Key result
Focal contralesional therapeutic hypothermia did not impact lesion volume (p=0.371) but significantly reduced the likelihood of shifting preference to the unimpaired paw (p≤0.043).
Why the study?
Does focal contralesional therapeutic hypothermia harm behavioral recovery after cortical injury in rats?
RCT
Randomly assigned
Does focal contralesional therapeutic hypothermia harm behavioral recovery after cortical injury in rats?
p-value: p=≤0.043
Localized contralesional therapeutic hypothermia does not impair learning or plasticity but may reduce unwanted shifts in limb preference after stroke in a rat model.
Supports safety of contralesional cooling in rat stroke models; hypothesis-generating for clinical translation.
Therapeutic hypothermia (TH) mitigates neuronal injury in models of ischemic stroke. Although this therapy is meant for injured tissue, most protocols cool the whole body, including the contralesional hemisphere. Neuroplasticity responses within this hemisphere can affect functional outcome. Thus, cooling the contralesional hemisphere serves no clear neuroprotective function and may instead be detrimental. In this study, we cooled the contralesional hemisphere to determine whether this harms behavioral recovery after cortical injury in rats. All rats were trained on skilled reaching and walking tasks. Rats then received a motor cortex insult contralateral to their dominant paw after which they were randomly assigned to focal contralesional TH (∼33°C) for 1-48, 1-97, or 48-96 hours postinjury, or to a normothermic control group. Contralesional cooling did not impact lesion volume (p = 0.371) and had minimal impact on neurological outcome of the impaired limb. However, rats cooled early were significantly less likely to shift paw preference to the unimpaired paw (p ≤ 0.043), suggesting that cooling reduced learned nonuse. In a second experiment, we tested whether cooling impaired learning of the skilled reaching task in naive rats. Localized TH applied to the hemisphere contralateral or ipsilateral to the preferred paw did not impair learning (p ≥ 0.677) or dendritic branching/length in the motor cortex (p ≥ 0.105). In conclusion, localized TH did not impair learning or plasticity in the absence of neural injury, but contralesional TH may reduce unwanted shifts in limb preference after stroke.
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Klahr et al. (2018) conducted an RCT in Motor cortex injury. Focal contralesional therapeutic hypothermia vs. Normothermic control group was evaluated on Shift in paw preference to the unimpaired paw (p=≤0.043). Focal contralesional therapeutic hypothermia did not impact lesion volume (p=0.371) but significantly reduced the likelihood of shifting preference to the unimpaired paw (p≤0.043).
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