Magnesium Is Not Consistently Neuroprotective for Perinatal Hypoxia-Ischemia in Term-Equivalent Models in Preclinical Studies: A Systematic Review

There is an important unmet need to further improve the outcome of neonatal encephalopathy in term infants. Meta-analyses of large controlled trials now suggest that maternal magnesium sulfate (MgSO4) therapy is associated with a reduced risk of cerebral palsy and gross motor dysfunction after premature birth, but that it has no effect on death or disability. Because of this inconsistency, it remains controversial whether MgSO4 is clinically neuroprotective and, thus, it is unclear whether it would be appropriate to test MgSO4 for treatment of encephalopathy in term infants. We therefore systematically reviewed the preclinical evidence for neuroprotection with MgSO4 before or after hypoxic-ischemic encephalopathy (HIE) in term-equivalent perinatal and adult animals. The outcomes were highly inconsistent between studies. Although there were differences in dose and timing of administration, there was evidence that beneficial effects of MgSO4 were associated with confounding mild hypothermia and, strikingly, the studies that included rigorous maintenance of environmental temperature or body temperature consistently suggested a lack of effect. On balance, these preclinical studies suggest that peripherally administered MgSO4 is unlikely to be neuroprotective. Rigorous testing in translational animal models of perinatal HIE is needed before MgSO4 should be considered in clinical trials for encephalopathy in term infants. (C) 2014 S. Karger AG, Basel

MEDICIN OCH HÄLSOVETENSKAP Medicinska och farmaceutiska grundvetenskaper Neurovetenskaper hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Neurosciences hsv//eng
Asphyxia
Brain injury
Cerebral palsy
Hypoxic-ischemic encephalopathy
Magnesium sulfate
FOCAL CEREBRAL-ISCHEMIA
NEWBORN PIGLET
BRAIN-DAMAGE
SULFATE
TREATMENT
MILD HYPOTHERMIA
BIRTH ASPHYXIA
INTRAVENOUS MAGNESIUM
HIPPOCAMPAL SLICES
ARTERY OCCLUSION
PRETERM INFANTS
Developmental Biology
Neurosciences

Bennet, L. (författare)
Groenendaal, F. (författare)
Lear, C. A. (författare)
Tan, S. (författare)
van Bel, F. (författare)
Juul, S. E. (författare)
Robertson, N. J. (författare)
Mallard, Carina,1963Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology(Swepub:gu)xmallc (författare)
Gunn, A. J. (författare)
Göteborgs universitetInstitutionen för neurovetenskap och fysiologi (creator_code:org_t)

Ingår i:Developmental Neuroscience: S. Karger AG36:2, s. 73-820378-58661421-9859

Av författaren/redakt...: Galinsky, R.; Bennet, L.; Groenendaal, F.; Lear, C. A.; Tan, S.; van Bel, F.; visa fler...; Juul, S. E.; Robertson, N. J.; Mallard, Carina, ...; Gunn, A. J.; visa färre...

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