Abstract WP557: Chronic Remote Ischemic Conditioning (C-RIC) Induces Collateral Remodeling and Improves Functional Outcomes Independent of Sex in Aged Mouse Model of Vascular Cognitive Impairment and Dementia (VCID)

Abstract

Background and Purpose: There is presently no specific therapy for the treatment of VCID. We reported that daily C-RIC (4mo) is effective in young mice by improving cerebral blood flow (CBF), minimizing white matter (WM) damage and improving functional outcomes in Bilateral Carotid Artery Stenosis model (BCAS.) The purpose of this study was to evaluate whether 4 months (4 MO-C-RIC) is effective in male and female aged mouse and if the treatment effects are durable out to 6MOS. Methods: Microcoil induced BCAS model was used to induce chronic hypoperfusion. Adult C57BL/6 both male & female mice (14-months ) were randomly assigned to 3-different groups (N=10), and subjected to Sham, BCAS+sham RIC, BCAS+RIC. C-RIC was started 7d post-surgery daily for 4MOs. Behavioral test and CBF was performed at 1, 4 and 6MO after BCAS and Sham surgery. Functional outcomes were assessed using novel object recognition (NOR) test for non-spatial working memory, and hanging wire and beam walk test for motor/muscular impairment. Histopathology as well as immunohistochemistry for CD31/α-SMA; GFAP, myelin basic protein (MBP) and beta-amyloid were also performed on the brain tissue collected after the neurobehavioral tests. Results: C-RIC-therapy for 4MO significantly improved CBF in the male and female BCAS+C-RIC groups at all time points compared to BCAS-Sham RIC groups. Mice from the BCAS group +Sham C-RIC group showed significant loss in the discrimination index as determined by the NOR test, and poor motor function in hanging wire and beam walk test. C-RIC- significantly improved these functional outcomes. Histopathology showed prevention of WM degeneration and myelin basic protein by C-RIC. Immunohistochemical analysis at 6 MOs showed increased CD31 (angiogenesis) and a-SMA staining (arteriogenesis) indicating collateral remodeling in the C-RIC group compared to BCAS-sham RIC. Conclusions: Daily 4MO C-RIC-therapy improves long term CBF and vascular architecture at 6 MO and reduces WM damage and improves functional outcomes in aged males and females C-RIC induces durable long term collateral remodeling. C-RIC is a promising therapy for VCID and is ready for future clinical trials in VCID.