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骶段脊髓损伤后清醒大鼠的痉挛性长期反射

Spastic long-lasting reflexes in the awake rat after sacral spinal cord injury.

作者信息

Bennett D J, Sanelli L, Cooke C L, Harvey P J, Gorassini M A

机构信息

Centre for Neuroscience, University of Alberta, Edmonton, Alberta T6G 2S2, Canada.

出版信息

J Neurophysiol. 2004 May;91(5):2247-58. doi: 10.1152/jn.00946.2003.

Abstract

Following chronic sacral spinal cord transection in rats the affected tail muscles exhibit marked spasticity, with characteristic long-lasting tail spasms evoked by mild stimulation. The purpose of the present paper was to characterize the long-lasting reflex seen in tail muscles in response to electrical stimulation of the tail nerves in the awake spastic rat, including its development with time and relation to spasticity. Before and after sacral spinal transection, surface electrodes were placed on the tail for electrical stimulation of the caudal nerve trunk (mixed nerve) and for recording EMG from segmental tail muscles. In normal and acute spinal rats caudal nerve trunk stimulation evoked little or no EMG reflex. By 2 wk after injury, the same stimulation evoked long-lasting reflexes that were 1) very low threshold, 2) evoked from rest without prior EMG activity, 3) of polysynaptic latency with >6 ms central delay, 4) about 2 s long, and 5) enhanced by repeated stimulation (windup). These reflexes produced powerful whole tail contractions (spasms) and developed gradually over the weeks after the injury (< or =52 wk tested), in close parallel to the development of spasticity. Pure low-threshold cutaneous stimulation, from electrical stimulation of the tip of the tail, also evoked long-lasting spastic reflexes, not seen in acute spinal or normal rats. In acute spinal rats a strong C-fiber stimulation of the tip of the tail (20 x T) could evoke a weak EMG response lasting about 1 s. Interestingly, when this C-fiber stimulation was used as a conditioning stimulation to depolarize the motoneuron pool in acute spinal rats, a subsequent low-threshold stimulation of the caudal nerve trunk evoked a 300-500 ms long reflex, similar to the onset of the long-lasting reflex in chronic spinal rats. A similar conditioned reflex was not seen in normal rats. Thus there is an unusually long low-threshold polysynaptic input to the motoneurons (pEPSP) that is normally inhibited by descending control. This pEPSP is released from inhibition immediately after injury but does not produce a long-lasting reflex because of a lack of motoneuron excitability. With chronic injury the motoneuron excitability is increased markedly, and the pEPSP then triggers sustained motoneuron discharges associated with long-lasting reflexes and muscle spasms.

摘要

大鼠慢性骶段脊髓横断后,受影响的尾部肌肉表现出明显的痉挛,轻微刺激即可诱发特征性的持续性尾部痉挛。本文的目的是描述清醒痉挛大鼠尾部肌肉对尾部神经电刺激产生的持续性反射,包括其随时间的发展以及与痉挛的关系。在骶段脊髓横断前后,将表面电极置于尾部,用于电刺激尾神经干(混合神经)并记录节段性尾部肌肉的肌电图。在正常和急性脊髓损伤大鼠中,尾神经干刺激诱发的肌电图反射很少或无反射。损伤后2周,相同刺激可诱发持续性反射,其特点为:1)阈值极低;2)在无先前肌电图活动的静息状态下诱发;3)多突触潜伏期,中枢延迟>6毫秒;4)约2秒长;5)重复刺激可增强(易化)。这些反射可产生强大的整个尾部收缩(痉挛),并在损伤后的数周内逐渐发展(测试时间≤52周),与痉挛的发展密切平行。对尾部尖端进行电刺激的纯低阈值皮肤刺激也可诱发持续性痉挛反射,这在急性脊髓损伤或正常大鼠中未见。在急性脊髓损伤大鼠中,对尾部尖端进行强烈的C纤维刺激(20×阈刺激)可诱发持续约1秒的微弱肌电图反应。有趣的是,当这种C纤维刺激用作条件刺激使急性脊髓损伤大鼠的运动神经元池去极化时,随后对尾神经干的低阈值刺激可诱发300 - 500毫秒长的反射,类似于慢性脊髓损伤大鼠中持续性反射的起始。正常大鼠中未见类似的条件反射。因此,存在一种异常长的低阈值多突触输入至运动神经元(pEPSP),其通常受下行控制的抑制。损伤后该pEPSP立即从抑制中释放,但由于运动神经元兴奋性不足,未产生持续性反射。随着慢性损伤,运动神经元兴奋性显著增加,此时pEPSP触发与持续性反射和肌肉痉挛相关的持续运动神经元放电。

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