Contribution of glial cells to the neuroprotective effects triggered by repetitive magnetic stimulation:a systematic review

Repetitive transcranial magnetic stimulation has been increasingly studied in different neurological diseases,and although most studies focus on its effects on neuronal cells,the contribution of nonneuronal cells to the improvement trigge red by repetitive transcranial magnetic stimulation in these diseases has been increasingly suggested.To systematically review the effects of repetitive magnetic stimulation on non-neuronal cells two online databases.Web of Science and PubMed were searched fo r the effects of high-frequency-repetitive transcranial magnetic stimulation,low-frequencyrepetitive transcranial magnetic stimulation,intermittent theta-bu rst stimulation,continuous thetaburst stimulation,or repetitive magnetic stimulation on non-neuronal cells in models of disease and in unlesioned animals or cells.A total of 52 studies were included.The protocol more frequently used was high-frequency-repetitive magnetic stimulation,and in models of disease,most studies report that high-frequency-repetitive magnetic stimulation led to a decrease in astrocyte and mic roglial reactivity,a decrease in the release of pro-inflammatory cyto kines,and an increase of oligodendrocyte proliferation.The trend towards decreased microglial and astrocyte reactivity as well as increased oligodendrocyte proliferation occurred with intermittent theta-burst stimulation and continuous theta-burst stimulation.Few papers analyzed the low-frequency-repetitive transcranial magnetic stimulation protocol,and the parameters evaluated were restricted to the study of astrocyte reactivity and release of pro-inflammatory cytokines,repo rting the absence of effects on these paramete rs.In what concerns the use of magnetic stimulation in unlesioned animals or cells,most articles on all four types of stimulation reported a lack of effects.It is also important to point out that the studies were developed mostly in male rodents,not evaluating possible diffe rential effects of repetitive transcranial magnetic stimulation between sexes.This systematic review supports that thro ugh modulation of glial cells repetitive magnetic stimulation contributes to the neuroprotection or repair in various neurological disease models.Howeve r,it should be noted that there are still few articles focusing on the impact of repetitive magnetic stimulation on non-neuronal cells and most studies did not perform in-depth analyses of the effects,emphasizing the need for more studies in this field.

Effect of Acupuncture Cooperated with Low-frequency Repetitive Transcranial Magnetic Stimulation on Chronic Insomnia： A Randomized Clinical Trial

The effect of acupuncture cooperated with low-frequency repetitive transcranial magnetic stimulation （rTMS） on chronic insomnia was explored. Seventy-eight patients with chronic insomnia were randomly allocated into two groups： treatment group and control group. In the treatment group, the patients received acupuncture combined with rTMS treatment, and those in the control group were given acupuncture cooperated with sham rTMS treatment, 3 days per week for 4 weeks. Before and after treatment, the primary outcomes including the scores on Insomnia Severity Index （ISI） and Pittsburgh Sleep Quality Index （PSQI） and the secondary outcomes including total sleep time （TST）, sleep onset latency （SOL）, wake after sleep onset （WASO）, sleep efficiency （SE%） recorded by sleeping diary and actigraphy were observed in both groups. Seventy-five participants finished the study （38 in treatment group and 37 in control group respectively）. After treatment, the scores in the two groups were improved significantly, more significantly in the treatment group than in the control group. It can be inferred that acupuncture cooperated with rTMS can effectively improve sleep quality, enhance the quality of life of patients and has less side effects.

Changes in plasma calcitonin gene-related peptide and serum neuron specific enolase in rats with acute cerebral ischemia after low-frequency electrical stimulation with different waveforms and intensities

Following acute cerebral ischemia in rats, plasma calcitonin gene-related peptide decreased and the level of serum neuron specific enolase and the volume of the infarction increased. Square-wave and triangular-wave electrical stimulation with low or high intensities could increase the plasma calcitonin gene-related peptide, decrease the serum neuron specific enolase and reduce the infarction volume in the brain in rats with cerebral ischemia. There was no significant difference between different wave forms and intensities. The experimental findings indicate that low-frequency electrical stimulation with varying waveforms and intensities can treat acute cerebral ischemia in rats.

Effect of low-frequency pulse percutaneous electric stimulation on peripheral nerve injuries at different sites

BACKGROUND： The postoperative recovery of nerve function in patients with peripheral nerve injury is always an important problem to solve after treatment. The electric stimulation induced electromagnetic field can nourish nerve, postpone muscular atrophy, and help the postoperative neuromuscular function. OBJECTIVE： To observe the effects of low-frequency pulse percutaneous electric stimulation on the functional recovery of postoperative patients with peripheral nerve injury, and quantitatively evaluate the results of electromyogram （EMG） examination before and after treatment. DESIGN ： A retrospective case analysis SETTING： The Sixth People＇s Hospital affiliated to Shanghai Jiaotong University PARTICIPANTS： Nineteen postoperative inpatients with peripheral nerve injury were selected from the De- partment of Orthopaedics, the Sixth People＇s Hospital affiliated to Shanghai Jiaotong University from June 2005 to January 2006, including 13 males and 6 females aged 24-62 years with an average of 36 years old. There were 3 cases of brachial plexus nerve injury, 3 of median nerve injury, 7 of radial nerve injury, 3 of ul- nar nerve injury and 3 of common peroneal nerve injury, and all the patients received probing nerve fiber restoration. Their main preoperative manifestations were dennervation, pain in limbs, motor and sensory disturbances. All the 19 patients were informed with the therapeutic program and items for evaluation. METHODS： ① Low-frequency pulse percutaneous electric stimulation apparatus： The patients were given electric stimulation with the TERESA cantata instrument （TERESA-0, Shanghai Teresa Health Technology, Co., Ltd.）. The patients were stimulated with symmetric square waves of 1-111 Hz, and the intensity was 1.2-5.0 mA, and it was gradually adjusted according to the recovered conditions of neural regeneration following the principle that the intensity was strong enough and the patients felt no obvious upset. They were treated for 4- 24 weeks, 10-30 minutes for each time, 1-3 times a day, and 6 weeks as a course. ② EMG examination was applied to evaluate the recoveries of recruitment, motor conduction velocity （MCV） and sensory conduction velocity （SCV） before and after treatment. The patients were examined with the EMG apparatus （DIS- A2000C, Danmark） before and after the treatment of percutaneous electric stimulation. ③Standards for evaluating the effects included cured （complete recovery of motor functions, muscle strength of grade 5, no abnormality in EMG examination）, obviously effective [general recovery of motor function, muscle strength of grade 4, no or a few denervation potentials, motor conduction velocity （MCV） and sensory conduction velocity （SCV）], improved （partial recovery of motor function, muscle strength of grade 3, denervation potentials and reinneration potentials, slowed MCV and SCV, invalid （no obvious changes of motor function）. MAIN OUTCOME MEASURES： ① Ameliorated degree of the nerve function of the postoperative patients with peripheral nerve injury treated with percutaneous electric stimulation; ② Changes of EMG examination before and after treatment. RESULTS： All the 19 postoperative patients with peripheral nerve injury were involved in the analysis of results. ① Comparison of nerve function before and after treatment in 19 patients with peripheral nerve injury of different sites： For the patients with radial nerve injury （n=7）, the nerve functions all completely recovered after 8-week treatment, and the cured and obvious rate was 100% （7/7）; For the patients with brachial plexus nerve injury （n=3）, 1 case had no obvious improvement, and the cured and obvious rate was 67% （2/3）; For the patients with common peroneal nerve injury （n=3）, the extension of foot dorsum generally recovered in 1 case of nerve contusion after 4-week treatment, and the cured and obvious rate was 67% （2/3）; For the patients with median nerve injury （n=3）, muscle strength was obviously recovered, and the cured and obvious rate was 100% （3/3）; For the patients with ulnar nerve injury （n=3）, 1 case only had recovery of partial senses, and the cured and obvious rate was 67% （2/3）. Totally 9 cases were cured, 7 were obviously effective, 1 was improved, and only 2 were invalid. After 4 courses, the cured rate of damaged nerve function after four courses was 47% （9/19）, and effective rate was 89% （17/19）.② Comparison of EMG examination before and after treatment： Before and after percutaneous electric stimulation, he effective rates of recruitment, MCV and SCV were 89% （17/19）, 58% （11/19）, 47% （9/19） respectively, and there were extremely obvious differences （P〈 0.01）. CONCLUSION： ①Low-frequency pulse percutaneous electric stimulation can improve the nerve function of postoperative patients with peripheral nerve injury of different sites, especially that the injuries of radial nerve and median nerve recover more obviously. ②Percutaneous electric stimulation can ameliorate the indexes of EMG examination, especially the recruitment, in postoperative patients with peripheral nerve injury.

ANALYSIS OF PARAMETERS OF ELECTRIC STIMULATION OF ELECTROACUPUNCTURE THERAPY TO PATIENTS WITH BI-SYNDROME, TAN-SYNDROME AND WEI-SYNDROME

In this paper the therapeutic results of PCE - 88A programme-controlled elec-troacupuncture machine in 191 patients of Bi-Syndrome (BS), Tan-Syndrome (TS) and Wei-Syn-drome(WS)are reported. The total effective rate was 98. 4 %. The study on the frequency and inten-sity of stimulation showed that the stimulation of an electric current with 5- 20 Hz was comfortable tothe patients. The intensity of stimulation should be varied according to the nature of the disease andthe location of stimulation to the body. The stimulation for WS should be much higher than that forother two diseases; higher for head than for limbs; and higher for the diseased side than for the nor-mal side. The intensity of stimulation to the diseased side should be gradually reduced following theamelioration of the disease.

Effects of cervical low-frequency electrical stimulation with various waveforms and densities on body mass,liver and kidney function,and death rate in ischemic stroke rats

Low-frequency electrical stimulation has resulted in favorable effects in the treatment of post-stroke dysphagia. However, the safety of cervical low-frequency electrical stimulation remains unclear because of numerous nerves and blood vessels in the neck. In the present study, rats with ischemic stroke underwent low-frequency electrical stimulation, and systemic and local effects of electrical stimulation at different densities and waveforms were investigated. Electrical stimulation resulted in no significant effects on body mass, liver or kidney function, or mortality rate. In addition, no significant adverse reaction was observed, despite overly high intensity of low-frequency electrical stimulation, which induced laryngismus, results from the present study suggested that it is safe to stimulate the neck with a low-frequency electricity under certain intensities.

Effect of Unilateral Low-Frequency Stimulation of Hippocampus on Rapid Kindling—Induced Seizure Development in Rats

Since the last decade deep brain stimulation has been proposed as an alternative treatment for patients who do not become seizure-free with the current pharmacological treatments and cannot undergo resective surgical procedure. However, the optimal stimulation parameters remain undetermined and active research in humans and animals is necessary. The present study was designed to investigate the effect of unilateral Low Frequency Stimulation (LFS) of hippocampus on seizure development by using the hippocampal rapid kindling method (hRK) in rats. We used male Wistar rats implanted with electrodes in the ventral hippocampus. All rats underwent hRK (biphasic square wave pulses, 20 Hz for 10 seconds) during three consecutive days (twelve stimulations per day). The control group (hRK;n = 6) received only RK stimulus, while the treated group (LFS-hRK;n = 8) received also LFS (biphasic square wave pulses, 1 Hz for 30 seconds) immediately before the RK stimulus, during three consecutive days. At the end of behavioral testing on day 3, 62% (P < 0.05) of the animals receiving LFS treatment were still not fully kindled staying in stages 0-III (P < 0.01). The number of stimulations needed to achieve generalized seizures (stage IV-V of Racine scale) was significantly higher (P < 0.05) in the LFS group with respect to control group. No significant differences in the cumulative daily afterdischarge duration were observed between both groups. These findings suggest that preemptive LFS can significantly decrease the incidence of hippocampus-kindled seizures and delay the progression and secondary generalization of focal seizures.

Effects of Electroacupuncture Combined with Repetitive Transcranial Magnetic Stimulation on the Expression of Nestin in Neural Stem Cell after Focal Cerebral Ischemia in Adult Rats

Objective:To investigate the influence of electroacupuncture(EA) combined with repetitive transcranial magnetic stimulation(rTMS) on the temporal profile of nestin expression after induction of focal cerebral ischemia in adult rats and to explore the mechanism of EA combined with rTMS in treating ischemic brain injury.Method:The model of transient focal ischemia was produced by occlusion of middle cerebral artery.Seventy-five Wistar rats were randomly divided into normal group,model group,EA group,rTMS group and EA +rTMS group.The neurologic impairment rating and ability of learning and memory were observed at the 7th、14th and 28th d after infarction respectively.Meanwhile,Western blotting was used to observe the number of nestin expression positive cells.Result:Nestin-positive cells were found in cortex,subgranular zone(SGZ),subventricular zone(SVZ) of the ipsilateral side at different time points after cerebral ischemia.The number of nestin-positive cells peaked at the 7th d,began to decrease at the 14th d and was significantly higher in EA+rTMS group than that in model group(P< 0.05),then almost reached normal at the 28th d.The improvement of neural motor function deficits as well as the indexes of learning and memory were more obvious in EA+rTMS group compared with model group(P<0.01,P<0.05).These effects were most obvious in EA +rTMS group compared with the EA and rTMS group(P<0.05).Conclusion:EA and rTMS possess the potency of building up and can increase the number of nestin-positive cells in some brain regions after focal cerebral ischemia,which might be one of the important mechanisms of EA combined with rTMS in treating ischemia brain injury.

Effects of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper limb motor dysfunction in patients with subacute cerebral infarction

Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.

Molecular mechanisms and roles of inflammatory responses on low-frequency residual hearing after cochlear implantation

Preservation of low-frequency residual hearing is very important for combined electro-acoustic stimulation after cochlear implantation.However,in clinical practice,loss of low-frequency residual hearing often occurs after cochlear implantation and its mechanisms remain unclear.Factors affecting lowfrequency residual hearing after cochlear implantation are one of the hot spots in current research.Inflammation induced by injury associated with cochlear implantation is deemed to be significant,as it may give rise to low-frequency residual hearing loss by interfering with the blood labyrinth barrier and neural synapses.Pathological changes along the pathway for low-frequency auditory signals transmission may include latent factors such as damage to neuroepithelial structures,synapses,stria vascularis and other ultrastructures.In this review,current research on mechanisms of low-frequency residual hearing loss after cochlear implantation and possible roles of inflammatory responses are summarized.

Hippocampal High-Frequency Stimulation Inhibites the Progression of Rapid Kindling-Induced Seizure in Rats

Epilepsy is one of the most common serious neurological disorders. Pharmacoresistant epilepsy patients are poorly controlled or their seizures are refractory to drug treatment. Resective surgery is frequently a promising therapy in this population, however, not all the patients meet the eligibility criteria for the surgical treatment. Deep brain stimulation has been investigated in clinical studies and animal studies as an alternative treatment, but the optimal stimulation parameters remain an issue. The present study was designed to investigate the effect of unilateral high-frequency stimulation (HFS) of hippocampus on seizure development by using the hippocampal rapid kindling method (hRK) in rats, and compared the results with those of low-frequency stimulation previously published by our group. We used male Wistar rats implanted with electrodes in the ventral hippocampus. All rats underwent hRK (biphasic square wave pulses, 20 Hz for 10 seconds) during three consecutive days (twelve stimulations per day). The control group (hRK;n = 7) received only RK stimulus, while the treated group (HFS-hRK;n = 9) received also HFS (biphasic square wave pulses, 130 Hz for 30 seconds) immediately before the RK stimulus, during three consecutive days. At the end of behavioral testing 78% (p 0.01) of the animals receiving HFS treatment were still not fully kindled staying in stages 0 -III (p 0.01). HFS group needed a higher number of stimulations to achieve stage III (p 0.05) with respect to control group. However, no significant differences in the cumulative daily afterdischarge duration were observed. HFS did not present significant differences compared with LFS in any of studied parameters. The findings suggest that unilateral HFS applied on hippocampus effectively inhibited the epileptogenic process induced by hippocampal rapid kindling. According to the comparative results about hippocampal rapid kindled animals stimulated with HFS and LFS (5 Hz), we found no conclusive information on which treatment is most efficient.

Regulation of"P35/P25-CDK5-Tau"signaling pathway in hippocampi and prefrontal cortex of AD rats by electroacupuncture

Fifty SD rats were randomly divided into control,sham,model and electroacupuncture treatment group in this study.AD model rats were established by injecting ABas.ss into the hippocampi,while the same amount of saline was injected into the sham rats.AD model rats were treated by electroacupuncture stimulation at"Baihui"and"Shenshu"acupoints once a day for 10 days.The behavioral experiments results showed that the learning and memory ability of the AD rats were significantly decreased compared with the controls and shams,while depression-related behaviors were significantly increased.

电针结合经颅交流电刺激对脑缺血大鼠神经炎症和凋亡相关基因表达的影响

目的:观察电针(electroacupuncture,EA)结合经颅交流电刺激(transcranial alternating current stimulation,tACS)对大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)模型大鼠神经功能、脑血流、炎症-细胞凋亡基因表达的影响,探讨脑缺血再灌注后脑功能康复的神经调控机制。方法:将40只SD大鼠随机分为假手术组(S组)、模型组(M组)、电针组(EA组)、经颅交流电刺激组(T组)及电针结合经颅交流电组(EA+T组),每组8只。缺血再灌注后2h,EA组选取双侧曲池、足三里进行电针干预;T组选取右侧M1区(motor cortex M1,运动皮质M1区)进行tACS干预;EA+T组选取电针结合tACS干预;S组与M组均进行气麻30min/次,连续7天。记录大鼠造模前(B)—造模后7天(D7)的神经缺损评分;B—D7右侧大脑中动脉供血区的血流值,记录血流量;D7时取脑RT-PCR方法检测缺血侧的炎症-细胞凋亡基因的表达。结果:神经缺损评分(neurological deficit scores,NDS):2h、D1时,M组、EA组、T组、EA+T组与S组相比显著增加(P<0.05);D3、D5、D7时,S组与其他各组相比显著降低、M组与其他各组相比显著增加(P<0.05)。EA组、T组、EA+T组各时间均有显著性差异(P<0.05);M组2h、D1、D3、D5、D7与B相比显著上升;D1、D3、D5、D7与2h相比显著下降(P<0.05)。血流量:EA+T组与S组均在2h时下降、D1时上升、D3时下降;EA组则从D3时上升;而M组在D1、D3、D5时与其他各相比均显著下降(P<0.05)。RT-PCR:运动皮质ΔCt法分析(参照基因):EA+T组的天冬氨酸蛋白水解酶12(cysteinyl aspartate specific proteinase12,Caspase 12)表达显著低于T组(P<0.05);EA组、EA+T组的细胞因子白介素-1β(interleukin-1β,IL-1β)、核苷酸结合寡聚化结构域样受体1(nucleotide-binding oligomerization domain-like receptor pyrin domain containing 1,NLRP1a)均显著低于S组(P<0.05)。缺血区2-ΔΔCt分析:M组的内质网应激相关蛋白激活转录因子4(activating transcription factor 4,ATF4)表达显著高于其他各组(P<0.05);M组的B淋巴细胞瘤-2基因(B-cell lymphoma,l-2)显著高于S组、EA组、EA+T组(P<0.01);M组的Bcl-2相关X蛋白(Bcl-2 associated X potein,Bax)、Caspase 12、细胞癌基因fos(cellular oncogene fos,fos)均显著高于S组(P<0.05)。结论:电针结合tACS对缺血性脑卒中的干预可能通过调控ATF4、Bcl-2、Bax、Caspase 12、C-fos的表达发挥调节作用,联合应用在减轻炎症反应、抑制细胞凋亡方面,可能优于单独电针或tACS干预,可为缺血性脑卒中的治疗提供新的策略。

电针联合低频经颅超声刺激对创伤性脑损伤大鼠脑电信号的影响

背景:创伤性脑损伤是由头部受到撞击、打击而导致大脑正常功能被破坏的疾病,目前需要寻找有效治疗方式和客观指标,帮助医生判别损伤状况及恢复患者脑功能。目的:探究电针联合低频经颅超声刺激对创伤性脑损伤大鼠脑电信号的影响。方法:将40只6周龄SPF级雄性SD大鼠随机分为假手术组、模型组、电针组、低频经颅超声刺激组和联合组(n=8),后4组采用Feeney自由落体法造模,假手术组只开骨窗而不打击。各干预组均于造模后1 d开始实施干预,电针组进行电针干预,低频经颅超声刺激组进行低频经颅超声刺激干预,联合组进行两者联合干预,共干预7 d。造模后8 h,用改良神经功能缺损评分评定大鼠神经功能缺损情况;干预7 d后观察大鼠Y迷宫自发轮流行为百分比,而后采集脑电信号,利用快速傅里叶变换分解出α、β、θ和δ波段,计算各频段振荡幅值、能量占比百分比以及Lempel-Ziv复杂度、样本熵。结果与结论:①造模后8 h,模型组、电针组、低频经颅超声刺激组和联合组的改良神经功能缺损评分显著高于假手术组(P<0.05);②造模后第7天,模型组的α波、δ波频带振荡幅值、δ波能量占比百分比显著高于假手术组(P<0.05),自发轮流行为百分比、α波、β波能量占比百分比、Lempel-Ziv复杂度、样本熵显著低于假手术组(P<0.05);③与模型组比较,联合组的α波、δ波频带振荡幅值显著下降(P<0.05),电针组、低频经颅超声刺激组、联合组的α波、β波频带能量占比百分比显著升高(P<0.05),δ波能量占比百分比显著下降(P<0.05);④与电针组和低频经颅超声刺激组相比,联合组的δ波能量占比百分比显著降低(P<0.05),自发轮流行为百分比、α波、β波能量占比百分比、Lempel-Zi复杂度、样本熵显著升高(P<0.05);⑤结果显示,创伤性脑损伤大鼠出现脑电信号异常,而电针联合低频经颅超声刺激干预后可以改善大鼠脑电信号的异常情况,提示脑电频域特征和非线性特征可用来评估创伤性脑损伤情况。

不同治疗顺序的电针联合重复经颅磁刺激治疗偏头痛的临床疗效研究

目的:比较不同治疗顺序的电针联合重复经颅磁刺激(rTMS)治疗偏头痛的疗效。方法:选取2022年8月~2023年9月于宜宾市第二人民医院康复医学科就诊的偏头痛患者96例为研究对象,采用随机数字表法分为先电后磁组、先磁后电组、电磁同步组3组,每组各32例。3组分别脱落2例、3例、1例,最终分别为30例、29例、31例。3组均接受常规治疗(药物治疗及卫生宣教),在此基础上,先电后磁组先进行电针治疗,间隔10min后进行rTMS治疗;先磁后电组先进行rTMS治疗,间隔10min后进行电针治疗;电磁同步组同步进行rTMS和电针治疗。电针和rTMS均为20min/次,1次/日,5次/周,3组均治疗4周。在治疗前、治疗1周、2周、4周后采用视觉模拟评分法(VAS)评估3组患者的疼痛程度。在治疗前和治疗4周后采用偏头痛特异性生活质量表(MSQ)评估生活质量,同时检测血中P物质(SP)、5-羟色胺(5-HT)水平;并采用经颅多普勒超声检测仪检测3组患者双侧大脑前动脉、大脑后动脉、大脑中动脉的平均血流速度。结果:治疗方法与时间对VAS评分存在交互作用(P<0.05),且电磁同步组在治疗2周、4周后的VAS评分均低于其余2组(均P<0.05);在治疗4周后,电磁同步组SP均低于其余2组(均P<0.05),5-HT均高于其余2组(均P<0.05),MSQ评分低于先磁后电组(P<0.05),与先电后磁组比较差异无统计学意义;治疗4周后,电磁同步组大脑前动脉、大脑后动脉、大脑中动脉的血流速度低于其余2组(均P<0.05)。结论:不同治疗顺序的电针联合rTMS治疗偏头痛疗效具有差异,同步治疗的效果可能优于先电后磁方案和先磁后电方案。

电刺激治疗脊髓损伤后神经源性膀胱的研究新进展

神经源性膀胱(neurogenic bladder,NB)是指由于神经系统病变引发的下尿路功能障碍(lower urinary tract dysfunction,LUTD),患者表现为一系列下尿路症状(lower urinary tract syndrome,LUTS),NB也是脊髓损伤(spinal cord injury,SCI)后常见的严重并发症,给患者生活质量和康复进程带来显著影响,甚至可导致患者死亡。因此,SCI后NB的研究也是重点与难点。当前,对于SCI后NB的治疗并没有明确有效的治疗方法,寻找安全有效的治疗方法迫在眉睫。SCI后由于神经反射通路受损,导致NB的发生,而长期反复的足疗程电刺激,可以重塑神经环路,这一观点与SCI后NB的发生机制不谋而合。电刺激治疗疾病作为一种非侵入性治疗手段,近年来显现出一定的治疗优势,是一种极具前景的治疗途径。学习近年来相关电刺激文献后对不同类型电刺激治疗SCI后NB的机制、电刺激部位、治疗效果以及安全性进行综述,以期为电刺激治疗SCI后NB提供参考。

电针上肢穴位对运动皮层躯干脑区皮质脊髓兴奋性的影响

目的观察电针上肢穴位对健康受试者初级运动皮层(primary motor cortex,M1)躯干脑区皮质脊髓兴奋性的影响。方法纳入15名健康受试者,采用交叉设计。试验一观察电针上肢穴位对竖脊肌(erector spinae,ES)皮质脊髓兴奋性的影响,受试者随机先后进入3组试验,A组电针合谷穴,B组电针孔最穴,C组假针合谷穴。运用经颅磁刺激,检测干预前后对侧M1第一骨间背侧肌、桡侧腕屈肌及ES的运动诱发电位(motor evoked potentials,MEPs)的波幅和潜伏期,ES的MEPs波幅升高者进入试验二。试验二为抑制背侧前运动皮层(premotor cortex,PMd)后电针上肢穴位对ES的皮质脊髓兴奋性的作用研究,受试者随机先后进入两组试验,D组采用抑制PMd配合电针合谷穴干预,E组采用抑制PMd配合电针孔最穴干预。观察并比较两组对侧M1上肢脑区和躯干脑区MEPs的波幅和潜伏期。结果A组和B组干预后上肢脑区及躯干脑区MEPs总波幅均较同组干预前显著增加(P<0.001,P<0.01)。A组干预后上肢脑区及躯干脑区MEPs总波幅均明显高于C组,B组干预后仅躯干脑区MEPs总波幅明显高于C组,差异均具有统计学意义(P<0.001)。D组干预后上肢脑区最佳刺激点MEPs平均波幅及总波幅较同组干预前均显著增加(P<0.05)。D组和E组干预前后躯干脑区最佳刺激点的MEPs平均波幅及总波幅比较,差异也均无统计学意义(P>0.05)。结论生理状况下,电针合谷、孔最穴均可增强ES的皮质脊髓兴奋性,二者之间无明显差异,PMd可能参与其过程。

电针联合重复经颅磁刺激治疗缺血性脑卒中后轻度认知障碍临床研究

目的:观察电针联合重复经颅磁刺激治疗缺血性脑卒中后轻度认知障碍的临床疗效。方法:将106例缺血性脑卒中后轻度认知障碍患者按随机数字表法分为对照组和观察组各53例。对照组在常规治疗基础上给予重复经颅磁刺激治疗,观察组在对照组基础上给予电针治疗。比较两组患者治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分、蒙特利尔认知评估量表(MoCA)评分和脑卒中专门化生存质量量表(SS-QOL)评分,并检测两组患者治疗前后与病情相关的血清学指标[包括血管内皮生长因子(VEGF)、可溶性血管内皮生长因子受体1(sFlt-1)、脑源性神经生长因子(BDNF)、肿瘤坏死因子-α(TNF-α)、泛酸羧基末端水解酶1(UCH-L1)、神经元特异性烯醇化酶(NSE)、神经元PAS结构域蛋白4(NPAS4)、丙二醛(MDA)、超氧化物歧化酶(SOD)]和脑氧代谢指标[包括动脉-静脉血氧含量差(Ca-vO2)、动脉血氧含量(CaO2)、脑氧摄取率(CERO2)]水平,评价两组临床疗效。结果:治疗后,两组NIHSS评分均较治疗前降低(P<0.05),MoCA、SS-QOL评分均较治疗前提高(P<0.05);观察组MoCA评分、SS-QOL评分高于对照组(P<0.05),NIHSS评分低于对照组(P<0.05)。治疗后,两组SOD、VEGF、BDNF水平均较治疗前升高(P<0.05),UCH-L1、TNF-α、MDA、sFlt-1、CaO2、Ca-vO2、CERO2、NSE、NPAS4水平均较治疗前降低(P<0.05);观察组SOD、VEGF、BDNF水平高于对照组(P<0.05),UCH-L1、TNF-α、MDA、sFlt-1、CaO2、Ca-vO2、CERO2、NSE、NPAS4水平低于对照组(P<0.05)。观察组总有效率明显高于对照组(P<0.05)。结论:电针联合重复经颅磁刺激治疗缺血性脑卒中后轻度认知障碍疗效确切,可减少氧化应激损伤及炎症反应,促进血管再生,改善脑氧代谢,修复神经及认知功能损伤,提高患者生活质量及疗效。

Electroacupuncture alleviates postoperative pain through inhibiting neuroinflammation via stimulator of interferon genes/type-1 interferon pathway

Objective This work explores the impact of electroacupuncture(EA)on acute postoperative pain(APP)and the role of stimulator of interferon genes/type-1 interferon(STING/IFN-1)signaling pathway modulation in the analgesic effect of EA in APP rats.Methods The APP rat model was initiated through abdominal surgery and the animals received two 30 min sessions of EA at bilateral ST36(Zusanli)and SP6(Sanyinjiao)acupoints.Mechanical,thermal and cold sensitivity tests were performed to measure the pain threshold,and electroencephalograms were recorded in the primary somatosensory cortex to identify the effects of EA treatment on APP.Western blotting and immunofluorescence were used to examine the expression and distribution of proteins in the STING/IFN-1 pathway as well as neuroinflammation.A STING inhibitor(C-176)was administered intrathecally to verify its role in EA.Results APP rats displayed mechanical and thermal hypersensitivities compared to the control group(P<0.05).APP significantly reduced the amplitude ofθ,αandγoscillations compared to their baseline values(P<0.05).Interestingly,expression levels of proteins in the STING/IFN-1 pathway were downregulated after inducing APP(P<0.05).Further,APP increased pro-inflammatory factors,including interleukin-6,tumor necrosis factor-αand inducible nitric oxide synthase,and downregulated anti-inflammatory factors,including interleukin-10 and arginase-1(P<0.05).EA effectively attenuated APP-induced painful hypersensitivities(P<0.05)and restored theθ,αandγpower in APP rats(P<0.05).Meanwhile,EA distinctly activated the STING/IFN-1 pathway and mitigated the neuroinflammatory response(P<0.05).Furthermore,STING/IFN-1 was predominantly expressed in isolectin-B4-or calcitonin-gene-related-peptide-labeled dorsal root ganglion neurons and superficial laminae of the spinal dorsal horn.Inhibition of the STING/IFN-1 pathway by intrathecal injection of C-176 weakened the analgesic and anti-inflammatory effects of EA on APP(P<0.05).Conclusion EA can generate robust analgesic and anti-inflammatory effects on APP,and these effects may be linked to activating the STING/IFN-1 pathway,suggesting that STING/IFN-1 may be a target for relieving APP.

耳甲电针对新型冠状病毒感染后睡眠障碍患者大脑皮质兴奋性的调节作用

目的:探讨耳甲电针对新型冠状病毒感染后睡眠障碍患者大脑皮质兴奋性的调节作用。方法:选取2022年6月至2023年6月广东省佛山市第八人民医院金沙分院中医科和康复科门诊失眠患者和健康志愿者各20例作为研究对象,采用匹兹堡睡眠质量指数(PSQI)量表和过度觉醒量表(HAS)来评估受试者的一般情况,同时利用单脉冲经颅磁刺激技术,采集2组受试者经耳甲电针治疗前后的皮层运动诱发电位相关指标,观察耳甲电针对皮层运动诱发电位潜伏期和波幅的调节作用。结果:治疗前观察组与对照组比较,患者的皮层运动诱发电位潜伏期短,波幅大;治疗后,患者的皮层运动诱发电位潜伏期未见显著变化,但波幅有所下降。结论:耳甲电针可以通过激活自主神经系统,调节大脑皮质兴奋性,从而抑制新型冠状病毒感染后睡眠障碍患者大脑皮质过度觉醒状态,可能是耳甲电针治疗失眠的机制之一。