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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(vagusnervestimulation,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(kainicacid,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50min,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?
Background: Long-term recurrent seizures can affect memory function as well as many unexpected complications. How to control and prevent their attacks is the focus of clinical and rehabilitation medicine. OBJECTIVE: To investigate the optimal activation time of vagus nerve stimulation (VNS) for the treatment of epilepsy by using rat epilepsy model. Design: Randomized controlled experimental study. Venue and Subject: Experimental Location: Department of Neurobiology, Capital Medical University. Subjects: 34 Wistar rats, level 2, provided by Experimental Animal Center, Capital Medical University. Methods: The rat epilepsy model was induced by kainic acid (KA). The electrocorticogram (ECoG) and behavioral findings were used to observe the left vagal nerve in rats before and after seizure. The vagal nerve stimulation Different start-up time on the duration of epileptic seizures to determine the best timing of vagus nerve stimulation output. MAIN OUTCOME MEASURES: ① Kainic acid-induced epilepsy latency and duration. ② VNS start-up time on the control of seizures. Results: Intermittent stimulation of the vagus nerve for 50 minutes before seizure significantly reduced the severity of seizures, shortened the duration of seizures and even completely suppressed seizures. However, once the seizure occurs again, the combined stimulus can only reduce the severity of the seizure, shorten the duration of the seizure, and can not completely suppress the seizure. There was a significant difference between the anti-epileptic effects of vagus nerve stimulation before and after the attack (F = 27.320, P <0.01). CONCLUSION: VNS can be used to increase the antiepileptic effect of VNS before the seizure. The appropriate combination of stimulus parameters is the control of seizures.