receptor antagonists does not affect developmental changes in NMDA receptor properties in vivo

Effects of acute and long-term treatment of neonatal rats with N-methyl-D-aspartate (NMDA) receptor antagonists on changes in NMDA receptor properties were examined. Animals received either on postnatal day 6 a single dose of the antagonists MK-801 (1 mg/kg), or D-CPPene (2 mg/kg) or during the period from postnatal day 5 to 14, two daily injections of MK-801 (0.25 mg/kg) or D-CPPene (0.75 mg/kg). Control littermates received saline injections. In both cases animals were sacrificed one day after the last injection. NMDA receptor properties were examined in membrane preparations derived from the cerebral cortex by studying the modulation of [3H]MK-801 binding by glutamate, Mg2+ and D-CPPene. The density of agonist- and antagonist-binding sites in the CA1 region of the hippocampus were determined by autoradiography, using [3H]CGP39653 or [3H]glutamate as ligands. A significant developmental increase in NMDA receptor binding sites was detected both in preparations of cerebral cortical membranes and in the CA1 area of the hippocampus. In addition, the Mg2+ sensitivity of [3H]MK-801 binding was significantly higher in membrane preparations from the cerebral cortex of postnatal day 15 compared to postnatal day 7 animals. Neither the single nor the subchronic treatment with NMDA receptor antagonists exerted a significant influence on the density of antagonist binding sites or on the modulation of [3H]MK-801 binding by glutamate, Mg2+ or D-CPPene. We conclude therefore that neonatal treatment with NMDA receptor antagonists in vivo does not involve significant alterations in the properties and the densities of NMDA receptors in the brain regions studies, i.e., during the period when expression of these receptors is subject to pronounced developmental regulation.

Correlation of early reduction in the apparent diffusion coefficient of water with blood flow reduction during middle cerebral artery occlusion in rats

To determine the relationship between reductions in the apparent diffusion coefficient of water (ADC) and in cerebral blood flow (CBF) during focal ischemia, we used diffusion-weighted magnetic resonance (D-MR) imaging and autoradiographic CBF analysis to examine rats subjected to 30 or 90 min of permanent middle cerebral artery (MCA) occlusion. In the 30-min occlusion group (n = 10), the area with substantially reduced ADC (15% or more below the contralateral level [ADC15]) corresponded best to the area with CBF below 25 ml/100 g/min and was significantly smaller than the area with CBF below 50 ml/100 g/min (CBF50), a level associated with reduced protein synthesis and delayed necrosis (40 +/- 13% versus 74 +/- 8% of the ischemic hemisphere; P < 0.0001). In the 90-min occlusion group (n = 6), the ADC15 area corresponded best to the CBF30 to CBF35 area and was again significantly smaller than the CBF50 area (54 +/- 13% versus 73 +/- 20%, P < 0.05). Thus, the area of substantially reduced ADC at 30 and 90 min represents only 53% and 74%, respectively, of the tissue at risk for infarction. These findings indicate a potential limitation in using early D-MR imaging to predict stroke outcome.

NMDA and kainate induce internucleosomal DNA cleavage associated with both apoptotic and necrotic cell death in the neonatal rat brain

Injection of N-methyl-D-aspartate (NMDA) or kainate in the striatum of 7-day-old rats induced massive cell loss in the ipsilateral striatum, hippocampus and inner cortical layers. In order to examine whether apoptosis contributes to cell death in this model of excitotoxic injury we examined the progression of internucleosomal DNA fragmentation and changes in cellular ultrastructure. Agarose gel electrophoresis of DNA extracted from the ipsilateral striatum, cerebral cortex and hippocampus clearly showed breakdown of DNA into oligonucleosome-sized fragments, indicative of apoptosis, 12 h post-NMDA injection. In addition, an increase between 12 and 24 h was observed as well as a continuous presence 5 days later. Kainate induced a similar time course of oligonucleosomal DNA fragmentation, but the intensity of the ethidium bromide stained bands was less compared with that observed for NMDA. DNA fragmentation was not detected in animals intrastriatally injected with Tris-HCl or in animals treated with MK-801 [(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohept-5,10-imine hydrogen maleate, 1 mg/kg] 30 min after NMDA injection. MK-801 had no effect on DNA fragmentation induced by kainate. In addition to agarose gel electrophoresis, terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labelling (TUNEL) was used for detection of DNA fragmentation in sections. A gradual increase in the density of both apoptotic and non-apoptotic TUNEL nuclei was found in the anterior cingulate (ACC) and retrosplenial (RSC) areas of the cortex, the striatum, and the CA1 area and dentate gyrus of the hippocampus over the first 24 h post-NMDA or kainate injection. In the contralateral hemisphere hardly any TUNEL nuclei were present and their density was comparable with that in animals injected with vehicle only. In the ipsilateral mammillary nucleus (MN), which showed no signs of acute cell swelling after intrastriatal injection with NMDA, internucleosomal DNA fragmentation was found 24 and 48 h after intrastriatal NMDA injection. Here, the density of TUNEL cells with apoptotic morphology was high at 12 and 24 h post-NMDA injection but returned to control levels by 5 days. Electron microscopy showed cells with a clearly apoptotic morphology in the ACC and RSC and in the MN 24 h after NMDA injection. In the CA1 area of the hippocampus a necrotic, rather than an apoptotic, ultrastructure prevailed, indicating that the TUNEL method stained both apoptotic and necrotic cells.(ABSTRACT TRUNCATED AT 400 WORDS)