Melatonin demonstrates neuroprotective properties in adult models of cerebral ischemia, acting as a potent antioxidant and anti-inflammatory agent. We investigated the effect of melatonin in a 7-d-old rat model of ischemia-reperfusion, leading to both cortical infarct and injury in the underlying white matter observed using MRI and immunohistochemistry. Melatonin was given i.p. as either a single dose before ischemia or a double-dose regimen, combining one before ischemia and one 24 h after reperfusion. At 48 h after injury, neither a significant reduction in cortical infarct volume nor a variation in the number of TUNEL-and nitrotyrosine-positive cells within the ipsilateral lesion was observed in melatonin-treated animals compared with controls. However, a decrease in the density of tomato lectin-positive cells after melatonin treatment was found in the white matter underlying cortical lesion. Furthermore, we showed a marked increase in the myelin basic protein-immunoreactivity in the cingulum and in the density of mature oligodendrocytes (APCimmunoreactive) in both the ipsilateral cingulum and external capsule. These results suggest that melatonin is not able to reduce cortical infarct volume in a neonatal stroke model but strongly reduces inflammation and promotes subsequent myelination in the white matter. (Pediatr Res 69: 51-55, 2011) N eonatal hypoxia-ischemia is an important cause of neonatal brain injury, resulting in cerebral palsy, learning disabilities, visual field deficits, and epilepsy (1). In addition to global cerebral ischemia arising from systemic asphyxia, recent data suggest a higher incidence of focal ischemiareperfusion leading to stroke in near-term neonates (2,3). Mechanisms of arterial ischemic injury without the confounding effect of hypoxia are not fully understood. Although therapeutic hypothermia has recently demonstrated a benefit by decreasing brain tissue injury in infants with hypoxicischemic encephalopathy (4,5), very little is known regarding potential neuroprotective strategies after neonatal stroke.Melatonin, an indoleamine, is synthesized and secreted from the pineal gland relative to the circadian rhythms. Melatonin readily crosses the blood-brain barrier, and after exogenous administration, it is found in high concentrations in the brain. It was demonstrated that melatonin has neuroprotective effects through either antiapoptotic (6) or antioxidant effects (7,8) or by decreasing the excitotoxic cascade (9). Melatonin has demonstrated neuroprotective properties in adult models of cerebral ischemia, acting as a potent antioxidant and antiinflammatory agent (10,11). Melatonin was shown to have a potent protective effect in several models of developing white matter damage, by not only promoting oligodendroglial maturation and myelination repair but also decreasing astrogliosis and microglial activation (12-15). We previously developed a neonatal model of stroke in 7-d-old (P7) rat characterized by apoptotic cell death (16,17), inflammatory responses (18,19), and oxid...