(Stroke. 2000;31:169.)
© 2000 American Heart Association, Inc.
Original Contributions |
From the Department of Neurosciences, University of California at San Diego School of Medicine, and Department of Neurology, Veterans Administration Medical Center, San Diego, Calif.
Correspondence to Dr Patrick Lyden (127), 3350 La Jolla Village Dr, San Diego, CA 92161.
Background and PurposeTherapy
with
-aminobutyric acid (GABA) agonists appears to improve outcome
after experimental hematoma but with unacceptable side effects.
We looked to synthetic GABA agonists, or positive GABA modulators,
widely developed as anticonvulsants and anxiolytics, to find compounds
that may be effective. Ganaxolone is a synthetic neuroactive steroid
that positively modulates GABA. We sought to determine whether
ganaxolone was beneficial using a model of intracerebral
hematoma.
MethodsWe stereotaxically injected varying doses of bacterial collagenase into the caudate nucleus of rats to induce blood-brain barrier failure and hematoma formation. Four hours later, we administered intravenously 15 or 30 mg/kg ganaxolone (n=23 each group), 20 mg/kg pregnanolone (n=21), or vehicle (n=30). Forty-eight hours after collagenase injection, we rated each animal using a standard rodent neurological examination. The ratings were compared with the amounts of injected collagenase using the quantal bioassay procedure. Other sets of animals were tested later for visuospatial learning. Brains were then prepared for histomorphometry, and brain volumes were estimated.
ResultsWe found that ganaxolone 30 mg/kg significantly increased the ED50 in the bioassay, for a potency ratio of 1.8±0.41 compared with vehicle (P<0.05). Ganaxolone 15 mg/kg and pregnanolone did not affect neurological outcome. Ganaxolone 30 mg/kg did not clearly improve visuospatial learning several weeks after hemorrhage. Ganaxolone exhibited a weak effect on cerebral volumes 48 hours after stroke, but 3 months after hemorrhage no such effect could be detected.
ConclusionsGanaxolone improves neurological outcome 48 hours after intracerebral hematoma but not visuospatial learning several weeks after intracerebral hematoma. Histological evidence of damage was reduced at 48 hours but not at 3 months.
Section of Neurosurgery, University of Chicago Medical Center, Chicago, Illinois {hd1}References
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