Barrier mechanisms in neonatal stroke

Kratzer, Ingrid; Chip, Sophorn; Vexler, Zinaida S.

doi:10.3389/fnins.2014.00359

Cited by 35 publications

(33 citation statements)

References 106 publications

(125 reference statements)

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“…The challenge in the field of neonatal brain injury has been the difficulty to clinically discern the mild-moderate NE severity within the short therapeutic window after birth. A sensitive and specific physiological marker that directly assesses neurovascular function in real-time, and is a marker of clinical outcomes, is critically needed to guide therapies8910.…”

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confidence: 99%

“…The neurovascular unit consists of neurons, astrocytes, endothelial cells of blood–brain barrier (BBB), myocytes, pericytes and extracellular matrix components which play an important role in the delivery of oxygen and nutrients to the brain and the maintenance of cerebral circulation homeostasis91112. Individual metrics of electroencephalography6131415 and near-infrared spectroscopy (NIRS)1617 have been used independently to assess the function of neurovascular unit, but the ability to study coupling in real time of NIRS and EEG in HIE has received little attention11171819 These methods demonstrated that a severe asphyxia insult leads to impaired function, but the extent of dysfunctional neurovascular coupling (NVC), and its impact on clinical outcome of newborns with encephalopathy cannot be currently assessed in real time due to limited methodology2021.…”

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confidence: 99%

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Novel Wavelet Real Time Analysis of Neurovascular Coupling in Neonatal Encephalopathy

Chalak

Tian

Adams‐Huet

et al. 2017

Sci Rep

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Birth asphyxia constitutes a major global public health burden for millions of infants, despite hypothermia therapy. There is a critical need for real time surrogate markers of therapeutic success, to aid in patient selection and/or modification of interventions in neonatal encephalopathy (NE). This is a proof of concept study aiming to quantify neurovascular coupling (NVC) using wavelet analysis of the dynamic coherence between amplitude-integrated electroencephalography (aEEG) and near-infrared spectroscopy in NE. NVC coupling is assessed by a wavelet metric estimation of percent time of coherence between NIRS SctO2 and aEEG for 78 hours after birth. An abnormal outcome was predefined by a Bayley III score <85 by 18–24 m. We observed high coherence, intact NVC, between the oscillations of SctO2 and aEEG in the frequency range of 0.00025–0.001 Hz in the non-encephalopathic newborns. NVC coherence was significantly decreased in encephalopathic newborns who were cooled vs. non-encephalopathic controls (median IQR 3[2–9] vs.36 [33–39]; p < 0.01), and was significantly lower in those with abnormal 24 months outcomes relative to those with normal outcomes (median IQR 2[1–3] vs 28[19–26], p = 0.04). Wavelet coherence analysis of neurovascular coupling in NE may identify infants at risk for abnormal outcomes.

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confidence: 99%

mentioning

confidence: 99%

Novel Wavelet Real Time Analysis of Neurovascular Coupling in Neonatal Encephalopathy

Chalak

Tian

Adams‐Huet

et al. 2017

Sci Rep

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“…Recovery mechanisms are complex, but unlike in older children or adults, the brain of the newborn is a very dynamic system, with an important part of synaptogenesis [15]. Some authors [16,17] have reported the important role of cell proliferation and migration of the sub-ventricular zone. Some of these cells are multipotent and provide training for neuroblasts and glial cells [16].…”

Section: Commentsmentioning

confidence: 99%

Newborn Stroke in Congo: First Case Report

Bowassa¹,

Ossou-Nguıet²,

Oko³

et al. 2015

AJPN

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Neonatal strokes are defined by the occurrence of any cerebrovascular event between the 20th week of gestation and 28th day after birth. It is an uncommon disease whose incidence varies according to the authors. The localized seizures are the main symptoms. But nonspecific symptoms like bradycardia, bradypnea and poor feeding may reveal the pathology. The diagnosis has been facilitated by the development of brain imaging techniques. It can be done during the acute phase or retrospectively by viewing sequelae's images. They are characterized by their etiology and therapeutic management that differ from those found in young adults. The prognosis is dominated by the occurrence of neurological sequelae such as epilepsy or motor deficits. We report a case of stroke in the neonatal period, observed on the sixteenth day of life.

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“…The ECM of the basement membrane continuously undergoes controlled remodeling during development and is important in hypoxic-ischemic brain injury and pediatric stroke [8][9][10][11][12][13]. Remodeling of the ECM is facilitated primarily by matrix metalloproteinases (MMPs) and their endogenous tissue inhibitors (TIMPs) [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Ischemic-Reperfusion Injury Increases Matrix Metalloproteinases and Tissue Metalloproteinase Inhibitors in Fetal Sheep Brain

Chen¹,

Patra²,

Sadowska³

et al. 2018

Dev Neurosci

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Hypoxic-ischemic brain injury is a leading cause of neurodevelopmental morbidities in preterm and full-term infants. Blood-brain barrier dysfunction represents an important component of perinatal hypoxic-ischemic brain injury. The extracellular matrix (ECM) is a vital component of the blood-brain barrier. Matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) are important ECM components. They contribute to brain development, blood-brain barrier maintenance, and to regenerative and repair processes after hypoxic-ischemic brain injury. We hypothesized that ischemia at different durations of reperfusion affects the ECM protein composition of MMPs and TIMPs in the cerebral cortex of fetal sheep. Cerebral cortical samples were snap-frozen from sham control fetuses at 127 days of gestation and from fetuses after exposure to 30-min carotid occlusion and 4-, 24-, and 48-h of reperfusion. Protein expression of MMP-2, -8, -9, and -13 and TIMP-1, -2, -3, and -4 was measured by Western immunoblotting along with the gelatinolytic activity of MMP-2 and MMP-9 by zymography. The expression of MMP-8 was increased (Kruskal-Wallis, p = 0.04) in fetuses 48 h after ischemia. In contrast, changes were not observed in the protein expression of MMP-2, -9, or -13. The gelatinolytic activity of pro-MMP-2 was increased (ANOVA, p = 0.02, Tukey HSD, p = 0.05) 24 h after ischemia. TIMP-1 and -3 expression levels were also higher (TIMP-1, ANOVA, p = 0.003, Tukey HSD, p = 0.01; TIMP-3, ANOVA, p = 0.006, Tukey HSD, p = 0.01) 24 h after ischemia compared with both the sham controls and with fetuses exposed to 4 h of reperfusion. The changes in the expression of TIMP-1, -2, and -3 correlated with the changes in the MMP-8 and -13 protein expression. We speculate that regulation of MMP-8, MMP-13, and TIMPs contributes to ECM remodeling after is chemic-reperfusion injury in the fetal brain.

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Barrier mechanisms in neonatal stroke

Cited by 35 publications

References 106 publications

Novel Wavelet Real Time Analysis of Neurovascular Coupling in Neonatal Encephalopathy

Novel Wavelet Real Time Analysis of Neurovascular Coupling in Neonatal Encephalopathy

Newborn Stroke in Congo: First Case Report

Ischemic-Reperfusion Injury Increases Matrix Metalloproteinases and Tissue Metalloproteinase Inhibitors in Fetal Sheep Brain

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