CAJ | 학술논문

背景:长期反复痫性发作可影响记忆功能以及发生许多意料不到的并发症.如何控制和预防其发作是临床和康复医学研究的重点.目的:应用大鼠癫痫模型,探讨迷走神经刺激(vagus nerve stimulation.VNS)治疗癫痫的最佳启动时间.设计:随机对照的实验研究.地点和对象:实验地点:首都医科大学神经生物学研究室.实验对象:Wistar大鼠34只,二级,首都医科大学实验动物中心提供.方法:应用海人酸(kainic acid,KA)复制大鼠癫痫模型,以大鼠皮质电图(electrocorticographic,ECoG)和行为学为观测指标,在癫痫发作前后分别刺激左侧迷走神经,比较两组迷走神经刺激不同的启动时间对癫痫发作持续时间的影响,确定迷走神经刺激输出的最佳时机.主要观察指标:①海人酸诱发癫痫的潜伏期和持续期.②VNS的启动时间对控制癫痫发作的影响.结果:在癫痫发作前,间断刺激迷走神经50 min,可显著降低癫痫发作的严重程度、缩短发作的持续时间,甚至完全抑制癫痫发作.而发作一旦发生再行该组合刺激,则只能降低发作的严重程度、缩短发作的持续期,而不能完全阻抑癫痫发作.发作前后进行迷走神经刺激的抗痫效果之间存在显著性差异(F=27.320,P＜0.01).结论:在癫痫发作前及时启动VNS可以显著提高VNS的抗痫效果,适宜的刺激参数组合是控制癫痫发作的关键,并为其预防发作奠定实验基础.
배경:장기반복간성발작가영향기억공능이급발생허다의료불도적병발증.여하공제화예방기발작시림상화강복의학연구적중점.목적:응용대서전간모형,탐토미주신경자격(vagus nerve stimulation.VNS)치료전간적최가계동시간.설계:수궤대조적실험연구.지점화대상:실험지점:수도의과대학신경생물학연구실.실험대상:Wistar대서34지,이급,수도의과대학실험동물중심제공.방법:응용해인산(kainic acid,KA)복제대서전간모형,이대서피질전도(electrocorticographic,ECoG)화행위학위관측지표,재전간발작전후분별자격좌측미주신경,비교량조미주신경자격불동적계동시간대전간발작지속시간적영향,학정미주신경자격수출적최가시궤.주요관찰지표:①해인산유발전간적잠복기화지속기.②VNS적계동시간대공제전간발작적영향.결과:재전간발작전,간단자격미주신경50 min,가현저강저전간발작적엄중정도、축단발작적지속시간,심지완전억제전간발작.이발작일단발생재행해조합자격,칙지능강저발작적엄중정도、축단발작적지속기,이불능완전조억전간발작.발작전후진행미주신경자격적항간효과지간존재현저성차이(F=27.320,P＜0.01).결론:재전간발작전급시계동VNS가이현저제고VNS적항간효과,괄의적자격삼수조합시공제전간발작적관건,병위기예방발작전정실험기출.
BACKGROUND:Repeated long-term seizures can impact on the function of memory and cause some unexpected complications. It is the study focus of clinic and rehabilitative medicine how to control and prevent its onset.OBJECTIVE: To probe into the most appropriate output time of vagus nerve stimulation(VNS) for treating seizure with the epileptic model of rat.DESIGN: A randomized and controlled study.SETTING and MATERIALS: The experiment was completed in the Department of Neurobiology, Capital University of Medical Sciences; Thirty-four Wistar rats, grade of cleanness, second degree, were supplied by the center of Experiment Animals Science, Capital University of Medical Science.METHODS: Epileptic model was prepared with Kainic Acid(KA) . The changes of eleetrocortieogram(ECoG) and behavior were observed by stimulating the left vagus nerve before or after the onset of seizures respectively. The seizure duration of two groups was compared to determine the most appropriate stimulus output time.MAIN OUTCOME MEASURES: ① The latent period and seizure duration induced by KA. ② Effect of stimulus output time of VNS on controlling the seizure.RESULTS: The intensity and duration of epileptic seizures were strikingly decreased or even aborted completely with VNS, stimulating 50 minutes before the onset of seizures. VNS shortened but did not shut down the seizure once it had begun. There was a significant difference between antiepileptic effects of VNS before or after the onset of seizures ( F = 27. 320, P ＜ 0. 01).CONCLUSION: The effects of stimulating the vagus nerve depend on the output time of VNS; the most effective method for preventing epilepsy is to stimulate vagus nerve before the onset of seizures . The method may provide an experimental basis for preventing the onset of seizure.