在體光遺傳學(xué)—電生理相結(jié)合研究—側(cè)半球控制雙側(cè)上肢運(yùn)動(dòng)的腦功能重塑機(jī)制
發(fā)布時(shí)間：2018-08-22 14:05
【摘要】：背景：作為中樞神經(jīng)損傷后較為嚴(yán)重的后遺癥之一,上肢痙攣性癱瘓的治療方法及效果均有限。課題組前期研究發(fā)現(xiàn)：通過(guò)改變周圍神經(jīng)通路增強(qiáng)同側(cè)神經(jīng)纖維對(duì)肢體的支配可以實(shí)現(xiàn)偏癱患者的健存大腦半球同時(shí)司管雙側(cè)上肢。但具體涉及到的神經(jīng)通路以及患肢運(yùn)動(dòng)功能恢復(fù)的動(dòng)態(tài)中樞機(jī)制尚不明確。本課題使用Thy1-ChR2-EYFP轉(zhuǎn)基因小鼠建立腦外傷和健側(cè)頸七神經(jīng)根移位至患側(cè)頸七神經(jīng)根的模型,通過(guò)光遺傳學(xué)-電生理相結(jié)合的技術(shù)、行為學(xué)以及逆行跨多突觸的神經(jīng)示蹤技術(shù),研究癱瘓肢體運(yùn)動(dòng)功能恢復(fù)的中樞機(jī)制。該技術(shù)具有皮層定位及刺激精確可控、可重復(fù)性佳以及高效無(wú)創(chuàng)的不可替代優(yōu)勢(shì),研究成果將有助于揭示一側(cè)皮層司管雙側(cè)上肢的動(dòng)態(tài)重塑規(guī)律,為后續(xù)積極干預(yù)腦重塑,促進(jìn)卒中、腦癱、腦外傷后遺癥的上肢功能恢復(fù)研究提供依據(jù)。方法：我們建立了小鼠左側(cè)控制性皮層撞擊腦外傷(CCI)及健側(cè)頸七-患側(cè)頸七神經(jīng)根切斷及移位模型,術(shù)后通過(guò)滾軸實(shí)驗(yàn)和階梯步行實(shí)驗(yàn)檢測(cè)上肢運(yùn)動(dòng)功能的損傷及恢復(fù)情況,在體光遺傳學(xué)-電生理技術(shù)相結(jié)合用于繪制正常小鼠初級(jí)運(yùn)動(dòng)皮層M1、前肢各肌肉代表區(qū)圖譜以及動(dòng)態(tài)記錄術(shù)后不同時(shí)間點(diǎn)健側(cè)皮層刺激后雙側(cè)上肢各靶肌肉代表區(qū)位置及運(yùn)動(dòng)誘發(fā)電位(MEP)參數(shù)的變化。采用偽狂犬病毒PRV-Bartha株dsred自患肢頸七神經(jīng)根注射,連續(xù)冰凍切片及免疫組化觀察其在健側(cè)皮層的神經(jīng)元標(biāo)記情況。結(jié)果：左側(cè)CCI后,小鼠對(duì)側(cè)肢體在滾軸實(shí)驗(yàn)和階梯步行實(shí)驗(yàn)的評(píng)分均出現(xiàn)顯著的降低,對(duì)照組(CCI+雙側(cè)頸七切斷組以及單純CCI組)的評(píng)分在CCI后1月內(nèi)均出現(xiàn)了一定程度的上升,但之后直至術(shù)后10個(gè)月對(duì)照組的患肢行為學(xué)評(píng)分未進(jìn)一步恢復(fù),而實(shí)驗(yàn)組(CCI+健側(cè)頸七-患側(cè)頸七移位組)的患肢在術(shù)后5月時(shí)滾軸實(shí)驗(yàn)的姿態(tài)、頭部姿勢(shì)以及前屈項(xiàng)目行為學(xué)評(píng)分開始好于對(duì)照組,至術(shù)后6個(gè)月時(shí)更為顯著且一直持續(xù)至術(shù)后10月。術(shù)后7月時(shí)患肢在滾軸實(shí)驗(yàn)的提攜項(xiàng)目評(píng)分以及階梯步行實(shí)驗(yàn)評(píng)分開始好于對(duì)照組,至術(shù)后8個(gè)月時(shí)更為顯著且一直持續(xù)至術(shù)后10月。而健側(cè)肢體功能僅在術(shù)后1月內(nèi)評(píng)分下降,術(shù)后1月恢復(fù)至術(shù)前并維持至術(shù)后10月。我們通過(guò)光遺傳學(xué)方法繪制了轉(zhuǎn)基因小鼠M1圖譜,并發(fā)現(xiàn)前肢代表區(qū)由位于偏前方較小面積的代表區(qū)RFA(6±1個(gè)刺激位點(diǎn),主要誘發(fā)出腕及趾活動(dòng))以及偏后方較大面積的代表區(qū)CFA(44±4個(gè)刺激位點(diǎn),主要誘發(fā)出肩肘及部分腕活動(dòng))構(gòu)成。術(shù)后4月以內(nèi),右(健)側(cè)皮層刺激僅能記錄到左(健)側(cè)肢體靶肌肉的MEP；術(shù)后5月時(shí),右(健)側(cè)皮層刺激可以同時(shí)記錄到雙側(cè)肱三頭肌的MEP,且術(shù)后右(患)側(cè)肱三頭肌代表區(qū)逐漸縮小并向左(健)側(cè)肱三頭肌代表區(qū)匯聚；術(shù)后7月時(shí),右(健)側(cè)皮層刺激可以同時(shí)記錄到雙側(cè)前臂伸肌群的MEP,且術(shù)后右(患)側(cè)前臂伸肌群代表區(qū)呈現(xiàn)出逐漸縮小并向左(健)側(cè)前臂伸肌群代表區(qū)匯聚的趨勢(shì),而右(健)側(cè)皮層內(nèi)刺激始終無(wú)法誘發(fā)出右(患)側(cè)肱二頭肌的MEP。右(健)側(cè)皮層刺激誘發(fā)出左(健)側(cè)肢體靶肌肉的代表區(qū)及波幅未見明顯變化。單純CCI組小鼠及CCI+雙側(cè)頸七神經(jīng)根切斷的小鼠的右(健)側(cè)皮層在各時(shí)間點(diǎn)均未發(fā)現(xiàn)被標(biāo)記的神經(jīng)元,而CCI+健側(cè)頸七移位的小鼠在術(shù)后5月,健側(cè)皮層中己能找到少量被標(biāo)記的神經(jīng)元,術(shù)后7月直至10月健側(cè)皮層中被標(biāo)記的神經(jīng)元密度進(jìn)一步增高。結(jié)論：對(duì)于重度CCI小鼠,健側(cè)頸七神經(jīng)根移位術(shù)可以促進(jìn)患肢粗大(伸肘)及部分精細(xì)(伸腕指及協(xié)調(diào))功能的恢復(fù),前者恢復(fù)更為顯著。術(shù)后健側(cè)皮層參與了對(duì)雙側(cè)上肢運(yùn)動(dòng)的支配,患肢代表區(qū)在術(shù)后早期覆蓋了健肢代表區(qū),且前者呈現(xiàn)出向后者逐漸縮小匯聚、精確有序的趨勢(shì)。
[Abstract]:BACKGROUND: As one of the more serious sequelae after central nerve injury, the therapeutic methods and effects of spastic paralysis of the upper extremity are limited. Previous studies have found that hemiplegic patients can survive cerebral hemisphere and manage bilateral upper extremities simultaneously by changing peripheral nerve pathways to enhance the innervation of ipsilateral nerve fibers to the extremities. The specific neural pathways involved and the dynamic central mechanism underlying the recovery of motor function in the affected limbs are still unclear. In this study, we used Thy1-ChR2-EYFP transgenic mice to establish models of brain injury and translocation of contralateral cervical seven nerve roots to the affected cervical seven nerve roots. Neural tracing technique is an irreplaceable technique with precise and controllable cortical location and stimulation, good repeatability and high efficiency. The results of this study will help to reveal the dynamic remodeling regularity of bilateral upper limbs of unilateral cortical canal, and actively intervene in brain remodeling and promote the follow-up. Methods: The models of CCI and CCI were established in mice with stroke, cerebral palsy and sequelae of traumatic brain injury. The combination of somatogenetics and electrophysiology was used to map the primary motor cortex M1, the representative areas of forelimb muscles, and to dynamically record the position of target muscles and the changes of motor evoked potential (MEP) parameters in bilateral upper limbs after stimulation of contralateral cortex at different time points. Results: After CCI, the scores of contralateral limbs in rolling test and stepped walking test were significantly lower than those in control group (CCI + bilateral cervical 7 amputation group and CCI group) within 1 month after CCI. However, the behavioral scores of the affected limbs in the control group did not recover further until 10 months after operation. The posture, head posture and bending item behavioral scores of the affected limbs in the experimental group (CCI + CCI + CCI + CCI + CCI) were better than those in the control group at 5 months after operation. 7 months after operation, the scores of lifting items and step walking test of the affected limbs were better than those of the control group, and were more significant at 8 months after operation and lasted until 10 months after operation. We mapped the M1 map of transgenic mice by photogenetics. We found that the forelimb representative region was composed of RFA (6 + 1 stimulus loci, mainly inducing wrist and toe activity) located in a small area in the front and CFA (44 + 4 stimulus loci, mainly inducing shoulder, elbow and part of wrist) in a large area in the rear. Within 4 months after surgery, the right (healthy) cortical stimulation could only record the MEP of the target muscle of the left (healthy) limb; 5 months after surgery, the right (healthy) cortical stimulation could simultaneously record the MEP of the bilateral triceps brachii, and the representative area of the right (affected) triceps brachii decreased gradually and converged to the left (healthy) triceps brachii. MEP of bilateral forearm extensors could be recorded simultaneously by right (healthy) cortical stimulation, and the representative area of right (affected) forearm extensors decreased gradually and converged to the representative area of left (healthy) forearm extensors, while the right (healthy) cortical stimulation could not induce MEP of right (affected) biceps brachii. No marked neurons were found in the right (healthy) cortex of CCI group mice and CCI + bilateral rhizotomy mice at all time points, while a small number of marked neurons were found in the contralateral cortex of CCI + transposition mice 5 months after operation. The density of the labeled neurons in the contralateral cortex was further increased from July to October. Conclusion: For severe CCI mice, transposition of the contralateral seven nerve roots can promote the recovery of the thick (elbow extension) and some fine (wrist extension and coordination) functions of the affected limbs, and the former is more significant. During the early postoperative period, the representative area of the affected limb covered the representative area of the healthy limb, and the former gradually reduced to the latter, accurately and orderly.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R741
本文編號(hào)：2197326
[Abstract]:BACKGROUND: As one of the more serious sequelae after central nerve injury, the therapeutic methods and effects of spastic paralysis of the upper extremity are limited. Previous studies have found that hemiplegic patients can survive cerebral hemisphere and manage bilateral upper extremities simultaneously by changing peripheral nerve pathways to enhance the innervation of ipsilateral nerve fibers to the extremities. The specific neural pathways involved and the dynamic central mechanism underlying the recovery of motor function in the affected limbs are still unclear. In this study, we used Thy1-ChR2-EYFP transgenic mice to establish models of brain injury and translocation of contralateral cervical seven nerve roots to the affected cervical seven nerve roots. Neural tracing technique is an irreplaceable technique with precise and controllable cortical location and stimulation, good repeatability and high efficiency. The results of this study will help to reveal the dynamic remodeling regularity of bilateral upper limbs of unilateral cortical canal, and actively intervene in brain remodeling and promote the follow-up. Methods: The models of CCI and CCI were established in mice with stroke, cerebral palsy and sequelae of traumatic brain injury. The combination of somatogenetics and electrophysiology was used to map the primary motor cortex M1, the representative areas of forelimb muscles, and to dynamically record the position of target muscles and the changes of motor evoked potential (MEP) parameters in bilateral upper limbs after stimulation of contralateral cortex at different time points. Results: After CCI, the scores of contralateral limbs in rolling test and stepped walking test were significantly lower than those in control group (CCI + bilateral cervical 7 amputation group and CCI group) within 1 month after CCI. However, the behavioral scores of the affected limbs in the control group did not recover further until 10 months after operation. The posture, head posture and bending item behavioral scores of the affected limbs in the experimental group (CCI + CCI + CCI + CCI + CCI) were better than those in the control group at 5 months after operation. 7 months after operation, the scores of lifting items and step walking test of the affected limbs were better than those of the control group, and were more significant at 8 months after operation and lasted until 10 months after operation. We mapped the M1 map of transgenic mice by photogenetics. We found that the forelimb representative region was composed of RFA (6 + 1 stimulus loci, mainly inducing wrist and toe activity) located in a small area in the front and CFA (44 + 4 stimulus loci, mainly inducing shoulder, elbow and part of wrist) in a large area in the rear. Within 4 months after surgery, the right (healthy) cortical stimulation could only record the MEP of the target muscle of the left (healthy) limb; 5 months after surgery, the right (healthy) cortical stimulation could simultaneously record the MEP of the bilateral triceps brachii, and the representative area of the right (affected) triceps brachii decreased gradually and converged to the left (healthy) triceps brachii. MEP of bilateral forearm extensors could be recorded simultaneously by right (healthy) cortical stimulation, and the representative area of right (affected) forearm extensors decreased gradually and converged to the representative area of left (healthy) forearm extensors, while the right (healthy) cortical stimulation could not induce MEP of right (affected) biceps brachii. No marked neurons were found in the right (healthy) cortex of CCI group mice and CCI + bilateral rhizotomy mice at all time points, while a small number of marked neurons were found in the contralateral cortex of CCI + transposition mice 5 months after operation. The density of the labeled neurons in the contralateral cortex was further increased from July to October. Conclusion: For severe CCI mice, transposition of the contralateral seven nerve roots can promote the recovery of the thick (elbow extension) and some fine (wrist extension and coordination) functions of the affected limbs, and the former is more significant. During the early postoperative period, the representative area of the affected limb covered the representative area of the healthy limb, and the former gradually reduced to the latter, accurately and orderly.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R741
【參考文獻(xiàn)】
相關(guān)期刊論文 前4條
1 古菁;黃懷;虞容豪;李寧;;腦外傷的康復(fù)評(píng)定和治療進(jìn)展[J];重慶醫(yī)學(xué);2009年08期
2 巢乃健;李勝天;;光學(xué)技術(shù)在神經(jīng)科學(xué)中的應(yīng)用及其進(jìn)展[J];生物物理學(xué)報(bào);2012年11期
3 朱秀卿,閆克里;急性腦卒中的治療研究現(xiàn)狀[J];中國(guó)藥物與臨床;2005年11期
4 張小年;張皓;;創(chuàng)傷性顱腦損傷國(guó)內(nèi)研究進(jìn)展[J];中國(guó)康復(fù)理論與實(shí)踐;2008年02期
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