{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:17:44Z","timestamp":1790907464619,"version":"4.1.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T00:00:00Z","timestamp":1666224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>The glymphatic system has recently been shown to clear brain extracellular solutes and can be extensively impaired after traumatic brain injury (TBI). Despite hypothermia being identified as a protective method for the injured brain via minimizing the formation of edema in the animal study, little is known about how hypothermia affects the glymphatic system following TBI. We use dynamic contrast-enhanced MRI (DCE-MRI) following cisterna magna infusion with a low molecular weight contrast agent to track glymphatic transport in male Sprague\u2013Dawley rats following TBI with hypothermia treatment and use diffusion-weighted imaging (DWI) sequence to identify edema after TBI, and further distinguish between vasogenic and cytotoxic edema. We found that hypothermia could attenuate brain edema, as demonstrated by smaller injured lesions and less vasogenic edema in most brain subregions. However, in contrast to reducing cerebral edema, hypothermia exacerbated the reduction of efficiency of glymphatic transportation after TBI. This deterioration of glymphatic drainage was present brain-wide and showed hemispherical asymmetry and regional heterogeneity across the brain, associated with vasogenic edema. Moreover, our data show that glymphatic transport reduction and vasogenic edema are closely related to reducing perivascular aquaporin-4 (AQP<jats:sub>4<\/jats:sub>) expression. The suppression of glymphatic transportation might eliminate the benefits of brain edema reduction induced by hypothermia and provide an alternative pathophysiological factor indicating injury to the brain after TBI. Thus, this study poses a novel emphasis on the potential role of hypothermia in managing severe TBI.<\/jats:p>","DOI":"10.3389\/fneur.2022.957055","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T15:37:57Z","timestamp":1666280277000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Hypothermia reduces glymphatic transportation in traumatic edematous brain assessed by intrathecal dynamic contrast-enhanced MRI"],"prefix":"10.3389","volume":"13","author":[{"given":"Yingnan","family":"Bai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyuan","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honglan","family":"Mi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengchen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinghui","family":"Bao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuehua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1007\/978-3-7091-6837-0_21","article-title":"Traumatic brain swelling in head injured patients: brain edema or vascular engorgement?","volume":"70","author":"Marmarou","year":"1997","journal-title":"Acta Neurochir Suppl."},{"key":"B2","first-page":"277","article-title":"Hypothermia as a potential treatment for cerebral ischemia","volume":"5","author":"Maher","year":"1993","journal-title":"Cerebrovasc Brain Metab Rev."},{"key":"B3","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1089\/ther.2019.0001","article-title":"A new vision for therapeutic hypothermia in the era of targeted temperature management: a speculative synthesis","volume":"9","author":"Jackson","year":"2019","journal-title":"Ther Hypothermia Temp Manag."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2211","DOI":"10.1001\/jama.2018.17075","article-title":"Effect of early sustained prophylactic hypothermia on neurologic outcomes among patients with severe traumatic brain injury: the POLAR randomized clinical trial","volume":"320","author":"Cooper","year":"2018","journal-title":"JAMA."},{"key":"B5","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1016\/S1474-4422(13)70077-2","article-title":"Comparison of hypothermia and normothermia after severe traumatic brain injury in children (Cool Kids): a phase 3, randomised controlled trial","volume":"12","author":"Adelson","year":"2013","journal-title":"Lancet Neurol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1056\/NEJMoa1411480","article-title":"Therapeutic hypothermia after out-of-hospital cardiac arrest in children","volume":"372","author":"Moler","year":"2015","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1056\/NEJM200102223440803","article-title":"Lack of effect of induction of hypothermia after acute brain injury","volume":"344","author":"Clifton","year":"2001","journal-title":"N Engl J Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"3063","DOI":"10.1093\/brain\/awm083","article-title":"and Macleod MR. 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