Stroke, Vol 23, 1463-1469, Copyright © 1992 by American Heart Association
PD Lyden and B Hedges
BACKGROUND: Excitatory neurotransmitters appear to cause cell death during
ischemia by inducing depolarization, influx of ions, and metabolic failure
in the postsynaptic neuron. If this hypothesis is correct, then
postsynaptic membrane hyperpolarization and inhibition of metabolism may be
protective. Antagonists of the excitotoxic amino acid glutamate protect
neurons in culture and in animal models of stroke but appear to cause
unacceptable side effects in humans. We propose an alternative strategy of
protection using agonists of the inhibitory neurotransmitter
gamma-aminobutyric acid. METHODS: We caused multifocal cerebral ischemia in
rats and rabbits by injecting microspheres into the carotid circulation. We
administered saline, muscimol, or MK-801 within 5 minutes of stroke onset.
We used a bioassay to measure outcome. In rats, we also used learning to
assess cortical function, and we performed detailed quantitative brain
morphometry 3 months after infarction. RESULTS: Using the bioassay, we
found that muscimol exerted a protective effect in rats (p less than 0.01).
There was a dose- response effect seen in muscimol-treated rabbits. Rats
treated with muscimol or MK-801 exhibited significantly better
visual-spatial learning compared with saline-treated subjects (p less than
0.001). Hemisphere volume after ischemia was comparable in all groups.
CONCLUSIONS: Agonists of gamma-aminobutyric acid and antagonists of
glutamate appear to protect brain during ischemia. Since agonists of
gamma-aminobutyric acid are known to have fewer side effects in humans,
they may prove more useful in the clinical setting as neuroprotective
agents.
ARTICLES
Protective effect of synaptic inhibition during cerebral ischemia in rats and rabbits
Department of Neurosciences, University of California, San Diego.
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