慢性缺氧性脑病诱发电位、行为与caspase-3凋亡蛋白表达的变化

目的:探讨大鼠慢性间断性缺氧后,脑诱发电位与慢性缺氧性脑损伤的关系,探讨脑诱发电位对缺氧性脑病的评估价值.方法:在建立慢性间断性缺氧大鼠模型的基础上,雄性SD大鼠随机分成缺氧组(H组)和对照组(N组),H组随机分为缺氧2周组(H2组)和缺氧4周组(H4组)2个亚组;应用Morris水迷宫检测各组大鼠的学习记忆能力;测定各组大鼠的脑干听觉诱发电位(BAEP)和短潜伏期体感诱发电位(SLSEP).免疫组织化学法检测caspase-3凋亡蛋白表达的变化.结果:缺氧组BAEP和SEP各波的峰潜伏期和峰间峰潜伏期比对照组明显延长,差异有显著性意义,缺氧组BAEP和SEP的变化与学习记忆能力和caspase-3凋亡蛋白表达有相关性.结论:BAEP和SEP的改变与慢性缺氧性脑损伤及损伤的程度明显相关,是反映缺氧性脑损伤比较敏感的指标.     

蛇毒神经生长因子促进周围神经再生的诱发电位观察

目的：研究蛇毒神经生长因子（sNGF)对大鼠坐骨神经损伤后诱发电位的影响,评价蛇毒神经生长因子在促进周围神经再生中的作用。方法：建立大鼠坐骨神经钳夹模型,局部滴加药物和术后肌注sNGF,通过脊髓诱发电位（SEP）,运动诱发电位（MEP）评定,观察坐骨神经修复情况。结果：sNGF治疗后可使伤后SEP,MEP提早出现,结论：蛇毒提取的NGF对大鼠坐骨神经损伤修复具有促进作用。     

蛛网膜下腔出血对大鼠脑血流量和体感诱发电位的影响

目的：探讨蛛网膜下腔出血（ＳＡＨ）后脑血流量、体感诱发电位（ＳＥＰ）潜伏期的改变及其与一氧化氮（ＮＯ）的关系。方法：对假手术对照组和ＳＡＨ模型组大鼠检测２４ｈ局部脑血流量（ｒＣＢＦ）、ＳＥＰ潜伏期和血清及脑组织ＮＯ含量动态变化。结果：非开颅刺破Ｗｉｌｌｉｓ环的方法可成功地诱发ＳＡＨ。ＳＡＨ后ｒＣＢＦ立即降低,在２４ｈ内无恢复趋势。ＳＥＰ潜伏期于ＳＡＨ后１ｈ开始至２４ｈ明显延长。血清和脑组织ＮＯ含量     

两种经皮穴位电刺激方法对脑卒中患者体感诱发电位影响的比较

摘要目的：比较经皮穴位电刺激（TAES）患侧上肢及双上肢两种不同方法对脑卒中患者体感诱发电位（SEP）的影响。方法：24名脑卒中患者根据TAES治疗的部位分为2组,刺激患侧上肢组（12名）和同时刺激双上肢组（12名）。两组对象分别接受一次30min的TAES治疗,刺激参数为频率4Hz,脉宽250μs,强度为患者最大耐受量。分析5R．上肢SEPN9,N20的波幅和潜伏期,比较两组患侧上肢电刺激前后SEP值的变化。结果：两种方法都能使患侧上肢SEPN9和N20的波幅明显增高而潜伏期明显缩短。虽然治疗后两组间SEP各参数比较差异无显著性,但两组间各参数变化率的比较差异有显著性（P〈0．05）。结论：单上肢或双上肢TAES治疗能改善脑卒中患者偏瘫肢体的SEP值,但双上肢组对SEP值的改变更明显。     

220例植物状态患者早期电生理与预后的相关性

目的：观察植物状态患者早期电生理检查脑干听觉诱发电位、体感诱发电位反应与后期意识是否恢复和预后的相关性。方法：对入院220例的植物状态患者分别在患病三个月内进行早期的脑干听觉诱发电位和体感诱发电位检查,每项电生理检查结果进行量化分级评分,并采用Glasgow结局量表（GOS）分别评价植物状态在一年时的意识状态和转归情况,出院的患者进行随访问卷调查,了解其预后情况。结果：植物状态患者早期脑干听觉诱发电位和体感诱发电位的不同表现与预后存在显著差异（P〈0．05）,表现越好,其预后就越好。脑干听觉诱发电位和体感诱发电位与植物状态患者意识恢复存在明显相关性（P〈0．05）。结论：脑干听觉诱发电位和体感诱发电位可作为早期评价植物状态患者意识转归和预后的重要工具。     

人体正中神经刺激的体感诱发电位观察

对30例正常成人,在 Erb 点、C_7处体表及大脑皮层相应体感区头皮(C_3或 C_4)记录正中神经刺激引起的体感诱发电位。测定了体感诱发电位各主要成分潜伏期,并计算出自腕部到 Erb 点之间正中神经外周传导速度(PCV)为70.80±2.60m/s。自 C_7到大脑皮层相应体感区之间中枢段(N_(18)-N_(13))传导时间(CCT)为5.90±0.65ms。左右两侧 PCV 和 CCT 均无显著差异(P>0.05),前者两侧之差的正常值上限为4.30m/s,后者为1.40ms。     

刺激大脑皮层联合区对C类纤维传入诱发皮层电反应的影响

电刺激猫大脑皮层前外侧回联合区(ALA)能使隐神经 C 类纤维传入引起的体感皮层(S(?)区)诱发电位(C-CEP)的幅值明显变小,并有后作用,表明 ALA 对 C-CEP 有抑制作用;切断ALA 与 SI 区之间的皮层内纤维联系后,ALA 对 C-CEP 的抑制作用明显减弱,抑制时程缩短;侧脑室微量注射阿片受体拮抗剂纳洛酮后,电刺激 ALA 对 C-CEP 的抑制作用明显减弱,表明 ALA 对 C-CEP 的抑制作用的作用途径之—可能是通过 ALA 与 SI 区之间的皮层内神经径路;可能与内源性阿片样物质的释放有关。提示大脑皮层联合区可能对体感皮层 C-CEP 有调制作用。     

γ—氨基丁酸在联合皮层抑制C类纤维皮层诱发电位效应中的作用

电刺激猫大脑皮层前外侧回联合区(ALA)对隐神经C类纤维传入引起的体感皮层(SI)诱发电位(C-CEP)有明显的抑制作用;侧脑室注射γ-氨基丁酸(GABA)能使C-CEP的幅值显著变小,潜伏期延长,表明GABA对C-CEP也有抑制作用;侧脑室注射GABA受体拮抗剂荷包牡丹硷后,电刺激ALA对C-CEP的抑制作用明显减弱,提示内源性GABA的释放可能参与大脑皮层联合区对C-CEP的调制过程。     

乙酰胆碱在刺激SⅡ区影响C类纤维传入诱发的SI区电反应中的作用

电刺激猫大脑皮层体感Ⅱ区(SⅡ)对隐神经C类纤维传入引起的体感Ⅰ区(SⅠ)诱发电位(C—CEP)有抑制和易化作用。在SⅠ区局部用阿托品能部分地阻断电刺激SⅡ区对C—CEP的抑制作用,但对易化作用的影响不明显;而用六烃季铵(C_6)能阻断易化作用,但对抑制作用的影响却不明显。在SⅠ区局部应用0.01％乙酰胆碱(ACh)对C—CEP有易化作用,用0.1％ACh则有抑制作用。结果提示,ACh可能参与SⅡ区对SⅠ区C—CEP的影响,通过SⅠ区的胆碱能M受体起抑制作用,通过N受体起易化作用。     

电针对椎间盘脱出模型犬体感诱发电位的影响

目的研究电针对椎间盘脱出模型犬脊髓损伤的修复作用及其对体感诱发电位(somatosensory evoked potential,SEP)的影响。方法比格犬随机分为三组,模型组和电针组采用球囊压迫法制作椎间盘脱出模型,电针组术后每天电针治疗;对照组进行假手术处理。术前(0 d)和术后1、4、7、14 d每只犬均使用德克萨斯犬脊髓损伤Texas Spinal Cord Injury Scale for Dogs(TSCIS)评分法评分,使用肌电诱发电位仪测量SEP并分析其潜伏期和波幅。结果术后1 d模型组和电针组与对照组TSCIS评分相比均显著降低(P0.01),术后14 d,电针组与模型组相比差异有显著性(P0.01);术后4 d模型组和电针组的SEP潜伏期相比显著降低(P0.05),术后14 d,电针组与模型组的潜伏期相比差异有显著性(P0.05);术后1 d模型组和电针组的SEP波幅与对照组相比显著降低(P0.05),术后14 d,电针组与模型组的波幅相比差异有显著性(P0.05)。结论电针能够有效促进椎间盘脱出模型犬的脊髓损伤修复,提高TSCIS评分,恢复SEP波形,缩短其潜伏期,提升其波幅;SEP能够在一定程度上反应脊髓损伤程度,评价电针治疗效果。     

Regulation of oxygen transport during brain activation: stimulus-induced hemodynamic responses in human and animal cortices

BACKGROUND: The correlation between regional changes in neuronal activity and changes in hemodynamics is a major issue for noninvasive neuroimaging techniques such as functional magnetic resonance imaging (fMRI) and near-infrared optical imaging (NIOI). A tight coupling of these changes has been assumed to elucidate brain function from data obtained with those techniques. In the present study, we investigated the relationship between neuronal activity and hemodynamic responses in the occipital cortex of humans during visual stimulation and in the somatosensory cortex of rats during peripheral nerve stimulation. METHODS: The temporal frequency dependence of macroscopic hemodynamic responses on visual stimuli was investigated in the occipital cortex of humans by simultaneous measurements made using fMRI and NIOI. The stimulus-intensity dependence of both microscopic hemodynamic changes and changes in neuronal activity in response to peripheral nerve stimulation was investigated in animal models by analyzing membrane potential (fluorescence), hemodynamic parameters (visible spectra and laser-Doppler flowmetry), and vessel diameter (image analyzer). RESULTS: Above a certain level of stimulus-intensity, increases in regional cerebral blood flow (rCBF) were accompanied by a decrease in regional cerebral blood volume (rCBV), i.e., dissociation of rCBF and rCBV responses occurred in both the human and animal experiments. Furthermore, the animal experiments revealed that the distribution of increased rCBF and O2 spread well beyond the area of neuronal activation, and that the increases showed saturation in the activated area. CONCLUSIONS: These results suggest that above a certain level of neuronal activity, a regulatory mechanism between regional cerebral blood flow (rCBF) and rCBV acts to prevent excess O2 inflow into the focally activated area.     

The cyclooxygenase inhibitors indomethacin and Rofecoxib reduce regional cerebral blood flow evoked by somatosensory stimulation in rats

The present study was designed to investigate whether administration of indomethacin (IMC), a non-selective cyclooxygenase (COX-1 and COX-2) inhibitor, and Rofecoxib, a highly selective COX-2 inhibitor, affect the regulation of regional cerebral blood flow response evoked by somatosensory activation (evoked rCBF). IMC and Rofecoxib were applied intravenously (6.25 and 3 mg/kg/hr, respectively). Somatosensory activation was induced by electrical hind paw stimuli of 0.2, 1, and 5 Hz (5-sec duration, 1.5 mA). The evoked rCBF was measured in alpha-chloralose anesthetized rats using laser-Doppler flowmetry. Before and after drug application, the evoked rCBF showed a frequency-dependent increase in the range of 0.2-5 Hz stimulation. IMC reduced significantly (about 50%-60%) evoked rCBF in response to all frequencies of hind paw stimulation (P< 0.05). Rofecoxib reduced significantly (about 50%) evoked rCBF in response to 1 and 5 Hz stimulation (P< 0.05), but did not affect evoked rCBF at 0.2 Hz. After IMC or Rofecoxib application, the normalized evoked rCBF curves peaked earlier as compared with that before their application (P< 0.05), although the rise time of 0.5 sec was nearly constant regardless of the stimulus frequency. The termination time of evoked rCBF curves was changed significantly after IMC application at 0.2 Hz stimulation (P< 0.05), but was not affected after Rofecoxib application. Neither COX inhibitor significantly affected the baseline level of CBF. The results suggest a participation of COX products in the regulation of evoked rCBF in response to somatosensory stimulation in the brain.     

大鼠脑血管痉挛时NO和ET—1变化及尼莫地平的影响

目的探讨蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)时脑组织一氧化氮(NO)和内皮素-1(ET-1)含量变化及尼莫地平(ND)对其影响。方法将135只Wistar大鼠随机均分为SAH组、ND处理组和假手术组,观察手术前后基底动脉管径,及24h内局部脑血流量(rCBF)、脑组织NO和ET-1含量动态改变,并行海马病理检查。结果SAH后rCBF明显而持续降低,基底动脉管径显著缩小;海马CAl区锥体细胞严重受损;脑组织NO和ET-1含量均在SAH后1～24h显著增加(P＜0．05～0．01)。ND处理后使上述异常变化均减轻。结论SAH后脑组织NO、ET-1增多可能参与了CVS所致脑损害过程,ND通过减轻CVS和拮抗脑组织NO及ET-1的病理性改变而发挥脑保护作用。     

Pre and postoperative assessment of regional cerebral blood flow in hydrocephalus by 99mTc-hexamethyl-propylenamine oxime SPECT

Cerebrovascular changes resulting from hydrocephalus still remain to be investigated. It has been suggested that hydrocephalus distorts the large feeding arteries and that the collapse of capillaries results in decreased cerebral blood flow. This clinical study was designed to evaluate the effect of shunting on regional cerebral blood flow in patients with obstructive hydrocephalus of varying duration. Technetium-99m hexamethyl propyleamine oxime (99mTc-HMPAO) was used to measure the cerebral perfusion, semiquantitatively, since the pattern of its distribution in brain is somewhat similar to that of regional cerebral blood flow (rCBF), and the pre and postoperative semiquantitative rCBF values of each lobe were calculated. Fifteen patients (8 F, 7 M) underwent both CT and single photon emission tomography (SPECT) using 99mTc-HMPAO examination before and 1 week after shunting. Mean percentage of all lobes were calculated by subtracting the preoperative mean rCBF of all lobes from the corresponding postoperative values. The patients were classified into 3 groups according to the mean percentage of all lobes. Group A: showed a marked increase in mean cortical blood flow (+ 16.00 +/- 2.9%), group B: a moderate increase (11.27 +/- 4.8%), and in group C: there was the least improvement in mean cortical blood flow (+ 1.17 +/- 2.7%). The mean duration of hydrocephalus of group A, group B and group C was 5 +/- 0.5 weeks, 8 +/- 1 weeks and more than 12 weeks, respectively. Psychological testing and clinical observation of the daily activities of the patients postoperatively showed some correlation with increased rCBF and clinical improvement.(ABSTRACT TRUNCATED AT 250 WORDS)     

The regional cerebral blood flow pattern of the normal human brain and its factor structure

The regional cerebral blood flow (rCBF) pattern of the normal human brain was drawn, and its structure was studied. Relative rCBF estimates for 66 regions of interest (cerebral anatomical-functional areas) were obtained using positron emission tomography in 158 healthy subjects aged 18–49 years. The rCBF rate variation range was 89–121% of the rCBF rate averaged over all regions of interest, taken as 100%. The rCBF rates were the highest (>115%) in the paracentral lobule, precuneus, insular cortex, primary visual cortex, and Broca’s area and the lowest (<95%) in the mediobasal regions of the temporal gyri and caudate nuclei. Analysis of the factor structure of the resultant pattern made it possible to classify cerebral anatomical-functional areas according to a predominant effect of one of the following factors on the interdependence between rCBF rates: (1) cytoarchitectonic characteristics; (2) the functional state of the cortex during quiet wakefulness; or (3) the brain vascular region to which the area belongs. The obtained pattern should be taken into account in both mapping of the functions of a normal brain and clinical diagnosis.     

Regional cerebral blood flow thresholds during cerebral ischemia.

The development of methods of determining regional cerebral blood flow (rCBF) has made possible the determination of thresholds for the appearance of cerebral ischemia. These thresholds vary depending on the method used for assessing cerebral ischemia. The following thresholds have been determined in man and nonhuman primates: 20 cc/100 g per min, electroencephalogram (EEG) and evoked cortical potential abnormalities appear, paralysis seen in waking monkeys; 15 cc/100 g per min. EEG and evoked cortical potential are lost; 12 cc/100 g per min, flows at this level in excess of 120 min produce infarction in waking animals; and 6 cc/100 g per min, massive loss of intracellular [K+]. The residual rCBF and the duration of ischemia determine the appearance of infarction in waking Macaca irus monkeys.     

Parasympathetic reflex vasodilation in the cerebral hemodynamics of rats

We investigated the role of parasympathetic reflex vasodilation in the regulation of the cerebral hemodynamics, and whether GABA_A receptors modulate the response. We examined the effects of activation of the parasympathetic fibers through trigeminal afferent inputs on blood flow in the internal carotid artery (ICABF) and the cerebral blood vessels (rCBF) in parietal cortex in urethane-anesthetized rats. Electrical stimulation of the central cut end of the lingual nerve (LN) elicited intensity- and frequency-dependent increases in ICABF that were independent of changes in external carotid artery blood flow. Increases in ICABF were elicited by LN stimulation regardless of the presence or absence of sympathetic innervation. The ICABF increases evoked by LN stimulation were almost abolished by the intravenous administration of hexamethonium (10 mg kg^?1) and were reduced significantly by atropine administration (0.1 mg kg^?1). Although the LN stimulation alone had no significant effect on rCBF, LN stimulation in combination with a blocker of the GABA_A receptor pentylenetetrazole increased the rCBF markedly. This increase in rCBF was reduced significantly by the administration of hexamethonium and atropine. These observations indicate that the increases in both ICABF and rCBF are evoked by parasympathetic activation via the trigeminal-mediated reflex. The rCBF increase evoked by LN stimulation is thought to be limited by the GABA_A receptors in the central nervous system. These results suggest that the parasympathetic reflex vasodilation and its modulation mediated by GABA receptors within synaptic transmission in the brainstem are involved in the regulation of the cerebral hemodynamics during trigeminal afferent inputs.     

Effect of ischemic preconditioning on cerebral blood flow after subsequent lethal ischemia in gerbils

Ischemic tolerance, the phenomenon where a sublethal ischemic preconditioning protects the brain against a subsequent lethal ischemia, has been widely studied. Studies have been done on cerebral blood flow levels prior to the lethal ischemia, but the hemodynamic pattern after global ischemia with ischemic preconditioning has not been reported. Sequential changes in regional cerebral blood flow (rCBF) in gerbil hippocampus after 5 min global ischemia with or without 2 min ischemic preconditioning were studied to determine if ischemic preconditioning affects rCBF. Four different treatments were given: (1) sham-operated, (2) 2 min ischemia, (3) non-preconditioned, and (4) preconditioned. Groups (1) and (2) (both groups n = 5) were given a 24-h recovery period and the rCBF was measured for baseline values. 24 h after sham-operation (3) and 2 min ischemia (4), gerbils were subjected to 5 min ischemia followed by 1 h, 6 h, 1-day or 7-day reperfusion periods (all groups n = 5). Although no regional difference was observed in the recovery pattern of rCBF, the values of rCBF were significantly higher in the preconditioned group throughout whole brain regions including hippocampus. These results indicate that ischemic preconditioning facilitated the recovery of rCBF after 5 min global ischemia. It needs further study to determine whether the protecting effects of preconditioning relate to the early recovery of rCBF or not. However, our results could be interpreted that the early recovery of rCBF may lead to benefits for cell survival in the CA1 neuron, probably facilitating other protecting mechanisms.     

Brain activation associated with ratings of the hedonic component of thermal sensation during whole-body warming and cooling

Thermal sensation has both discriminative and hedonic components. The neural network associated with thermal discrimination has been described, but the representation of the hedonic component of thermal sensation in the brain has yet to be demonstrated. This study measured regional cerebral blood flow (rCBF) with Positron Emission Tomography in human participants during whole-body cooling and warming. Ratings of the hedonic dimension of thermal sensation were correlated with rCBF and compared to brain activation maps of skin and core temperature changes. The hedonic dimension of thermal sensation was represented in a widely distributed network that included somatosensory, limbic, paralimbic, and associative cortices. Changes in rCBF associated with ratings of the hedonic dimension of thermal sensation were contrasted with changes in rCBF associated with skin and core temperature to identify brain regions that were uniquely activated by the hedonic dimension of thermal sensation. The contrast between the correlates of the hedonic dimension of thermal sensation and the correlates of skin and core temperatures identified a region in the posterior part of the mid cingulate cortex (pMCC). The independent relationship between rCBF changes in the pMCC with ratings of the hedonic dimension of thermal sensation may indicate an important role for the pMCC in the integration of temperature-related signals from receptors in the skin and core.