Brain injury: how can MRI predict which patients will respond to neural stem cell therapy?

Written by Alice Bough (Future Science Group)

Researchers from Sanford Burnham Prebys Medical Discovery Institute (CA, USA) and Loma Linda University Health(CA, USA) have collaborated to assess how magnetic resonance imaging (MRI) can be used to identify how the properties of brain lesions caused by hypoxic–ischemic brain injury (HIBI) impact the efficacy of neural stem cell therapy.

The authors of the study, published in Cell Reports, hope that their findings in rats can be applied in newborns who have experienced perinatal HIBI to determine the best course of treatment.

In the study, MRI was used to assess the brain lesions in rats with HIBI. In each animal they identified a core region, consisting of dead neurons, and a penumbra, consisting of mildly injured neurons.

Rats then received human neural stem cell therapy. The stem cells were seen to localize to the penumbra, not the core. Rats then underwent behavioral tests to assess memory and neurological abilities. It was found that those with a larger penumbra and a smaller core performed better in the tests.

In animals that did not receive stem cell therapy, the neurons in the penumbra deteriorated and became part of the core.

The next step for the researchers is to test their findings in a clinical trial involving newborns with perinatal HIBI. MRI is already a standard diagnostic tool used in the care of newborns with HIBI.

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“Based on our findings, only newborns with a large penumbral volume in relation to core volume should receive a transplant of human neural stem cells,” commented lead author, Evan Snyder (Sanford Burnham Prebys).

It was also proposed that the MRI scans could be used to identify patients who would not respond well to neural stem cell therapy.

“Newborns so severely injured that only a core is present, or babies with such a mild case of [HIBI] that not even a penumbra is present, should not receive human neural stem cells, as the treatment is unlikely to be impactful,” continued Snyder. “I am hopeful that MRI, which is already used during the course of care for these newborns, will help ensure that infants who experience HII get the best, most appropriate treatment possible.”

The authors hope that their research will also allow MRI to be used to assess potential efficacy of neural stem cell therapy for other conditions. “In the future, MRI could help guide the use of stem cells to treat – or in some instances, not treat – additional brain disorders such as spinal cord injury and stroke,” concluded Snyder.

Sources: Hartman RE, Nathan NH, Ghosh N et al. A biomarker for predicting responsiveness to stem cell therapy based on mechanism-of-action: evidence from cerebral injury. Cell Rep. 31, 107622 (2020); www.sbpdiscovery.org/news/scientists-show-mri-predicts-efficacy-of-a-stem-cell-therapy-for-brain-injury