Evaluating effects of normobaric oxygen therapy in acute stroke with MRI-based predictive models.

Abstract

BACKGROUND:

Voxel-based algorithms using acute multiparametric-MRI data have been shown to accurately predict tissue outcome after stroke. We explored the potential of MRI-based predictive algorithms to objectively assess the effects of normobaric oxygen therapy (NBO), an investigational stroke treatment, using data from a pilot study of NBO in acute stroke.

METHODS:

The pilot study of NBO enrolled 11 patients randomized to NBO administered for 8 hours, and 8 Control patients who received room-air. Serial MRIs were obtained at admission, during gas therapy, post-therapy, and pre-discharge. Diffusion/perfusion MRI data acquired at admission (pre-therapy) was used in generalized linear models to predict the risk of lesion growth at subsequent time points for both treatment scenarios: NBO or Control.

RESULTS:

Lesion volume sizes 'during NBO therapy' predicted by Control-models were significantly larger (P = 0.007) than those predicted by NBO models, suggesting that ischemic lesion growth is attenuated during NBO treatment. No significant difference was found between the predicted lesion volumes at later time-points. NBO-treated patients, despite showing larger lesion volumes on Control-models than NBO-models, tended to have reduced lesion growth.

CONCLUSIONS:

This study shows that NBO has therapeutic potential in acute ischemic stroke, and demonstrates the feasibility of using MRI-based algorithms to evaluate novel treatments in early-phase clinical trials.

• Authors: Ona Wu, Thomas Benner, Luca Roccatagliata, Mingwang Zhu, Pamela W Schaefer, Alma Gregory Sorensen, Aneesh B Singhal
• Journal: Medical gas research (Med Gas Res) Vol. 2 Issue 1 Pg. 5 (Mar 09 2012) ISSN: 2045-9912 [Electronic] Australia
• PMID: 22404875 (Publication Type: Journal Article)