Department of Neurological Surgery, Neurotrauma Research Center, and The Miami Project to Cure Paralysis, University of Miami School of Medicine, Miami, Florida, USA.
J Neurotrauma. 2011 Jan;28(1):35-42. doi: 10.1089/neu.2010.1383. Epub 2010 Oct 12.
The purpose of this study was to investigate the effects of an induced period of post-traumatic epilepsy (PTE) on the histopathological damage caused by traumatic brain injury (TBI). Male Sprague Dawley rats were given a moderate parasagittal fluid-percussion brain injury (1.9-2.1 atm) or sham surgery. At 2 weeks after surgery, seizures were induced by administration of a GABA(A) receptor antagonist, pentylenetetrazole (PTZ, 30 mg/kg). Seizures were then assessed over a 1-h period using the Racine clinical rating scale. To evaluate whether TBI-induced pathology was exacerbated by the seizures, contusion volume and cortical and hippocampal CA3 neuronal cell loss were measured 3 days after seizures. Nearly all TBI rats showed clinical signs of PTE following the decrease in inhibitory activity. In contrast, clinically evident seizures were not observed in TBI rats given saline or sham-operated rats given PTZ. Contusions in TBI-PTZ-treated rats were significantly increased compared to the TBI-saline-treated group (p < 0.001). In addition, the TBI-PTZ rats showed less NeuN-immunoreactive cells within the ipsilateral parietal cerebral cortex (p < 0.05) and there was a trend for decreased hippocampal CA3 neurons in TBI-PTZ rats compared with TBI-saline or sham-operated rats. These results demonstrate that an induced period of post-traumatic seizures significantly exacerbates the structural damage caused by TBI. These findings emphasize the need to control seizures after TBI to limit even further damage to the injured brain.
本研究旨在探讨外伤性癫痫(PTE)诱导期对创伤性脑损伤(TBI)所致组织病理学损伤的影响。雄性 Sprague Dawley 大鼠接受中度旁矢状线液压冲击脑损伤(1.9-2.1 atm)或假手术。手术后 2 周,通过给予 GABA(A) 受体拮抗剂戊四氮(PTZ,30 mg/kg)诱导癫痫发作。然后使用 Racine 临床评分量表在 1 小时内评估癫痫发作。为了评估 TBI 引起的病理是否因癫痫发作而加重,在癫痫发作后 3 天测量挫伤体积以及皮质和海马 CA3 神经元细胞丢失。几乎所有接受 TBI 的大鼠在抑制活性降低后均出现 PTE 的临床体征。相比之下,接受生理盐水的 TBI 大鼠或接受 PTZ 的假手术大鼠未观察到明显的临床癫痫发作。与 TBI-生理盐水处理组相比,TBI-PTZ 处理组的挫伤明显增加(p<0.001)。此外,与 TBI-生理盐水或假手术组相比,TBI-PTZ 大鼠同侧顶叶大脑皮质内的 NeuN 免疫反应性细胞减少(p<0.05),并且 TBI-PTZ 大鼠的海马 CA3 神经元有减少的趋势。这些结果表明,外伤性癫痫诱导期显著加重了 TBI 引起的结构损伤。这些发现强调了需要控制 TBI 后的癫痫发作,以进一步限制对受损大脑的损害。