Remote ischaemic conditioning-a new paradigm of self-protection in the brain

David C. Hess, Rolf A. Blauenfeldt, Grethe Andersen, Kristina D. Hougaard, Md Nasrul Hoda, Yuchuan Ding, Xunming Ji

Research output: Contribution to journalReview articlepeer-review

143 Scopus citations


Remote ischaemic conditioning (RIC) triggers endogenous protective pathways in distant organs such as the kidney, heart and brain, and represents an exciting new paradigm in neuroprotection. RIC involves repetitive inflation and deflation of a blood pressure cuff on the limb, and is safe and feasible. The exact mechanism of signal transmission from the periphery to the brain is not known, but both humoral factors and an intact nervous system seem to have critical roles. Early-phase clinical trials have already been conducted to test RIC in the prehospital setting in acute ischaemic stroke, and in subarachnoid haemorrhage for the prevention of delayed cerebral ischaemia. Furthermore, two small randomized clinical trials in patients with symptomatic intracranial atherosclerosis have shown that RIC can reduce recurrence of stroke and have neuroprotective activity. RIC represents a highly practical and translatable therapy for acute, subacute, and chronic neurological diseases with an ischaemic or inflammatory basis. In this Review, we consider the principles and mechanisms of RIC, evidence from preclinical models and clinical trials that RIC is beneficial in neurological disease, and how the procedure might be used in the future in disorders such as vascular cognitive impairment and traumatic brain injury.

Original languageEnglish (US)
Pages (from-to)698-710
Number of pages13
JournalNature Reviews Neurology
Issue number12
StatePublished - Dec 1 2015

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience


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