Effect of the 21-aminosteroid tirilazad on cerebral pH and somatosensory evoked potentials after incomplete ischemia

Yuichi Maruki, Raymond C. Koehler, Jeffrey Kirsch, Kathleen K. Blizzard, Richard J. Traystman

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background and Purpose: Postischemic evoked potential recovery correlates with acidosis during ischemia and early reperfusion. Acidosis promotes lipid peroxidation in vitro. We tested the hypothesis that the 21-aminosteroid tirilazad mesylate (U74006F), an inhibitor of lipid peroxidation in vitro, ameliorates somatosensory evoked potential recovery and acidosis during reperfusion after severe incomplete cerebral ischemia. Methods: Cerebral perfusion pressure was reduced to 11±1 mm Hg (±SEM) for 30 minutes by cerebral ventricular fluid infusion in anesthetized dogs. Cerebral intracellular pH and high-energy phosphates were measured by magnetic resonance spectroscopy. Dogs were randomized to receive vehicle (citrate buffer; n=8) or tirilazad (1 mg/kg; n=8) before ischemia in a blinded study. Results: Cerebral blood flow was reduced to 6±1 mL/min per 100 g during ischemia, resulting in nearly complete loss of high-energy phosphates and an intracellular pH of 6.0-6.1 in both groups. Initial postischemic hyperemia was similar between groups but lasted longer in the vehicle group. Tirilazad accelerated mean recovery time of intracellular pH from 31±5 to 15±3 minutes and of inorganic phosphate from 13±2 to 6±1 minutes. Recovery of somatosensory evoked potential amplitude was greater with tirilazad (49±3%) than vehicle (33±6%). Fractional cortical water content was less with tirilazad (0.819±0.003) than vehicle (0.831±0.002). Conclusions: Tirilazad attenuates cerebral edema and improves somatosensory evoked potential recovery after incomplete ischemia associated with severe acidosis. Accelerated pH and inorganic phosphate recovery indicates that this antioxidant acts during the early minutes of reperfusion.

Original languageEnglish (US)
Pages (from-to)724-730
Number of pages7
JournalStroke
Volume24
Issue number5
StatePublished - 1993
Externally publishedYes

Fingerprint

Somatosensory Evoked Potentials
Ischemia
Acidosis
Cerebrovascular Circulation
Phosphates
Reperfusion
Dogs
Brain Edema
Hyperemia
tirilazad
Brain Ischemia
Evoked Potentials
Citric Acid
Lipid Peroxidation
Buffers
Magnetic Resonance Spectroscopy
Antioxidants
Water

Keywords

  • Acidosis
  • Cerebral blood flow
  • Cerebral ischemia
  • Evoked potentials, somatosensory
  • Spectroscopy, nuclear magnetic resonance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing
  • Neuroscience(all)

Cite this

Maruki, Y., Koehler, R. C., Kirsch, J., Blizzard, K. K., & Traystman, R. J. (1993). Effect of the 21-aminosteroid tirilazad on cerebral pH and somatosensory evoked potentials after incomplete ischemia. Stroke, 24(5), 724-730.

Effect of the 21-aminosteroid tirilazad on cerebral pH and somatosensory evoked potentials after incomplete ischemia. / Maruki, Yuichi; Koehler, Raymond C.; Kirsch, Jeffrey; Blizzard, Kathleen K.; Traystman, Richard J.

In: Stroke, Vol. 24, No. 5, 1993, p. 724-730.

Research output: Contribution to journalArticle

Maruki, Y, Koehler, RC, Kirsch, J, Blizzard, KK & Traystman, RJ 1993, 'Effect of the 21-aminosteroid tirilazad on cerebral pH and somatosensory evoked potentials after incomplete ischemia', Stroke, vol. 24, no. 5, pp. 724-730.
Maruki, Yuichi ; Koehler, Raymond C. ; Kirsch, Jeffrey ; Blizzard, Kathleen K. ; Traystman, Richard J. / Effect of the 21-aminosteroid tirilazad on cerebral pH and somatosensory evoked potentials after incomplete ischemia. In: Stroke. 1993 ; Vol. 24, No. 5. pp. 724-730.
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AU - Koehler, Raymond C.

AU - Kirsch, Jeffrey

AU - Blizzard, Kathleen K.

AU - Traystman, Richard J.

PY - 1993

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N2 - Background and Purpose: Postischemic evoked potential recovery correlates with acidosis during ischemia and early reperfusion. Acidosis promotes lipid peroxidation in vitro. We tested the hypothesis that the 21-aminosteroid tirilazad mesylate (U74006F), an inhibitor of lipid peroxidation in vitro, ameliorates somatosensory evoked potential recovery and acidosis during reperfusion after severe incomplete cerebral ischemia. Methods: Cerebral perfusion pressure was reduced to 11±1 mm Hg (±SEM) for 30 minutes by cerebral ventricular fluid infusion in anesthetized dogs. Cerebral intracellular pH and high-energy phosphates were measured by magnetic resonance spectroscopy. Dogs were randomized to receive vehicle (citrate buffer; n=8) or tirilazad (1 mg/kg; n=8) before ischemia in a blinded study. Results: Cerebral blood flow was reduced to 6±1 mL/min per 100 g during ischemia, resulting in nearly complete loss of high-energy phosphates and an intracellular pH of 6.0-6.1 in both groups. Initial postischemic hyperemia was similar between groups but lasted longer in the vehicle group. Tirilazad accelerated mean recovery time of intracellular pH from 31±5 to 15±3 minutes and of inorganic phosphate from 13±2 to 6±1 minutes. Recovery of somatosensory evoked potential amplitude was greater with tirilazad (49±3%) than vehicle (33±6%). Fractional cortical water content was less with tirilazad (0.819±0.003) than vehicle (0.831±0.002). Conclusions: Tirilazad attenuates cerebral edema and improves somatosensory evoked potential recovery after incomplete ischemia associated with severe acidosis. Accelerated pH and inorganic phosphate recovery indicates that this antioxidant acts during the early minutes of reperfusion.

AB - Background and Purpose: Postischemic evoked potential recovery correlates with acidosis during ischemia and early reperfusion. Acidosis promotes lipid peroxidation in vitro. We tested the hypothesis that the 21-aminosteroid tirilazad mesylate (U74006F), an inhibitor of lipid peroxidation in vitro, ameliorates somatosensory evoked potential recovery and acidosis during reperfusion after severe incomplete cerebral ischemia. Methods: Cerebral perfusion pressure was reduced to 11±1 mm Hg (±SEM) for 30 minutes by cerebral ventricular fluid infusion in anesthetized dogs. Cerebral intracellular pH and high-energy phosphates were measured by magnetic resonance spectroscopy. Dogs were randomized to receive vehicle (citrate buffer; n=8) or tirilazad (1 mg/kg; n=8) before ischemia in a blinded study. Results: Cerebral blood flow was reduced to 6±1 mL/min per 100 g during ischemia, resulting in nearly complete loss of high-energy phosphates and an intracellular pH of 6.0-6.1 in both groups. Initial postischemic hyperemia was similar between groups but lasted longer in the vehicle group. Tirilazad accelerated mean recovery time of intracellular pH from 31±5 to 15±3 minutes and of inorganic phosphate from 13±2 to 6±1 minutes. Recovery of somatosensory evoked potential amplitude was greater with tirilazad (49±3%) than vehicle (33±6%). Fractional cortical water content was less with tirilazad (0.819±0.003) than vehicle (0.831±0.002). Conclusions: Tirilazad attenuates cerebral edema and improves somatosensory evoked potential recovery after incomplete ischemia associated with severe acidosis. Accelerated pH and inorganic phosphate recovery indicates that this antioxidant acts during the early minutes of reperfusion.

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