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Selective Brain Cooling: A New Horizon of Neuroprotection

Therapeutic hypothermia (TH), which prevents irreversible neuronal necrosis and ischemic brain damage, has been proven effective for preventing ischemia-reperfusion injury in post-cardiac arrest syndrome and neonatal encephalopathy in both animal studies and clinical trials. However, lowering the wh...

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Autores principales: Hong, Ji Man, Choi, Eun Sil, Park, So Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251464/
https://www.ncbi.nlm.nih.gov/pubmed/35795804
http://dx.doi.org/10.3389/fneur.2022.873165
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author Hong, Ji Man
Choi, Eun Sil
Park, So Young
author_facet Hong, Ji Man
Choi, Eun Sil
Park, So Young
author_sort Hong, Ji Man
collection PubMed
description Therapeutic hypothermia (TH), which prevents irreversible neuronal necrosis and ischemic brain damage, has been proven effective for preventing ischemia-reperfusion injury in post-cardiac arrest syndrome and neonatal encephalopathy in both animal studies and clinical trials. However, lowering the whole-body temperature below 34°C can lead to severe systemic complications such as cardiac, hematologic, immunologic, and metabolic side effects. Although the brain accounts for only 2% of the total body weight, it consumes 20% of the body's total energy at rest and requires a continuous supply of glucose and oxygen to maintain function and structural integrity. As such, theoretically, temperature-controlled selective brain cooling (SBC) may be more beneficial for brain ischemia than systemic pan-ischemia. Various SBC methods have been introduced to selectively cool the brain while minimizing systemic TH-related complications. However, technical setbacks of conventional SBCs, such as insufficient cooling power and relatively expensive coolant and/or irritating effects on skin or mucosal interfaces, limit its application to various clinical settings. This review aimed to integrate current literature on SBC modalities with promising therapeutic potential. Further, future directions were discussed by exploring studies on interesting coping skills in response to environmental or stress-induced hyperthermia among wild animals, including mammals and birds.
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spelling pubmed-92514642022-07-05 Selective Brain Cooling: A New Horizon of Neuroprotection Hong, Ji Man Choi, Eun Sil Park, So Young Front Neurol Neurology Therapeutic hypothermia (TH), which prevents irreversible neuronal necrosis and ischemic brain damage, has been proven effective for preventing ischemia-reperfusion injury in post-cardiac arrest syndrome and neonatal encephalopathy in both animal studies and clinical trials. However, lowering the whole-body temperature below 34°C can lead to severe systemic complications such as cardiac, hematologic, immunologic, and metabolic side effects. Although the brain accounts for only 2% of the total body weight, it consumes 20% of the body's total energy at rest and requires a continuous supply of glucose and oxygen to maintain function and structural integrity. As such, theoretically, temperature-controlled selective brain cooling (SBC) may be more beneficial for brain ischemia than systemic pan-ischemia. Various SBC methods have been introduced to selectively cool the brain while minimizing systemic TH-related complications. However, technical setbacks of conventional SBCs, such as insufficient cooling power and relatively expensive coolant and/or irritating effects on skin or mucosal interfaces, limit its application to various clinical settings. This review aimed to integrate current literature on SBC modalities with promising therapeutic potential. Further, future directions were discussed by exploring studies on interesting coping skills in response to environmental or stress-induced hyperthermia among wild animals, including mammals and birds. Frontiers Media S.A. 2022-06-20 /pmc/articles/PMC9251464/ /pubmed/35795804 http://dx.doi.org/10.3389/fneur.2022.873165 Text en Copyright © 2022 Hong, Choi and Park. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Hong, Ji Man
Choi, Eun Sil
Park, So Young
Selective Brain Cooling: A New Horizon of Neuroprotection
title Selective Brain Cooling: A New Horizon of Neuroprotection
title_full Selective Brain Cooling: A New Horizon of Neuroprotection
title_fullStr Selective Brain Cooling: A New Horizon of Neuroprotection
title_full_unstemmed Selective Brain Cooling: A New Horizon of Neuroprotection
title_short Selective Brain Cooling: A New Horizon of Neuroprotection
title_sort selective brain cooling: a new horizon of neuroprotection
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251464/
https://www.ncbi.nlm.nih.gov/pubmed/35795804
http://dx.doi.org/10.3389/fneur.2022.873165
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