{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T09:10:57Z","timestamp":1781601057427,"version":"3.54.5"},"reference-count":58,"publisher":"IOP Publishing","issue":"3","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["J. Neural Eng."],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>\n                  <jats:italic>Objective.<\/jats:italic> In ischemic stroke, treatments to protect neurons from irreversible damage are urgently needed. Studies in animal models have shown that neuroprotective treatments targeting neuronal silencing improve brain recovery, but in clinical trials none of these were effective in patients. This failure of translation poses doubts on the real efficacy of treatments tested and on the validity of animal models for human stroke. Here, we established a human neuronal model of the ischemic penumbra by using human induced pluripotent stem cells and we provided an in-depth characterization of neuronal responses to hypoxia and treatment strategies at the network level.\n<jats:italic>Approach.<\/jats:italic> We generated neurons from induced pluripotent stem cells derived from healthy donor and we cultured them on micro-electrode arrays. We measured the electrophysiological activity of human neuronal networks under controlled hypoxic conditions. We tested the effect of different treatment strategies on neuronal network functionality.\n<jats:italic>Main results.<\/jats:italic> Human neuronal networks are vulnerable to hypoxia reflected by a decrease in activity and synchronicity under low oxygen conditions. We observe that full, partial or absent recovery depend on the timing of re-oxygenation and we provide a critical time threshold that, if crossed, is associated with irreversible impairments. We found that hypoxic preconditioning improves resistance to a second hypoxic insult. Finally, in contrast to previously tested, ineffective treatments, we show that stimulatory treatments counteracting neuronal silencing during hypoxia, such as optogenetic stimulation, are neuroprotective.\n<jats:italic>Significance.<\/jats:italic> We presented a human neuronal model of the ischemic penumbra and we provided insights that may offer the basis for novel therapeutic approaches for patients after stroke. The use of human neurons might improve drug discovery and translation of findings to patients and might open new perspectives for personalized investigations.<\/jats:p>","DOI":"10.1088\/1741-2552\/abe68a","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T22:35:44Z","timestamp":1613428544000},"page":"036016","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":34,"title":["Neuroprotective effect of hypoxic preconditioning and neuronal activation in a in vitro human model of the ischemic penumbra"],"prefix":"10.1088","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2530-5535","authenticated-orcid":false,"given":"Sara","family":"Pires Monteiro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Voogd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2893-6057","authenticated-orcid":false,"given":"Lorenzo","family":"Muzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmarco","family":"De Vecchis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4393-5506","authenticated-orcid":false,"given":"Britt","family":"Mossink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marloes","family":"Levers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerco","family":"Hassink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Van Putten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0605-1437","authenticated-orcid":false,"given":"Joost","family":"Le Feber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Hofmeijer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9697-3282","authenticated-orcid":false,"given":"Monica","family":"Frega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"jneabe68abib1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0147287","article-title":"Endovascular treatment with stent-retriever devices for acute ischemic stroke: a meta-analysis of randomized controlled trials","volume":"11","author":"Bush","year":"2016","journal-title":"PLoS One"},{"key":"jneabe68abib2","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1001\/jama.294.6.725","article-title":"Prognosis and decision making in severe stroke","volume":"294","author":"Holloway","year":"2005","journal-title":"JAMA"},{"key":"jneabe68abib3","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1212\/WNL.0b013e318266fc40","article-title":"Early stroke mortality, patient preferences, and the withdrawal of care bias","volume":"79","author":"Kelly","year":"2012","journal-title":"Neurology"},{"key":"jneabe68abib4","doi-asserted-by":"publisher","first-page":"2095","DOI":"10.1016\/S0140-6736(12)61728-0","article-title":"Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Lozano","year":"2012","journal-title":"Lancet"},{"key":"jneabe68abib5","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1056\/NEJMoa1411587","article-title":"A randomized trial of intraarterial treatment for acute ischemic stroke","volume":"372","author":"Berkhemer","year":"2015","journal-title":"New Engl. 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