Research Article
Effects of Sex and Mild Intrainsult Hypothermia on
Neuropathology and Neural Reorganization following
Neonatal Hypoxic Ischemic Brain Injury in Rats
Amanda L. Smith,
1
Ted S. Rosenkrantz,
2
and R. Holly Fitch
1
1
Department of Psychology, Behavioral Neuroscience Division, Te University of Connecticut, 406 Babbidge Road,
Storrs, CT 06269, USA
2
Department of Pediatrics/Neonatology, Te University of Connecticut Health Center, 263 Farmington Avenue,
Farmington, CT 06030, USA
Correspondence should be addressed to Amanda L. Smith; amanda.l.smith@uconn.edu
Received 4 November 2015; Revised 8 January 2016; Accepted 31 January 2016
Academic Editor: Mariya Hristova
Copyright © 2016 Amanda L. Smith et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Hypoxia ischemia (HI) is a recognized risk factor among late-preterm infants, with HI events leading to varied neuropathology and
cognitive/behavioral defcits. Studies suggest a sex diference in the incidence of HI and in the severity of subsequent behavioral
defcits (with better outcomes in females). Mechanisms of a female advantage remain unknown but could involve sex-specifc
patterns of compensation to injury. Neuroprotective hypothermia is also used to ameliorate HI damage and attenuate behavioral
defcits. Tough currently prescribed only for HI in term infants, cooling has potential intrainsult applications to high-risk late-
preterm infants as well. To address this important clinical issue, we conducted a study using male and female rats with a postnatal (P)
day 7 HI injury induced under normothermic and hypothermic conditions. Te current study reports patterns of neuropathology
evident in postmortem tissue. Results showed a potent beneft of intrainsult hypothermia that was comparable for both sexes.
Findings also show surprisingly diferent patterns of compensation in the contralateral hemisphere, with increases in hippocampal
thickness in HI females contrasting reduced thickness in HI males. Findings provide a framework for future research to compare
and contrast mechanisms of neuroprotection and postinjury plasticity in both sexes following a late-preterm HI insult.
1. Introduction
A common brain insult, associated with preterm birth (<37
weeks of gestational age (GA); [1, 2]), very low birth weight
(VLBW; <1500 grams), and term birth complications (e.g.,
cord prolapse and cord asphyxia [3, 4]), involves a drop in
blood and/or oxygen fow to the brain (hypoxia ischemia;
HI). In preterm infants, the vulnerability of the developing
brain plays a pivotal role in the etiology of HI, with fragility
of the neurovascular system leading to increased risk of
hemorrhagic and nonhemorrhagic (ischemic) brain injuries
[1, 3, 5–7]. In turn, contemporary premature cohorts ofen
exhibit mild/difuse forms of injury that include grey matter
damage in areas such as the cortex and hippocampus and
white-matter tissue loss characteristic of difuse periventricu-
lar leukomalacia (PVL; e.g., tissue loss in corpus callosum and
internal capsule [8, 9]). While the brain is highly vulnerable
in the preterm infant, the plasticity of the developing brain
simultaneously provides a prime target for neural reorganiza-
tion, prompting further study of brain injuries specifc to this
unique population of infants. Compensatory mechanisms
could ofset severe tissue loss (as would be seen in adults
with comparable HI events) and instead lead to more subtle
anomalies.
Tough obvious sex diferences characterize development
(i.e., delays in male fetal development that may lead to pro-
longed vulnerability to brain injury in the neonatal period)
and are also reported in behavioral outcomes following an
HI insult (in both clinical studies and animal models [10–
15]), clinicians currently implement identical neuroprotective
regimens (hypothermia or “cooling”) for both male and
female term infants with hypoxic ischemic encephalopathy
Hindawi Publishing Corporation
Neural Plasticity
Volume 2016, Article ID 2585230, 11 pages
http://dx.doi.org/10.1155/2016/2585230