目的研究迷走神经电刺激(VNS)对脑外伤(TBI)昏迷大鼠的促醒效果及其机制。方法168只健康Sprague-Dawley大鼠随机分为空白组、TBI组、拮抗剂组和VNS组,每组42只。空白组不做任何处理,TBI组、VNS组、拮抗剂组撞击法复制脑外伤模型,造模后昏迷至少30 min的大鼠入选。VNS组予VNS,拮抗剂组侧脑室注射Orexin A受体1拮抗剂SB334867后加VNS,TBI组予假VNS。分别于干预后6 h、12 h、24 h观察大鼠意识水平,应用免疫组化、Western blotting检测前额叶皮质γ-氨基丁酸b1受体(GABAb1R)表达水平。结果最终空白组42只、TBI组11只、拮抗剂组13只、VNS组28只大鼠觉醒。Western blotting显示,干预后12 h、24 h,GABAb1R蛋白表达TBI组>拮抗剂组>空白组>VNS组(F>60.412, P<0.001)。免疫组化显示,GABAb1R蛋白表达TBI组>拮抗剂组>VNS组>空白组(H=15.121, P=0.002),但不同时间点无显著性差异(H=3.028, P=0.220)。结论VNS可促TBI昏迷大鼠觉醒,其促醒机制可能与Orexin A介导大鼠前额叶皮质GABAb1R表达水平下调有关。
ObjectiveTo investigate the wake-promoting effect of vagus nerve stimulation (VNS) on coma rats after traumatic brain injury (TBI), and the related mechanism. MethodsA total of 168 healthy Sprague-Dawley rats were randomly divided into blank group, TBI group, antagonist group and VNS group, 42 rats in each group. The latter three groups were established TBI model with impact, and the rats in coma at least 30 minutes were included. VNS group accepted VNS, the antagonist group were injected intralateroventricularly Orexin A receptor 1 (OXR1) antagonist SB334867, and TBI group accepted sham VNS. Their behaviors were observed to determine the level of consciousness six, twelve and 24 hours after intervention, while the expression of γ-aminobutyric acid b1 receptor (GABAb1R) in prefrontal cortex was detected with immunohistochemistry and Western blotting. ResultsThere were 42 rats in the blank group, 11 rats in TBI group, 13 rats in the antagonist group, and 28 rats in VNS group awakened finally. The expression of GABAb1R in prefrontal cortex ranged as TBI group, antagonist group, blank group and VNS group from more to less twelve and 24 hours after intervention under Western blotting (F>60.412, P<0.001), and it ranged as TBI group, antagonist group, VNS group and blank group under immunohistochemistry (H=15.121, P=0.002), with no significant difference among time points (H=3.028, P=0.220). ConclusionVNS can promote waking from coma in rats after TBI, which may relate with the decrease of GABAb1R in prefrontal cortex that induced by Orexin A.
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