Transcranial cortex-wide imaging of murine ischemic perfusion with large-field multifocal illumination fluorescence microscopy

Ischemic stroke is a common cause of death worldwide and a main cause of morbidity. Presently, computed tomography and magnetic resonance imaging are the mainstay for stroke diagnosis and therapeutic monitoring. These modalities are often limited in terms of accessibility as well as their ability to map brain perfusion with sufficient spatial and temporal resolution, particularly in the context of preclinical studies, thus calling for development of new brain perfusion techniques featuring rapid imaging speed, cost-effectiveness, and ease of use. Herein, we report on cortex-wide perfusion imaging in murine ischemic stroke with large-field multi-focal illumination fluorescence microscopy (LMI). We attained quantitative readings of hemodynamic and structural changes in cerebral vascular network and pial vessels at capillary level resolution and 80 Hz frame rate fully transcranially. The in vivo perfusion maps accurately delineated the ischemic core and penumbra, further exhibiting strong correlation with ex vivo triphenyl tetrazolium chloride staining. Interestingly, monitoring of therapeutic effects of thrombolysis in stroke has revealed that early recanalization could effectively save the penumbra whilst reducing the infarct area. Furthermore, cross-strain comparison of perfusion dynamics affirmed that C57BL/6 mice, benefiting from more extensive pial collateral recruitment, feature a larger penumbra and smaller infarct core as compared to BALB/c mice which have few or no collaterals. Finally, we apply LMI to show that sensory stimulation-based treatment enhances blood flow and abolish perfusion deficit in the ischemic core and penumbra regions. The simple, cost-effective and minimally invasive nature of the proposed approach offers new venues for brain perfusion research under various disease conditions such as stroke, neurodegeneration or epileptic seizures. ### Competing Interest Statement The authors have declared no competing interest.