Perfusion Changes in Acute Stroke Treated with Theophylline as an Add-on to Thrombolysis: A Randomized Clinical Trial Subgroup Analysis
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Perfusion Changes in Acute Stroke Treated with Theophylline as an Add-on to Thrombolysis: A Randomized Clinical Trial Subgroup Analysis. / Modrau, Boris; Winder, Anthony; Hjort, Niels; Nygård Johansen, Martin; Andersen, Grethe; Fiehler, Jens; Vorum, Henrik; Forkert, Nils D.
in: CLIN NEURORADIOL, Jahrgang 32, Nr. 2, 06.2022, S. 345-352.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Perfusion Changes in Acute Stroke Treated with Theophylline as an Add-on to Thrombolysis: A Randomized Clinical Trial Subgroup Analysis
AU - Modrau, Boris
AU - Winder, Anthony
AU - Hjort, Niels
AU - Nygård Johansen, Martin
AU - Andersen, Grethe
AU - Fiehler, Jens
AU - Vorum, Henrik
AU - Forkert, Nils D
N1 - © 2021. The Author(s).
PY - 2022/6
Y1 - 2022/6
N2 - PURPOSE: Theophylline has been suggested to have a neuroprotective effect in ischemic stroke; however, results from animal stroke models and clinical trials in humans are controversial. The aim of this study was to assess the effect of theophylline on the cerebral perfusion with multiparametric magnetic resonance imaging (MRI).METHODS: The relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) in the infarct core, penumbra, and unaffected tissue were measured using multi-parametric MRI at baseline and 3‑h follow-up in patients treated with theophylline or placebo as an add-on to thrombolytic therapy.RESULTS: No significant differences in mean rCBF, rCBV, and rMTT was found in the penumbra and unaffected tissue between the theophylline group and the control group between baseline and 3‑h follow-up. In the infarct core, mean rCBV increased on average by 0.05 in the theophylline group and decreased by 0.14 in the control group (p < 0.04). Mean rCBF and mean rMTT in the infarct core were similar between the two treatment groups.CONCLUSION: The results indicate that theophylline does not change the perfusion in potentially salvageable penumbral tissue but only affects the rCBV in the infarct core. In contrast to the penumbra, the infarct core is unlikely to be salvageable, which might explain why theophylline failed in clinical trials.
AB - PURPOSE: Theophylline has been suggested to have a neuroprotective effect in ischemic stroke; however, results from animal stroke models and clinical trials in humans are controversial. The aim of this study was to assess the effect of theophylline on the cerebral perfusion with multiparametric magnetic resonance imaging (MRI).METHODS: The relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) in the infarct core, penumbra, and unaffected tissue were measured using multi-parametric MRI at baseline and 3‑h follow-up in patients treated with theophylline or placebo as an add-on to thrombolytic therapy.RESULTS: No significant differences in mean rCBF, rCBV, and rMTT was found in the penumbra and unaffected tissue between the theophylline group and the control group between baseline and 3‑h follow-up. In the infarct core, mean rCBV increased on average by 0.05 in the theophylline group and decreased by 0.14 in the control group (p < 0.04). Mean rCBF and mean rMTT in the infarct core were similar between the two treatment groups.CONCLUSION: The results indicate that theophylline does not change the perfusion in potentially salvageable penumbral tissue but only affects the rCBV in the infarct core. In contrast to the penumbra, the infarct core is unlikely to be salvageable, which might explain why theophylline failed in clinical trials.
U2 - 10.1007/s00062-021-01029-x
DO - 10.1007/s00062-021-01029-x
M3 - SCORING: Journal article
C2 - 34259904
VL - 32
SP - 345
EP - 352
JO - CLIN NEURORADIOL
JF - CLIN NEURORADIOL
SN - 1869-1439
IS - 2
ER -
