Abstract

In the search of animal stroke models providing translational advantages for biomedical research, pigs are large mammals with interesting brain characteristics and wide social acceptance. Compared to rodents, pigs have human-like highly gyrencephalic brains. In addition, increasingly through phylogeny, animals have more sophisticated white matter connectivity; thus, ratios of white-to-gray matter in humans and pigs are higher than in rodents. Swine models provide the opportunity to study the effect of stroke with emphasis on white matter damage and neuroanatomical changes in connectivity, and their pathophysiological correlate. In addition, the subarachnoid space surrounding the swine brain resembles that of humans. This allows the accumulation of blood and clots in subarachnoid hemorrhage models mimicking the clinical condition. The clot accumulation has been reported to mediate pathological mechanisms known to contribute to infarct progression and final damage in stroke patients. Importantly, swine allows trustworthy tracking of brain damage evolution using the same non-invasive multimodal imaging sequences used in the clinical practice. Moreover, several models of comorbidities and pathologies usually found in stroke patients have recently been established in swine. We review here ischemic and hemorrhagic stroke models reported so far in pigs. The advantages and limitations of each model are also discussed.

Highlights

  • Stroke is a life-threatening disease that causes neuronal loss and subsequent high rates of mortality or permanent disability

  • Stroke treatment is limited to interventions that restore blood flow in the ischemic stroke type, either pharmacologically or via mechanical thrombectomy, and only a small 15% of all stroke patients might benefit from these therapies

  • Early reports allowed to assess hypoperfusion of the brain areas affected using either: (1) Apparent diffusion of water or apparent diffusion coefficient (ADC) obtained from diffusion-weighted imaging (DWI) Magnetic resonance (MR) combined with metabolic parameters of oxygen and glucose obtained by positron emission tomography (PET), showing that ADC below 75% of the normal tissue value indicates irreversible infarction in a transient middle cerebral artery occlusion (MCAO) model [113], or (2) computed tomography perfusion (CTP) and/or PET to determine cerebral blood flow and the hypoperfusion threshold to develop infarct [59,110], or determining areas of infarct core, penumbra, or oligemia [109], as used in the swine model of induced cerebral ischemia by endothelin injection

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Summary

Introduction

Stroke is a life-threatening disease that causes neuronal loss and subsequent high rates of mortality or permanent disability. Stroke treatment is limited to interventions that restore blood flow in the ischemic stroke type, either pharmacologically or via mechanical thrombectomy, and only a small 15% of all stroke patients might benefit from these therapies. Damage to the WM areas is increasingly recognized as a cause of long-term cognitive and motor disabilities in most stroke survivors. This is why research, development, and characterization of swine models of stroke, which combine both the mechanistic knowledge gained in rodent research and a greater degree of neuroanatomical and connectivity similarities with humans, may play a key role to bridge the gap from pre-clinical findings to clinical implementation

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