经颅直流电刺激对脑梗死大鼠神经行为学、脑血流和血管再生以及相关蛋白的影响  

The effects of transcranial direct current stimulation on cerebral blood flow and new vascularization after cerebral infarction

作　　者：蔡缘邯 杨文 白安娜 王莎[1] 孙艳冬[1] 梁宇[1] 王璐[3] 邓慧[4] 郝利霞[1] Cai Yuanhan;Yang Wen;Bai Anna;Wang Sha;Sun Yandong;Liang Yu;Wang Lu;Deng Hui;Hao Lixia(Rehabilitation Department of Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000,China;Rehabilitation Department of Baoding First Central Hospital,Baoding 071000,China;Medical Experiment Center of Inner Mongolia Medical University,Hohhot 010000,China;Department of Neurology,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000,China)

机构地区：[1]内蒙古医科大学附属医院康复科,呼和浩特010000 [2]保定市第一中心医院康复科,保定071000 [3]内蒙古医科大学医学实验中心,呼和浩特010000 [4]内蒙古医科大学附属医院神经内科,呼和浩特010000

出　　处：《中华物理医学与康复杂志》2023年第10期865-871,共7页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：内蒙古自治区自然科学基金项目(2020MS08049);内蒙古自治区卫生健康委2022年度医疗卫生科技计划项目(202201254)。

摘　　要：目的探讨经颅直流电刺激(tDCS)对脑梗死大鼠神经行为学、脑血流(CBF)、血管再生、血管内皮生长因子(VEGF)和CD34蛋白表达的影响。方法选取成年雄性SD大鼠32只,按照随机数字表法将其分为假手术组(Sham组)、模型组[大脑中动脉闭塞(MCAO)组]、阳极经颅直流电刺激组(A-tDCS组)、阴极经颅直流电刺激组(C-tDCS组),每组8只。采用线栓法将MCAO组、A-tDCS组、C-tDCS组大鼠制成MCAO模型。造模后24 h开始给予大鼠tDCS刺激,Sham组和MCAO组大鼠均安装电极,但不给予电流刺激,A-tDCS组给予阳极电极刺激,C-tDCS组给予阴极电极刺激,刺激强度200μA,每日20 min,刺激5 d,休息2 d,再刺激5 d,整体周期共12 d。造模前、造模后24 h和治疗12 d后,采用Longa神经行为学评分法对4组大鼠进行神经行为学评分;造模后3 d和治疗12 d后,采用MRI观察4组大鼠的CBF变化情况;治疗12 d后,采用免疫荧光法观察4组大鼠血管的再生情况,采用Western blot法检测大鼠VEGF和CD34蛋白的表达水平。结果造模后24 h和治疗12 d后,MCAO组、A-tDCS组、C-tDCS组大鼠均存在不同程度的神经功能缺损症状。组内比较发现,A-tDCS组、C-tDCS组治疗12 d后的神经行为学评分较造模前和造模后24 h降低(P<0.05)。组间比较发现,A-tDCS组[(1.3±0.4)分]、C-tDCS组[(1.9±0.32)分]治疗12 d后的神经行为学评分较MCAO组[(2.6±0.52)分]低(P<0.05),且A-tDCS组低于C-tDCS组(P<0.05)。造模后3 d,三维动脉自旋标记(3D-ASL)扫描示MCAO组、A-tDCS组、C-tDCS组大鼠缺血灶周围CBF明显减少,治疗12 d后缺血灶周围CBF有不同程度的增加。A-tDCS组、C-tDCS组的ΔCBF较MCAO组大(P<0.05),且A-tDCS组ΔCBF较C-tDCS组大(P<0.05)。治疗12 d后,A-tDCS组、C-tDCS组大鼠大脑梗死区的新生微血管密度、脑组织VEGF和CD34蛋白表达较MCAO组高(P<0.05),A-tDCS组上述指标较C-tDCS组高(P<0.05)。结论tDCS可以改善脑梗死大鼠的神经功能缺损症状,促进血管再生,Objective To explore any effect of transcranial direct current stimulation(tDCS)on neurons,behavior,cerebral blood flow(CBF),vascular regeneration,and the expression of vascular endothelial growth factor(VEGF)and CD34 protein in rats modeling cerebral infarction.Methods Thirty-two adult male Sprague-Dawley rats were randomly divided into a sham surgery group(Sham group),a model group(modeled with middle cerebral artery occlusion,MCAO group),an anode transcranial direct current stimulation group(A-tDCS group),and a cathode transcranial direct current stimulation group(C-tDCS group),each of 8.MCAO models were established in the rats of the MCAO,A-tDCS and C-tDCS groups using thread fixation.Twenty-four hours after successful modeling,both the Sham and MCAO groups were connected with electrodes without current stimulation,while the A-tDCS and C-tDCS groups were given 20 minutes of 200μA anodic or cathodic electrical stimulation daily,5 days a week for 12 days.Before and 24 hours after the modeling,and then after the 12 days of treatment,the four groups received Longa neurobehavioral scoring.Moreover,three days after the modeling as well as after the 12 days of treatment,changes in CBF were observed using MRI.Any blood vessel regeneration was observed using immunofluorescence methods,and the expression of VEGF and CD34 proteins were detected using western blotting.Results The rats in the MCAO,A-tDCS and C-tDCS groups exhibited various degrees of neurological deficit after the modeling.After the 12 days of treatment the average neurobehavioral scores of the A-tDCS and C-tDCS groups were significantly lower than that of the MCAO group,with the A-tDCS group′s average significantly lower than that of the C-tDCS group.Three days after the modeling,3D-arterial spin labeling scanning showed a significant decrease in CBF around the ischemic lesion in the MCAO,A-tDCS and C-tDCS groups,but that had increased to varying degrees after 12 days of treatment.The changes in the A-tDCS and C-tDCS groups were significantly larger t

关 键 词：经颅直流电刺激 脑梗死 脑血流 血管再生 VEGF CD34 

分 类 号：R743.33[医药卫生—神经病学与精神病学]