功能性电刺激对急性脑梗死大鼠神经功能及梗死侧皮质巢蛋白表达的影响  

Effects of functional electrical stimulation on neural function recovery and expression of nestin around cere-bral infracted area of rats with acute stroke

作　　者：郑修元[1] 李胜活[1] 燕铁斌[1] 刘慧华[1] 向云[1] 庄志强[1] 金冬梅[1] 彭源[1] 

机构地区：[1]中山大学孙逸仙纪念医院康复医学科,510120广州

出　　处：《中华物理医学与康复杂志》2011年第5期325-328,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：国家自然基金资助项目（30973166,30772304）

摘　　要：目的观察功能性电刺激（FES）对急性脑梗死大鼠梗死侧顶叶皮质巢蛋白（nestin）表达的影响，初步探讨FES治疗在脑梗死后早期促进神经功能恢复的分子机制。方法将60只雄性SD大鼠分为电刺激组、安慰刺激组、对照组，每组20只，每组大鼠再分为治疗1，3，7，14d共4个亚组，每个亚组5只。参照改良Longa线栓法制作急性脑梗死大鼠大脑中动脉栓塞（MCAO）模型。电刺激组与安慰刺激组于MCAO后第3天开始治疗。电刺激组以表面电极刺激偏瘫侧前肢，FES参数设置的强度以前肢能发生明显的伸腕、伸趾动作为宜。安慰刺激组将FES治疗仪的治疗电极放在偏瘫侧前肢伸肌群的运动点上，但关闭电源不予以电刺激，对照组不给予任何治疗。所有大鼠分别于治疗前、治疗后第1，3，7，14天给予改良的神经功能缺损评分（mNSS）评定，同时，以免疫组织化学技术分析大鼠脑梗死侧周围远隔区顶叶皮质nestin表达的阳性细胞数。结果治疗3d后，电刺激组与安慰刺激组和对照组大鼠的mNSS评分组间差异无统计学意义（P〉0．05）；在治疗7d和14d后，电刺激组大鼠mNSS评分显著高于安慰刺激组和对照组（P〈0．05）；但安慰刺激组与对照组之间mNSS评分在各时间点差异无统计学意义（P〉0．05）；治疗3，7，14d后电刺激组大鼠脑梗死侧周围顶叶皮质nestin表达的阳性细胞数较安慰刺激组和对照组明显增加（P〈0．05），安慰刺激组和对照组之间在各时间点脑梗死灶周围远隔区顶叶皮质nestin的阳性细胞数差异无统计学意义（P〉0．05）。结论FES治疗脑梗死早期大鼠偏瘫肢体可显著促进其神经功能的恢复；FES治疗可促进梗死灶周围nestin的表达，这可能说明了FES治疗的另一个分子机制。Objective To study the effects of functional electric stimulation （FES）on neural funetion recov-ery and expression of nestin around cerebral infraet area of rats with acute stroke. Methods The model of middle cerebral artery occlusion （MCAO）of male adult SD rats was established with the method of modified intraluminal fila-ment occlusion. Sixty successfully established model rats were randomly allocated into FES group,placebo group and control group（20/group）. Three days after MCAO＇ s surgery, rats in FES group were treated with FES device while the ones in placebo stimulation group were treated with the same FES device hut without electrical output. Rats in control group had no treatment. All groups were randomly assigned into 4 subgroups according to treatment time：l d, 3 d ,7 d and 14 d （5/subgroup）. The modified neurological severity score （mNSS）was adopted to evaluate neural function recovery before and after treatment in 4 time points as mentioned above. Meanwhile,the nestin expression in various time points was detected by immunohistochemistry stain in distant area of ipsilateral cortex of infarction. Results The mNSS scots in FES group is lower than that in placebo simulation group and control group at the 7 thd and 14 thd （ P 〈 0.05） ;The expression of nestin-positive cells in distant area of ipsilateral cortex of infarction of rats in FES group is higher than that in placebo stimulation group and control group （ P 〈 0.05 ）. Conclusions FES may improve the recovery of neural function in the earlier stage of cerebral infarction. FES treatment could improve the ex- pression of nesitin around cerebral infarct area and it could be one of the mechanisms of FES＇ s effect.

关 键 词：功能性电刺激 脑梗死 神经功能 巢蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]