The ischemic penumbra: a new opportunity for neuroprotection
Department of Neurology
Animals; Benzenesulfonates; Brain; Brain Ischemia; Clinical Trials as Topic; *Diffusion Magnetic Resonance Imaging; Drug Design; Humans; *Magnetic Resonance Angiography; Neuroprotective Agents; Patient Selection; Recombinant Proteins; Stroke; Time Factors; Tissue Plasminogen Activator; *Tomography, X-Ray Computed
Neurology | Neuroscience and Neurobiology
The development of acute stroke therapies has yielded only limited success and many failures in multiple clinical trials. The target of acute stroke therapy is that portion of the ischemic region that is still potentially salvageable, i.e. the ischemic penumbra. Neuroprotective drugs have the potential to prevent a portion of the ischemic penumbra from evolving into infracted tissue and designing trials that target neuroprotective drugs at patients with persistent penumbra should enhance the likelihood of a positive outcome. Currently, diffusion and perfusion MRI has the potential to approximate the location and persistence of the ischemic penumbra and can be used in clinical trials to select appropriate patients for inclusion and to evaluate a meaningful treatment effect. Perfusion CT may also have similar capabilities. Use of these imaging modalities in clinical trials and ultimately in clinical practice will likely help in the development and utilization of novel neuroprotective drugs.
Rights and Permissions
Citation: Cerebrovasc Dis. 2006;21 Suppl 2:64-70. Epub 2006 May 2. Link to article on publisher's site