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魏天祺,冯 珍.正中神经电刺激对脑外伤后昏迷大鼠γ-氨基丁酸b受体表达变化的影响[J].中国康复医学杂志,2016,(1):9~13
正中神经电刺激对脑外伤后昏迷大鼠γ-氨基丁酸b受体表达变化的影响    点此下载全文
魏天祺  冯 珍
南昌大学第一附属医院康复医学科,江西,330006
基金项目:国家自然科学基金(81260295);江西省自然基金(20132BAB205063)
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摘要:
      摘要 目的:研究正中神经电刺激(median nerve electrical stimulation, MNES)对脑外伤昏迷大鼠前额叶皮质γ-氨基丁酸(γ-aminobutyric acid b receptor, GABA)b受体表达的影响及促醒可能机制。 方法:将SD大鼠分为空白对照组、假刺激组、MNES组、GABA b受体激动剂巴氯芬组,应用MNES治疗脑外伤后昏迷大鼠,观察其行为学变化,实验完成后6h、12h、24h每组每个时间点各处死10只大鼠,用蛋白质印迹技术检测前额叶皮质GABA b受体的表达。 结果:大鼠经“自由落体撞击法”造模后出现与临床昏迷状态相似的行为学变化,经MNES后表现出短暂的行为觉醒反应。空白对照组意识状态全部为Ⅰ级,假刺激组平均为(5.33±0.758)级,刺激组平均为(3.80±1.064)级,巴氯芬组平均为(4.63±0.964)级,4组的意识状态分级呈“空<刺<巴<假”递增趋势,组间两两比较差异有显著性意义(P<0.05)。Western blot结果显示同一组3个时间点的前额叶皮质GABA b受体表达呈“6h<12h<24h”趋势,空白对照组及刺激组3个时间点间差异显著性意义(P>0.05),假刺激组及巴氯芬组3个时间点间差异有显著性意义(P<0.05)。而同一时间点4组的GABA b受体表达呈“刺<空<巴<假”递增趋势,6h、12h、24h空白对照组与刺激组比较差异显著性意义(P>0.05),其余同一时间点4组间两两比较差异有显著性意义(P<0.05)。 结论:正中神经电刺激后大鼠出现短暂的兴奋性反应,意识状态等级提高,正中神经电刺激是治疗脑外伤后昏迷的有效治疗方法,其机制可能与降低前额叶抑制性递质GABA b受体表达有关。
关键词:γ-氨基丁酸b受体  巴氯芬  正中神经电刺激  脑外伤  昏迷  促醒
Effects of median nerve electrical stimulation on expression of γ-aminobutyric acid b receptor in prefrontal cortex of coma rats after traumatic brain injury    Download Fulltext
Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Jiangxi, 330006
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Abstract:
      Abstract Objective: To investigate the changes of γ-aminobutyric acid b receptor (GABA bR) expression in prefrontal cortex of coma rats models after traumatic brain injury with median nerve electrical stimulation (MNES), and to explore the effects and possible mechanisms of MNES in coma and wake. Method: SD rats were divided into 4 groups: control group, sham-stimulation group, MNES group and baclofen group. MNES was applied to traumatic brain injury coma rats. Then, behaviors of rats were observed and the prefrontal cortices of each group were extracted at 6h, 12h, 24h after the experiment. Western-blot techniques were used to detect the expressions of GABA bR. Result: Rats' "free-fall drop model" appeared behavioral changes similar to clinical coma, while after MNES, the comatose rats showed a transient behavioral arousal. The states of consciousness in control group all were class I, in sham-stimulation group were class (5.33±0.758), stimulation group were class(3.80±1.064), baclofen group were class (4.63±0.964). The consciousness grade for four groups was "control<stimulation<baclofen<sham-stimulation", there were statistical significances among the four groups (P<0.05). Western-blot results showed that the expressions of GABA bR in prefrontal cortex in the same group at the three time points was “6h<12h<24h”, there was no statistical significance at the three time points in control group and stimulation group (P>0.05), while there were statistical significances at the three time points in sham-stimulation group and baclofen group (P<0.05). In each time point the expressions of GABA bR in prefrontal cortex was “NMES<control<Baclofen<sham-stimulation”, there was no statistical significance between control group and NMES group (P>0.05), while at the same time point there were statistical significances among the comparisons of each 2 groups (P<0.05). Conclusion: The comatose rats showed a transient behavioral arousal and the class of consciousness states increased after MNES. The expression of GABA bR in prefrontal cortex of traumatic brain injury coma rats after MNES was down-regulated, which certified the arousal effect of MNES.
Keywords:γ-aminobutyric acid b receptor  baclofen  median nerve electrical stimulation  traumatic brain injury  coma  arousal
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