title: Evaluating effects of normobaric oxygen therapy in acute stroke with MRI-based predictive models.
abstract: BACKGROUND
  Voxel-based algorithms using acute multiparametric-MRI data have been shown to accurately predict tissue outcome after stroke. We explored the potential of MRI-based predictive algorithms to objectively assess the effects of normobaric oxygen therapy (NBO), an investigational stroke treatment, using data from a pilot study of NBO in acute stroke.
  
  
  METHODS
  The pilot study of NBO enrolled 11 patients randomized to NBO administered for 8 hours, and 8 Control patients who received room-air. Serial MRIs were obtained at admission, during gas therapy, post-therapy, and pre-discharge. Diffusion/perfusion MRI data acquired at admission (pre-therapy) was used in generalized linear models to predict the risk of lesion growth at subsequent time points for both treatment scenarios: NBO or Control.
  
  
  RESULTS
  Lesion volume sizes 'during NBO therapy' predicted by Control-models were significantly larger (P = 0.007) than those predicted by NBO models, suggesting that ischemic lesion growth is attenuated during NBO treatment. No significant difference was found between the predicted lesion volumes at later time-points. NBO-treated patients, despite showing larger lesion volumes on Control-models than NBO-models, tended to have reduced lesion growth.
  
  
  CONCLUSIONS
  This study shows that NBO has therapeutic potential in acute ischemic stroke, and demonstrates the feasibility of using MRI-based algorithms to evaluate novel treatments in early-phase clinical trials.
authors.affiliation: Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston MA 02114, USA. asinghal@partners.org.
authors.forename: Ona
authors.initials: O
authors.lastname: Wu
authors.forename: Thomas
authors.initials: T
authors.lastname: Benner
authors.forename: Luca
authors.initials: L
authors.lastname: Roccatagliata
authors.forename: Mingwang
authors.initials: M
authors.lastname: Zhu
authors.forename: Pamela W
authors.initials: PW
authors.lastname: Schaefer
authors.forename: Alma Gregory
authors.initials: AG
authors.lastname: Sorensen
authors.forename: Aneesh B
authors.initials: AB
authors.lastname: Singhal