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Professor Marianne Thoresen

Professor Marianne Thoresen

Professor Marianne Thoresen
MD, PhD(Oslo)

Professor of Neonatal Neuroscience

Area of research

Physiology and neuroprotection of the newborn

Neonatology,
St Michael's Hospital, Southwell Street BS2 8EG
(See a map)

+44 (0) 117 34 25751
+44 (0) 117 34 25607

Summary

Worldwide, newborn infants suffer death or permanent brain damage caused by diseases arising before or around the time of birth. I do translational research aimed at developing effective treatment. By integrating my studies of normal physiological changes in many organ systems with pathological changed seen during disease, I have -together with my students - developed experimental models that mimic global hypoxic-ischemic injury and brain haemorrhage leading to permanent disability in children. The neuroprotective effect of cooling newborns first presented in these models led to international clinical trials where we documented the same neuroprotective effect in humans that were cooled and this treatment is now implemented worldwide as the first effective treatment after perinatal asphyxia. With our experimental models we have shown that adding the inert gas xenon to cooling we double the neuroprotection. Xenon was, for the first time in the world, given to a baby who was cooled when our feasibilitystudy "CoolXenon" started in March 2010.

For my CV and a full list of publications, please visit my website here.

1. Circulation Physiology

Studies include

  • cerebral circulation and the influence of blood pressure, temperature and body positioning
  • cerebral venous drainage
  • positive pressure ventilation
  • cardiovascular responses to tilting
  • uterine and mammary circulation during normal pregnancy
  • skin circulation and thermoregulation
  • Physiological Method studies of Doppler velocity, electromagnetic Flowmetry, pletysmography, cerebral circulation, blood pressure and temperature.
  • Models of human disease in; newborn asphyxia, intraventricular haemorrhage

2. Neuroprotection

I have developed 3 experimental models mimicking diseases leading to permanent handicap. We use these to understand disease mechanisms and repair processes, and develop treatments for injury caused by asphyxia or low brain blood flow.

Our clinical trials have confirmed effectiveness seen in the experimental models. Now, worldwide, we are applying hypothermia after perinatal asphyxia.

Adding Xenon inhalation to hypothermia doubles neuroprotection in both small and large newborn brain injury models. Our approved Xe delivery system, with safety data and long term survival results, precedes our clinical feasibility study which is now recruiting.

Activities / Findings

Current projects include:

  • The neuroprotective effect of Xenon inhalation and hypothermia in both a small and large neonatal survival models
  • Xenon and cerebral blood flow, autoregulation, cerecral pressure reactivity
  • The effect of xenon hypothermia on brain and organ protection (heart, lung, liver, kidney)
  • Clinical use of Xenon and hypothermia, ongoing feasibility study(UK) in newborn asphyxiated babies
  • Selective head cooling with normothermia bodytemperature as neuroprotection in the premature asphyxiated newborn
  • Temperature effects on clinical drugs. 
  • Mechanisms of hypothermic neuroprotection and Xenon.
  • Antifibrotic drugs in the treatment of hydrocephalus after intraventricular haemorrhage

 


Keywords

  • Circulation Physiology
  • Neuroprotection

Skills

  • Ischemic brain damage from many causes and ages; perinatal asphyxia
  • cardiac arrest
  • perinatal and adult stroke
  • cerebral palsy
  • seizures
  • cognitive disability
  • post haemorrhagic ventricular dilatation and subarachnoid haemorrhage

Processes and functions

  • Neuroprotection in a wider sense
  • white and grey matter injury
  • cellular markers of brain injury
  • ATP depletion
  • excitotoxicity
  • long term survival
  • behavioural and neuromotor examinations. The effect of temperature changes on normal and abnormal organ function

Methodologies

  • Cardiovascular monitoring
  • laser Doppler flow studies
  • cardiac echo and cardiac output (invasive and non-invasive)
  • intracranial pressure
  • regional temperature
  • EEG
  • aEEG
  • neurological assessment
  • short and long term behavioural testing
  • ultrasound imaging
  • biochemistry
  • immuno-histochemistry
  • light microscopy

Expertise

I trained as a physiotherapist. Treating children with cerebral palsy motivated me to study medicine. While a medical student I took a PhD on cerebral blood flow in the newborn infant. I was a postdoctoral fellow at the Karolinska Institute, Stockholm and then trained as a clinical paediatrician in Oslo. I became interested in cerebral protection from hypothermia in 1990 and was, in 1995, the first to show that post-hypoxic cooling could reduce brain damage in the newborn. I have investigated the mechanisms by which hypothermia protects the newborn brain and was one of the first to pilot the clinical use of hypothermia in babies when I moved to UK in 1998. I am currently working as a Consultant Neonatologist at St Michael's Hospital in Bristol.

  • effect of temperature on the development of brain injury
  • cellular mechanisms of hypothermic neuroprotection
  • drugs and hypothermia
  • protective strategies against posthaemhorrhagic ventricular dilatation
  • Memberships

    Organisations

    School of Clinical Sciences

    Other sites

    Academic staff

    Research groupings

    Recent publications

    View complete publications list in the University of Bristol publications system

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