Perfusion Changes in Acute Stroke Treated with Theophylline as an Add-on to Thrombolysis: A Randomized Clinical Trial Subgroup Analysis

Boris Modrau, Anthony Winder, Niels Hjort, Martin Nygård Johansen, Grethe Andersen, Jens Fiehler, Henrik Vorum, Nils D Forkert

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

PURPOSE: Theophylline has been suggested to have a neuroprotective effect in ischemic stroke; however, results from animal stroke models and clinical trials in humans are controversial. The aim of this study was to assess the effect of theophylline on the cerebral perfusion with multiparametric magnetic resonance imaging (MRI).

METHODS: The relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) in the infarct core, penumbra, and unaffected tissue were measured using multi-parametric MRI at baseline and 3‑h follow-up in patients treated with theophylline or placebo as an add-on to thrombolytic therapy.

RESULTS: No significant differences in mean rCBF, rCBV, and rMTT was found in the penumbra and unaffected tissue between the theophylline group and the control group between baseline and 3‑h follow-up. In the infarct core, mean rCBV increased on average by 0.05 in the theophylline group and decreased by 0.14 in the control group (p < 0.04). Mean rCBF and mean rMTT in the infarct core were similar between the two treatment groups.

CONCLUSION: The results indicate that theophylline does not change the perfusion in potentially salvageable penumbral tissue but only affects the rCBV in the infarct core. In contrast to the penumbra, the infarct core is unlikely to be salvageable, which might explain why theophylline failed in clinical trials.

Original languageEnglish
JournalClinical Neuroradiology
Number of pages8
ISSN1869-1439
DOIs
Publication statusE-pub ahead of print - 14 Jul 2021

Bibliographical note

© 2021. The Author(s).

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