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Cerebellar Purkinje Cell Neurodegeneration After Cardiac Arrest: Effect of Therapeutic Hypothermia.
MedLine Citation:
PMID:  22683500     Owner:  NLM     Status:  Publisher    
AIMS: : The cerebellum is among the brain regions most vulnerable to damage caused by cardiac arrest, and cerebellar Purkinje cell loss may contribute to neurologic dysfunction, including post-hypoxic myoclonus. However, it remains unknown whether cerebellar Purkinje cells are protected by post-cardiac arrest therapeutic hypothermia (TH). Therefore, we examined the effect of post-cardiac arrest TH onset and duration on cerebellar Purkinje cell loss. METHODS: : Samples from a previously published study of post-cardiac arrest TH were utilized for the present analysis. Adult male rats subjected to asphyxial cardiac arrest and cardiopulmonary resuscitation were block randomized to normothermia (37.0°C) or TH (33.0°C) initiated 0, 1, 4, or 8hours after return of spontaneous circulation (ROSC) and maintained for 24 or 48hours. Cerebella from rats surviving 7 days after ROSC were processed for histology and immunohistochemistry. Purkinje cell density was quantified in Nissl-stained sections of the primary fissure of the cerebellar vermis. RESULTS: : With post-cardiac arrest normothermia, Purkinje cell density in the primary fissure was severely reduced compared to sham-injured controls (3.8±1.8 cells/mm vs. 35.9±2.4 cells/mm, p<0.001). TH moderately improved Purkinje cell survival in all groups combined (14.0±5.6 cells/mm, p<0.001 compared to normothermia). There was no statistical difference in Purkinje cell protection based on TH onset time or duration. CONCLUSION: : These results indicate that post-cardiac arrest TH protects selectively vulnerable cerebellar Purkinje cells within a broad therapeutic window. The potential clinical implications for improving Purkinje cell survival require further investigation.
Michael Gregory Paine; Dongfang Che; Luchuan Li; Robert William Neumar
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-6
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ireland Ltd.
Center for Resuscitation Science, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania.
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