Bekker Alex, Haile Michael, Li Yong-Sheng, Galoyan Samuel, Garcia Edwardo, Quartermain David, Kamer Angela, Blanck Thomas
Department of Anesthesiology, New York University Langone Medical Center, New York, NY 10016, USA.
Anesth Analg. 2009 Dec;109(6):1943-8. doi: 10.1213/ANE.0b013e3181beeb3b.
Hypotension and a resultant decrease in cerebral blood flow have been implicated in the development of cognitive dysfunction. We tested the hypothesis that nimodipine (NIMO) administered at the onset of nitroglycerin (NTG)-induced hypotension would preserve long-term associative memory.
The passive avoidance (PA) paradigm was used to assess memory retention. For PA training, latencies (seconds) were recorded for entry from a suspended platform into a Plexiglas tube where a shock was automatically delivered. Latencies were recorded 48 h later for a testing trial. Ninety-six Swiss-Webster mice (30-35 g, 6-8 wk), were randomized into 6 groups 1) saline (control), 2) NTG immediately after learning, 3) NTG 3 h after learning, 4) NTG and NIMO, 5) vehicle, and 6) NIMO alone. The extent of hypotension and changes in brain tissue oxygenation (PbtO(2)) and in cerebral blood flow were studied in a separate group of animals.
All groups exhibited similar training latencies (17.0 +/- 4.6 s). Mice subjected to hypotensive episodes showed a significant decrease in latency time (178 +/- 156 s) compared with those injected with saline, NTG + NIMO, or delayed NTG (580 +/- 81 s, 557 +/- 67 s, and 493 +/- 146 s, respectively). A Kruskal-Wallis 1-way analysis of variance indicated a significant difference among the 4 treatment groups (H = 15.34; P < 0.001). In a separate group of mice not subjected to behavioral studies, the same dose of NTG (n = 3) and NTG + NIMO (n = 3) caused mean arterial blood pressure to decrease from 85.9 +/- 3.8 mm Hg sem to 31.6 +/- 0.8 mm Hg sem and from 86.2 +/- 3.7 mm Hg sem to 32.6 +/- 0.2 mm Hg sem, respectively. Mean arterial blood pressure in mice treated with NIMO alone decreased from 88.1 +/- 3.8 mm Hg to 80.0 +/- 2.9 mm Hg. The intergroup difference was statistically significant (P < 0.05). PbtO(2) decreased from 51.7 +/- 4.5 mm Hg sem to 33.8 +/- 5.2 mm Hg sem in the NTG group and from 38.6 +/- 6.1 mm Hg sem to 25.4 +/- 2.0 mm Hg sem in the NTG + NIMO groups, respectively. There were no significant differences among groups.
In a PA retention paradigm, the injection of NTG immediately after learning produced a significant impairment of long-term associative memory in mice, whereas delayed induced hypotension had no effect. NIMO attenuated the disruption in consolidation of long-term memory caused by NTG but did not improve latency in the absence of hypotension. The observed effect of NIMO may have been attributable to the preservation of calcium homeostasis during hypotension, because there were no differences in the PbtO(2) indices among groups.
低血压以及随之而来的脑血流量减少与认知功能障碍的发生有关。我们检验了这样一个假设,即在硝酸甘油(NTG)诱导的低血压发作时给予尼莫地平(NIMO)可保留长期联想记忆。
采用被动回避(PA)范式评估记忆保持情况。在PA训练中,记录从悬挂平台进入有机玻璃管(管内会自动施加电击)的潜伏期(秒)。48小时后进行测试试验并记录潜伏期。将96只瑞士韦伯斯特小鼠(30 - 35克,6 - 8周龄)随机分为6组:1)生理盐水(对照组),2)学习后立即给予NTG,3)学习后3小时给予NTG,4)NTG与NIMO,5)赋形剂,6)单独给予NIMO。在另一组动物中研究低血压程度以及脑组织氧合(PbtO₂)和脑血流量的变化。
所有组的训练潜伏期相似(17.0±4.6秒)。与注射生理盐水、NTG + NIMO或延迟给予NTG的小鼠相比,经历低血压发作的小鼠潜伏期时间显著缩短(分别为178±156秒、580±81秒、557±67秒和493±146秒)。Kruskal - Wallis单向方差分析表明4个治疗组之间存在显著差异(H = 15.34;P < 0.001)。在另一组未进行行为学研究的小鼠中,相同剂量的NTG(n = 3)和NTG + NIMO(n = 3)分别使平均动脉血压从85.9±3.8毫米汞柱降至31.6±0.8毫米汞柱,以及从86.2±3.7毫米汞柱降至32.6±0.2毫米汞柱。单独给予NIMO治疗的小鼠平均动脉血压从88.1±3.8毫米汞柱降至80.0±2.9毫米汞柱。组间差异具有统计学意义(P < 0.05)。NTG组的PbtO₂从51.7±4.5毫米汞柱降至33.8±5.2毫米汞柱,NTG + NIMO组的PbtO₂从38.6±6.1毫米汞柱降至25.4±2.0毫米汞柱。各组之间无显著差异。
在PA保持范式中,学习后立即注射NTG会导致小鼠长期联想记忆显著受损,而延迟诱导的低血压则无影响。NIMO减轻了NTG引起的长期记忆巩固破坏,但在无低血压情况下未改善潜伏期。观察到的NIMO的作用可能归因于低血压期间钙稳态的维持,因为各组之间的PbtO₂指标无差异。