title: Inadequate food and water intake determine mortality following stroke in mice.
abstract: Experimental stroke models producing clinically relevant functional deficits are often associated with high mortality. Because the mechanisms that underlie post-stroke mortality are largely unknown, results obtained using these models are often difficult to interpret, thereby limiting their translational potential. Given that specific forms of post-stroke care reduce mortality in patients, we hypothesized that inadequate food and water intake may underlie mortality following experimental stroke. C57BL/6 mice were subjected to 1 h of intraluminal filament middle cerebral artery occlusion. Nutritional support beginning on the second day after filament middle cerebral artery occlusion reduced the 14-day mortality rate from 59% to 15%. The surviving mice in the post-stroke support group had the same infarct size as non-surviving control mice, suggesting that post-stroke care was not neuroprotective and that inadequate food and/or water intake are the main reasons for filament middle cerebral artery occlusion-induced mortality. This notion was supported by the presence of significant hypoglycemia, ketonemia, and dehydration in control mice. Taken together, these data suggest that post-filament middle cerebral artery occlusion mortality in mice is not primarily caused by ischemic brain damage, but secondarily by inadequate food and/or water intake. Thus, providing nutritional support following filament middle cerebral artery occlusion greatly minimizes mortality bias and allows the study of long-term morphological and functional sequelae of stroke in mice.
authors.affiliation: 1 Laboratory of Experimental Stroke Research, Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Munich, Germany.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Lourbopoulos
authors.affiliation: 1 Laboratory of Experimental Stroke Research, Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Munich, Germany.
authors.forename: Uta
authors.initials: U
authors.lastname: Mamrak
authors.affiliation: 1 Laboratory of Experimental Stroke Research, Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Roth
authors.affiliation: 1 Laboratory of Experimental Stroke Research, Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Munich, Germany.
authors.forename: Matilde
authors.initials: M
authors.lastname: Balbi
authors.affiliation: 1 Laboratory of Experimental Stroke Research, Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Munich, Germany.
authors.forename: Joshua
authors.initials: J
authors.lastname: Shrouder
authors.affiliation: 1 Laboratory of Experimental Stroke Research, Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Munich, Germany.|2 Munich Cluster for Systems Neurology (Synergy), LMU Munich, Munich, Germany.
authors.forename: Arthur
authors.initials: A
authors.lastname: Liesz
authors.affiliation: 1 Laboratory of Experimental Stroke Research, Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Munich, Germany.
authors.forename: Farida
authors.initials: F
authors.lastname: Hellal
authors.affiliation: 1 Laboratory of Experimental Stroke Research, Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Munich, Germany.|2 Munich Cluster for Systems Neurology (Synergy), LMU Munich, Munich, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Plesnila
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004326:Drinking / Q000502:physiology*; D004435:Eating / Q000502:physiology*; D008297:Male; D008810:Mice, Inbred C57BL; D018529:Nutritional Support; D020521:Stroke / Q000503:physiopathology* / Q000628:therapy*; D016019:Survival Analysis
keywords: chronic stroke model; filament middle cerebral artery occlusion; mortality; stroke care; translational medicine