专题脑卒中针刺机理与功能康复

弥散张量成像观察电针对缺血性脑卒中大鼠运动皮层-纹状体神经传导束的影响

  • 林冰冰 ,
  • 王鲜 ,
  • 柳维林 ,
  • 梁胜祥 ,
  • 杨敏光 ,
  • 陶静 ,
  • 陈立典.
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  • 福建中医药大学康复医学院,福建福州市 350122;
    2.中国科学院高能物理研究所,北京市 100049。
林冰冰(1991-),女,汉族,福建福州市人,硕士研究生,主要研究方向:神经康复与认知科学。

收稿日期: 2017-01-16

  网络出版日期: 2017-08-07

基金资助

国家自然科学基金项目(No.81373778)

Effects of Electroacupuncture on Nerve Bundle of Motor Cortex and Striatum in Rats with Ischemic Stroke: Observed with Diffusion Tensor Imaging

  • LIN Bing-bing ,
  • WANG Xian ,
  • LIU Wei-lin ,
  • LIANG Sheng-xiang ,
  • YANG Min-guang ,
  • TAO Jing ,
  • CHEN Li-dian
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  • 1. Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, China;
    2. Institute of High Energy Physics Chinese Academy of Sciences, Beijing 100049, China

Received date: 2017-01-16

  Online published: 2017-08-07

摘要

目的运用小动物磁共振弥散张量成像(DTI),探讨电针曲池、足三里穴对大脑中动脉闭塞致缺血性脑卒中模型大鼠缺血侧运动皮层-纹状体神经传导束完整性的影响。方法36只成年雄性Sprague-Dawley大鼠随机分为假手术组、模型组和电针组,每组12只,后两组线栓法制备缺血2 h再灌注模型。术后24 h,电针组电针患侧曲池、足三里穴,每天1次,连续14 d。改良神经功能缺损评分(mNSS)评价大鼠神经功能缺损情况;转棒测试观察大鼠运动功能;小动物磁共振成像系统行T2加权成像(T2WI)、DTI扫描,测量脑梗死体积,运动皮层、纹状体区神经传导束相对各向异性分数(rFA)和相对神经纤维数。结果模型组和电针组大鼠较假手术组mNSS评分显著增加;干预7 d、14 d后,电针组评分较模型组降低(P<0.05);转棒测试电针组较模型组转棒上停留时间延长(P<0.05)。T2WI成像显示,电针组较模型组脑梗死体积减少(P<0.05);DTI成像发现,电针组较模型组大鼠缺血侧运动皮层、纹状体rFA增加,运动皮层相对纤维束数增多(P<0.05)。结论电针曲池、足三里穴可改善缺血性脑卒中大鼠运动功能,与促进缺血侧运动皮层-纹状体神经传导束损伤的修复相关。

本文引用格式

林冰冰 , 王鲜 , 柳维林 , 梁胜祥 , 杨敏光 , 陶静 , 陈立典. . 弥散张量成像观察电针对缺血性脑卒中大鼠运动皮层-纹状体神经传导束的影响[J]. 中国康复理论与实践, 2017 , 23(7) : 756 -761 . DOI: 10.3969/j.issn.1006-9771.2017.07.003

Abstract

ObjectiveTo explore the effect of electroacupuncture at Quchi (LI11) and Zusanli (ST36) acupoints on motor behaviors, the axonal integrity and nerve bundle of motor cortex and striatum in rat model of ischemic stroke induced by middle cerebral artery occlusion (MCAO) using diffusion tensor imaging (DTI). MethodsThirty-six adult male Sprague-Dawley rats were randomly assigned to sham operation group (sham group), ischemia control group (model group) and electroacupuncture treatment group (EA group) with twelve rats in each group. The later two groups were occluded their middle cerebral arteries for two hours. Twenty-four hours after modeling, EA group received electroacupuncture at Quchi (LI11) and Zusanli (ST36) acupoints on the paralyzed limb, once a day, for 14 days. They were assessed with modified Neurological Severity Scores (mNSS) and Rota-rod test, and scanned with small animal magnetic resonance imaging system for T2-weighted image (T2WI) and DTI, the infarct size, related fractional anisotropy (rFA) and related number of tracks of motor cortex and striatum were recorded. ResultsCompared with the sham group, the score of mNSS increased in the model group and EA group after modeling, and was lower in EA group than in the model group seven days and 14 days after intervention (P<0.05). Rota-rod test showed that the retention time was significantly longer in EA group than in the model group (P<0.05). T2WI showed that the infarct size was smaller in EA group than in the model group (P<0.05). DTI showed that rFA in motor cortex and striatum was higher in EA group than in the model group (P<0.05), as well as the related number of tracks (P<0.05) in motor cortex. ConclusionElectroacupuncture at Quchi and Zusanli acupoints could improve the motor function in rats with ischemic stroke, which may be related to the recovery of nerve bundle of motor cortex and striatum in ischemic side.

参考文献

[1] Hamner MA, Möller T, Ransom BR. Anaerobic function of CNS white matter declines with age [J]. J Cereb Blood Flow Metab, 2011, 31(4): 996-1002.
[2] Pantoni L, Garcia JH, Gutierrez JA. Cerebral white matter is highly vulnerable to ischemia [J]. Stroke, 1996, 27(9): 1641-1646.
[3] Le Bihan D. Looking into the functional architecture of the brain with diffusion MRI [J]. Nat Rev Neurosci, 2003, 4(6): 469-480.
[4] Kodiweera C, Alexander AL, Harezlak J, et al. Age effects and sex differences in human brain white matter of young to middle-aged adults: A DTI, NODDI, and q-space study [J]. Neuroimage, 2016, 128: 180-192.
[5] 王亚平,史勇红,刘桂雪,等. 基于DTI技术的健康成人胼胝体、扣带回、中脑白质纤维束密度随年龄变化关系的研究[J]. 神经解剖学杂志, 2016, 32(4): 429-435.
[6] Viallon M, Cuvinciuc V, Delattre B, et al. State-of-the-art MRI techniques in neuroradiology: principles, pitfalls, and clinical applications [J]. Neuroradiology, 2015, 57(5): 441-467.
[7] 王凯,赵津京,王晓东,等. 急性脑卒中后DTI成像与运动神经损伤康复疗效的预测研究[J].中华脑血管病杂志(电子版), 2012, 6(4): 192-195.
[8] Koizumi JI, Yoshida Y, Nakazawa T, et al. Experimental studies of ischemic brain edema: 1. A new experimental model of cerebral embolism in rats in which recirculation can be introduced in the ischemic area [J]. Jpn J Stroke, 1986, 8(1): 1-8.
[9] Pignataro G, Meller R, Inoue K, et al. In vivo and in vitro characterization of a novel neuroprotective strategy for stroke: ischemic postconditioning [J]. J Cereb Blood Flow Metab, 2008, 28(2): 232-241.
[10] 邓春雷. 实验针灸学[M]. 北京:人民卫生出版社, 1998.
[11] Chen J, Li Y, Wang L, et al. Therapeutic benefit of intravenous administration of bone marrow stromal cells after cerebral ischemia in rats [J]. Stroke, 2001, 32(4): 1005-1011.
[12] Borlongan CV, Randall TS, Cahill DW, et al. Asymmetrical motor behavior in rats with unilateral striatal excitotoxic lesions as revealed by the elevated body swing test [J]. Brain Res, 1995, 676(1): 231-234.
[13] Chen J, Sanberg PR, Li Y, et al. Intravenous administration of human umbilical cord blood reduces behavioral deficits after stroke in rats [J]. Stroke, 2001, 32(11): 2682-2688.
[14] Tsai LK, Wang Z, Munasinghe J, et al. Mesenchymal stem cells primed with valproate and lithium robustly migrate to infarcted regions and facilitate recovery in a stroke model [J]. Stroke, 2011, 42(10): 2932-2939.
[15] Zhang QW, Deng XX, Sun X, et al. Exercise promotes axon regeneration of newborn striatonigral and corticonigral projection neurons in rats after ischemic stroke [J]. PLoS One, 2013, 8(11): e80139.
[16] Ding G, Jiang Q, Li L, et al. Longitudinal magnetic resonance imaging of sildenafil treatment of embolic stroke in aged rats [J]. Stroke, 2011, 42(12): 3537-3541.
[17] Ramos-Cejudo J, Gutiérrez-Fernández M, Otero-Ortega L, et al. Brain-derived neurotrophic factor administration mediated oligodendrocyte differentiation and myelin formation in subcortical ischemic stroke [J]. Stroke, 2015, 46(1): 221-228.
[18] Wang Z, Tsai LK, Munasinghe J, et al. Chronic valproate treatment enhances postischemic angiogensis and promotes functional recovery in a rat model of ischemic stroke [J]. Stroke, 2012, 43(9): 2430-2436.
[19] Fan SJ, Lee FY, Cheung MM, et al. Bilateral substantia nigra and pyramidal tract changes following experimental intracerebral hemorrhage: an MR diffusion tensor imaging study [J]. NMR Biomed, 2013, 26(9):1089-1095.
[20] 公维军,张通,崔利华. 电针足三里应用于脑卒中后痉挛状态的可行性研究[J]. 中国康复理论与实践, 2008, 14(12): 1165-1167.
[21] 谢西梅,安军明,黄琳娜,等. 针刺对缺血性中风患者运动功能障碍影响的随机对照研究[J]. 针灸临床杂志, 2012, 28(12): 15-18.
[22] Gao Y, Lin Z, Tao J, et al. Evidence of timing effects on acupuncture: A functional magnetic resonance imaging study [J]. Exp Ther Med, 2015, 9(1): 59-64.
[23] 高燕玲,陈立典,陶静. 电针肌肉运动点对脑卒中患者手功能障碍的影响[J]. 中国康复医学杂志, 2011, 26(12): 1167-1168.
[24] Lan L, Tao J, Chen A, et al. Electroacupuncture exerts anti-inflammatory effects in cerebral ischemia-reperfusion injured rats via suppression of the TLR4/NF-kappaB pathway [J]. Int J Mol Med, 2013, 31(1): 75-80.
[25] Xue X, You Y, Tao J, et al. Electro-acupuncture at points of Zusanli and Quchi exerts anti-apoptotic effect through the modulation of PI3K/Akt signaling pathway [J]. Neurosci Lett, 2014, 558: 14-19.
[26] 张华,司卫军,谭中建,等. 针刺阳陵泉对脑梗死患者白质结构的影响[J]. 中国康复理论与实践, 2014, 20(10): 955-959.
[27] Koyama T, Marumoto K, Miyake H, et al. Relationship between diffusion tensor fractional anisotropy and motor outcome in patients with hemiparesis after corona radiata infarct [J]. J Stroke Cerebrovasc Dis, 2013, 22(8): 1355-1360.
[28] Sun YY, Morozov YM, Yang D, et al. Synergy of combined tPA-edaravone therapy in experimental thrombotic stroke [J]. PLoS One, 2014, 9(6): e98807.
[29] Wu Z, Hu J, Du F, et al. Long-term changes of diffusion tensor imaging and behavioural status after acupuncture treatment in rats with transient focal cerebral ischaemia [J]. Acupunct Med, 2012, 30(4): 331-338.
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