Goriunova A V, Bazarnaia N A, Sorokina E G, Semenova N Iu, Globa O V, Semenova Zh B, Pinelis V G, Roshal' L M, Maslova O I
Zh Nevrol Psikhiatr Im S S Korsakova. 2006;106(8):50-3.
Autoantibodies (aAB) to AMPA (Glu R1 subunit) and NMDA (NR 2A subunit) glutamate receptors were studied in blood serum of 60 children, aged 7-16 years, with chronic posttraumatic headache after mild skull injury. All the children were divided into 2 groups: group 1 included 48 children with concussion of the brain, group 2--12 children with brain contusion. Group 1 was divided into 2 subgroups: subgroup 1a comprised 34 children with single concussion and subgroup 1b--14 children with repeated concussion. The aAB level was determined 6 months and 1 year after skull injury. The aAB concentration was expressed in percents to the control level being considered significant if the increase was higher than 120%. The increased NMDA aAB level was observed during the first year after skull injury. In the la subgroup, the NR2 aAB level in blood serum was 145 +/- 12,6%, in the 1b one--108 +/- 12,4%, in group 2--165 +/- 34%. The content of aAB to AMPA receptors was elevated only in children of lb subgroup and group 2 (150 +/- 16,8% and 167 +/- 31,3%, respectively). The EEG examination of this group revealed the nonspecific paroxysmal discharges in 18% of cases and epileptiform activity in 6% of children. The results obtained suggest that children with posttraumatic headache have elevated levels of aAB to glutamate receptors, hyperstimulation of which reflects hypoxic processes in the brain, and are in need of metabolic therapy.
对60名7至16岁患有轻度颅脑损伤后慢性创伤后头痛的儿童血清中的抗α-氨基-3-羟基-5-甲基-4-异恶唑丙酸(AMPA,Glu R1亚基)和N-甲基-D-天冬氨酸(NMDA,NR 2A亚基)谷氨酸受体自身抗体(aAB)进行了研究。所有儿童被分为两组:第1组包括48名脑震荡儿童,第2组包括12名脑挫裂伤儿童。第1组又分为两个亚组:亚组1a包括34名单次脑震荡儿童,亚组1b包括14名反复脑震荡儿童。在颅脑损伤后6个月和1年测定aAB水平。aAB浓度以相对于对照水平的百分比表示,如果增加高于120%则被认为具有显著性。在颅脑损伤后的第一年观察到NMDA aAB水平升高。在亚组1a中,血清中NR2 aAB水平为145±12.6%,在亚组1b中为108±12.4%,在第2组中为165±34%。仅在亚组1b儿童和第2组儿童中,AMPA受体的aAB含量升高(分别为150±16.8%和167±31.3%)。该组的脑电图检查显示,18%的病例有非特异性阵发性放电,6%的儿童有癫痫样活动。所得结果表明,创伤后头痛儿童的谷氨酸受体aAB水平升高,其过度刺激反映了大脑中的缺氧过程,需要进行代谢治疗。