CAJ | 학술논문

背景:迷走神经刺激参数直接关系到迷走神经刺激的抗痫效果及患者使用的安全性,选择适宜的迷走神经刺激参数组合是实现迷走神经刺激抗痫作用的关键因素.目的:观察电刺激参数包括输出电流、波宽、频率、开启时间、关闭时间、何时启动等在迷走神经刺激控制癫痫中的作用.设计:单一样本实验.单位:首都医科大学基础医学院神经生物学系.材料:实验于2000-09/2002-09在首都医科大学基础医学院神经生物学系电生理实验室完成.选择健康成年Wistar大鼠36只.方法:36只大鼠经海人藻酸复制大鼠癫痫模型,通过采用不同的迷走神经刺激参数组合,以大鼠行为学、心电图、皮层电图、海马神经元放电活动为观测指标,观察迷走神经刺激参数在控制致痫大鼠中的作用,并从中筛选适宜的刺激参数组合.主要观察指标:①海人藻酸致痫效应.②迷走神经刺激参数组合及其抗痫效应.结果:36只大鼠均进入结果分析.①迷走神经刺激的抗痫效应的观察主要在痫性发作4 h以内.②当波宽为2 ms,刺激强度为3～3.5 mA,频率为30～35 Hz,开启1 min,关闭2 min时,连续刺激迷走神经50 min时,抗痫效果显著,痫性皮层电图的发作时间明显缩短,严重程度显著降低;致痫大鼠海马CA1区神经元暴发性放电频率降低(P＜0.05).结论:在保证受试者心电活动正常的前提下,能有效控制痫性发作的最小刺激参数组合为最适参数组合,且对心脏功能没有影响.
배경:미주신경자격삼수직접관계도미주신경자격적항간효과급환자사용적안전성,선택괄의적미주신경자격삼수조합시실현미주신경자격항간작용적관건인소.목적:관찰전자격삼수포괄수출전류、파관、빈솔、개계시간、관폐시간、하시계동등재미주신경자격공제전간중적작용.설계:단일양본실험.단위:수도의과대학기출의학원신경생물학계.재료:실험우2000-09/2002-09재수도의과대학기출의학원신경생물학계전생리실험실완성.선택건강성년Wistar대서36지.방법:36지대서경해인조산복제대서전간모형,통과채용불동적미주신경자격삼수조합,이대서행위학、심전도、피층전도、해마신경원방전활동위관측지표,관찰미주신경자격삼수재공제치간대서중적작용,병종중사선괄의적자격삼수조합.주요관찰지표:①해인조산치간효응.②미주신경자격삼수조합급기항간효응.결과:36지대서균진입결과분석.①미주신경자격적항간효응적관찰주요재간성발작4 h이내.②당파관위2 ms,자격강도위3～3.5 mA,빈솔위30～35 Hz,개계1 min,관폐2 min시,련속자격미주신경50 min시,항간효과현저,간성피층전도적발작시간명현축단,엄중정도현저강저;치간대서해마CA1구신경원폭발성방전빈솔강저(P＜0.05).결론:재보증수시자심전활동정상적전제하,능유효공제간성발작적최소자격삼수조합위최괄삼수조합,차대심장공능몰유영향.
BACKGROUND:The stimulation parameters concern directly the antiepileptic effect and safety of vagus nerve stimulation in epileptic patients, and the optimal setting of these parameters is crucial to ensure safe and effective application for antiepileptic treatment.OBJECTIVE: To observe the effect of such parameters as output current,wave width, frequency, on/off time of intermittent stimulation in electric vagus nerve stimulation for antiepileptic therapy.DESIGN: Single-sample experiment.SETTING: Department of Neurobiology, School of Basic Medical Sciences, Capital University of Medical Sciences.MATERIALS: The experiment was carried out at Electrophysiological Laboratory of Department of Neurobiology, School of Basic Medical Sciences, Capital University of Medical Sciences between September 2000and September 2002, using totally 36 healthy adult Wistar rats.METHODS: Epileptic models were established in 36 healthy adult Wistar rats by cervical subcutaneous kainic acid injection, in which various settings of vagus nerve stimulation parameters were applied and their antiepileptic effects observed in terms of changes in the behaviors, electrocardiogram (ECG), electrocorticogram (ECoG), and hippocampal neuronal discharge to identify the optimal parameter setting.rameters.nerve stimulation produced antiepileptic effect mainly within 4 hours of with wave width of 2 ms, current intensity of 3-3.5 mA, frequency of 30-35 Hz, 1-minute on/2-minute off intermittent stimulation produced remarkable antiepileptic effect presented by obviously reduced seizure duration in ECoG and epileptic severity, with lowered frequency of bursting discharge in the epileptic rat CA1 neurons (P ＜ 0.05).CONCLUSION: With normal cardiac electric activity ensured, the minimum stimulation parameters sufficient for effective epilepsy control can be considered as the optimal parameter setting in electric vagus nerve stimulation, which has no adverse effect on the heart.