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.

中文翻译：

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用茶碱作为溶栓治疗的急性中风的灌注变化

目的

已提出茶碱对缺血性中风具有神经保护作用。然而，动物中风模型和人体临床试验的结果存在争议。本研究的目的是通过多参数磁共振成像 (MRI) 评估茶碱对脑灌注的影响。

方法

使用多参数 MRI 在基线和 3 h在接受茶碱或安慰剂作为溶栓治疗的附加治疗的患者中。

结果

在基线和 3 小时随访期间，茶碱组和对照组之间的半影和未受影响组织的平均 rCBF、rCBV 和 rMTT 没有显着差异。在梗塞核心，茶碱组平均 rCBV 平均增加 0.05，而对照组平均减少 0.14（p  < 0.04）。梗死核心区的平均 rCBF 和平均 rMTT 在两个治疗组之间相似。

结论

结果表明，茶碱不会改变潜在可挽救的半影组织中的灌注，而只会影响梗塞核心中的 rCBV。与半影相反，梗死核心不太可能被挽救，这可能解释了为什么茶碱在临床试验中失败。