title: Caudoputamen is damaged by hypocapnia during mechanical ventilation in a rat model of chronic cerebral hypoperfusion.
abstract: OBJECTIVE
  Postoperative brain dysfunction, such as delirium, is a common complication of anesthesia and is sometimes prolonged, especially in patients with cerebrovascular disease. In the present study we investigated the effect of hypocapnia during anesthesia on neuronal damage using a rat model of chronic cerebral hypoperfusion.
  
  
  METHODS
  Chronic cerebral hypoperfusion was induced by clipping the bilateral common carotid arteries in male Wistar rats. Fourteen days after the operation, these animals were mechanically ventilated for 2 hours and then kept in suitable conditions for an additional 14 days. Twenty-four rats were assigned to 4 groups: those with chronic cerebral hypoperfusion with either hypocapnia or normocapnia during anesthesia, and those given sham operation with either hypocapnia or normocapnia. White matter lesions in the brain sections were evaluated with Klüver-Barrera staining. Proliferation of glial cells was estimated with the use of immunohistochemistry of glial fibrillary acidic protein, a marker for astroglia, and CD11b, a marker for microglia. Computer-assisted morphometry was applied to the immunohistochemical results of microtubule-associated protein 2 to evaluate the loss of neurons.
  
  
  RESULTS
  The histological damage was localized almost exclusively in the white matter in the rats subjected to chronic cerebral hypoperfusion but without hypocapnia. Neuronal damage and astroglial proliferation occurred with aggravated white matter lesions in the caudoputamen in the rats with chronic cerebral hypoperfusion and hypocapnia. No lesions were observed in sham-operated rats with either hypocapnia or normocapnia.
  
  
  CONCLUSIONS
  These results indicate that hypocapnia during anesthesia causes tissue damage in the caudoputamen, which may be responsible for long-lasting postoperative delirium in patients with stroke and/or dementia.
authors.affiliation: Department of Anesthesiology, Kansai Medical University, Osaka, Japan. nstosaka@med.gunma-u.ac.jp
authors.forename: E
authors.initials: E
authors.lastname: Miyamoto
authors.forename: H
authors.initials: H
authors.lastname: Tomimoto
authors.forename: S
authors.initials: S
authors.lastname: Nakao Si
authors.forename: H
authors.initials: H
authors.lastname: Wakita
authors.forename: I
authors.initials: I
authors.lastname: Akiguchi
authors.forename: K
authors.initials: K
authors.lastname: Miyamoto
authors.forename: K
authors.initials: K
authors.lastname: Shingu
mesh_terms: D000758:Anesthesia; D000818:Animals; D000943:Antigens, Differentiation / Q000096:biosynthesis; D001480:Basal Ganglia Diseases / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D001783:Blood Flow Velocity; D002545:Brain Ischemia / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D002421:Caudate Nucleus / Q000378:metabolism / Q000473:pathology; D002560:Cerebrovascular Circulation; D002908:Chronic Disease; D015140:Dementia, Vascular / Q000209:etiology; D004195:Disease Models, Animal; D016857:Hypocapnia / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D007150:Immunohistochemistry; D008297:Male; D009457:Neuroglia / Q000378:metabolism / Q000473:pathology; D009474:Neurons / Q000378:metabolism / Q000473:pathology; D011699:Putamen / Q000378:metabolism / Q000473:pathology; D051381:Rats; D017208:Rats, Wistar; D012121:Respiration, Artificial; D015996:Survival Rate; D013995:Time
chemical_list: D000943:Antigens, Differentiation