Neural Stem Cell Extracellular Vesicles Disrupt Midline Shift Predictive Outcomes in Porcine Ischemic Stroke Model

Area of Science:

• Neurology
• Biomarkers
• Medical Imaging

Background:

• Magnetic resonance imaging (MRI) is crucial for real-time stroke assessment.
• Identifying predictive biomarkers for stroke outcomes is essential for guiding treatment and rehabilitation.
• Current methods for predicting functional recovery post-stroke require further refinement.

Purpose of the Study:

• To investigate MRI as a predictive measure of clinical and functional outcomes in a porcine ischemic stroke model.
• To identify novel biomarkers for stroke functional outcome.
• To evaluate the impact of withholding or providing stroke intervention on MRI-based outcome prediction.

Main Methods:

• Utilized a middle cerebral artery occlusion (MCAO) porcine ischemic stroke model.
• Measured fifteen MRI and ninety functional parameters.
• Conducted multiparametric analysis correlating MRI measurements with functional outcomes.

Main Results:

• Acute midline shift (MLS) at 24 hours post-stroke correlated with decreased survival and functional recovery (mRS) in untreated animals.
• MLS was significantly associated with acute and chronic gait and behavioral impairments in non-treated animals.
• Neural stem cell-derived extracellular vesicle (NSC EV) treatment disrupted MLS-outcome correlations and improved outcomes irrespective of MLS severity.

Conclusions:

• Midline shift (MLS) on MRI serves as a potential non-invasive biomarker for predicting stroke patient outcomes and prognosis.
• MLS may guide therapeutic interventions and rehabilitation strategies, particularly in patients not receiving acute treatments.
• NSC EV therapy offers a promising approach to improve stroke recovery, independent of initial imaging biomarkers like MLS.