Neuroimaging tools for brain edema

Characterize secondary brain injury

We develop novel neuroimaging tools to better quantify brain edema and blood-brain barrier integrity in the setting of cerebral ischemia. By creating high specificity methods using non-invasive imaging, we have advanced our understanding of the role brain edema plays in modulating neurological recovery after stroke. These studies have revealed that brain edema may impact recovery in up to 25% of all stroke patients. Our imaging tools not only provide insight into the pathophysiology of secondary brain injury, but can also serve as intermediate endpoints in clinical trials as part of proof of concept studies for anti-edema treatments.

We hypothesize that brain edema is associated with a cycle of neuronal injury. The initial ischemic insult occurs with blood vessel occlusion. The resulting hypoperfusion leads to tissue infarction. Brain edema, which ensues 12 to 48 hours after the initial ischemic injury, exacerbates hypoperfusion, which in turn amplifies neuronal loss within the existing stroke lesion. We believe this cascading cycle of hypoperfusion and infarction leads to greater brain injury and ultimately, worse neurological function. Using stroke cohorts with serial brain imaging, our studies seek to build evidence for each segment of this cycle.

Related Publications:

Portable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke
Yuen MM, Prabhat AM, Mazurek MH, Chavva IR, Crawford A, Cahn BA, Beekman R, Kim JA, Gobeske KT, Petersen NH, Falcone GJ, Gilmore EJ, Hwang DY, Jasne AS, Hardik A, Sharma R, Matouk C, Ward A, Schindler J, Sansing L, de Havenon A, Aydin A, Wira C, Sze G, Rosen MS, Kimberly WT, Sheth KN. Sci. Adv., 8:eabm3952 (2022). view PDF
Assessment of Brain Injury Using Portable, Low-Field Magnetic Resonance Imaging at the Bedside of Critically Ill Patients
Sheth KN, Mazurek MH, Yuen MM, Cahn BA, Shah JT, Kim JA, Gilmore EJ, Falcone GJ, Petersen N, Gobeske KT, Kaddouh F, Hwang DY, Rothberg J, Sze G, Siner J, Rosen MS, Spudich S, and Kimberly WT. JAMA Neurol78:41-47 (2021). view PDF
Association of Reperfusion With Brain Edema in Patients With Acute Ischemic Stroke: A Secondary Analysis of the MR CLEAN Trial
Kimberly WT, Dutra BG, Boers AMM, Alves HCBR, Berkhemer OA, van den Berg L, Sheth KN, Roos YBWEM, van der Lugt A, Beenen LFM, Dippel DWJ, van Zwam WH, van Oostenbrugge RJ, Lingsma HF, Marquering H, Majoie CBLM; on behalf of the MR CLEAN investigators. JAMA Neurol, 75:453-461 (2018). view PDF
Reperfusion after ischemic stroke is associated with reduced brain edema
Irvine HJ, Ostwaldt A-C, Bevers MB, Dixon S, Battey TWK, Campbell BCV, Davis SM, Donnan GA, Sheth KN, Jehan R, Saver JL, Kidwell CS and Kimberly WT. J Cereb Blood Flow Metab, 38:1807-1817 (2018). view PDF
Early neurological stability predicts adverse outcome after acute ischemic stroke
  1. Irvine HJ, Battey TWK, Ostwaldt A-C, Campbell BCV, Davis SM, Donnan GA, Sheth KN and Kimberly WT. Int J Stroke, 11:882-889 (2016).
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