Shijo Katsunori, Ghavim Sima, Harris Neil G, Hovda David A, Sutton Richard L
UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-6901, USA; Department of Neurosurgery, David Geffen School of Medicine at UCLA, 300 Stein Plaza, Ste. 562, Box 956901, Los Angeles, CA 90095-6901, USA.
UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-6901, USA; Department of Neurosurgery, David Geffen School of Medicine at UCLA, 300 Stein Plaza, Ste. 562, Box 956901, Los Angeles, CA 90095-6901, USA; Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-6901, USA.
Brain Res. 2015 Jul 21;1614:94-104. doi: 10.1016/j.brainres.2015.04.022. Epub 2015 Apr 21.
The impact of hyperglycemia after traumatic brain injury (TBI), and even the administration of glucose-containing solutions to head injured patients, remains controversial. In the current study adult male Sprague-Dawley rats were tested on behavioral tasks and then underwent surgery to induce sham injury or unilateral controlled cortical impact (CCI) injury followed by injections (i.p.) with either a 50% glucose solution (Glc; 2g/kg) or an equivalent volume of either 0.9% or 8% saline (Sal) at 0, 1, 3 and 6h post-injury. The type of saline treatment did not significantly affect any outcome measures, so these data were combined. Rats with CCI had significant deficits in beam-walking traversal time and rating scores (p's < 0.001 versus sham) that recovered over test sessions from 1 to 13 days post-injury (p's < 0.001), but these beam-walking deficits were not affected by Glc versus Sal treatments. Persistent post-CCI deficits in forelimb contraflexion scores and forelimb tactile placing ability were also not differentially affected by Glc or Sal treatments. However, deficits in latency to retract the right hind limb after limb extension were significantly attenuated in the CCI-Glc group (p < 0.05 versus CCI-Sal). Both CCI groups were significantly impaired in a plus maze test of spatial working memory on days 4, 9 and 14 post-surgery (p < 0.001 versus sham), and there was no effect of Glc versus Sal on this cognitive outcome measure. At 15 days post-surgery the loss of cortical tissue volume (p < 0.001 versus sham) was significantly less in the CCI-Glc group (30.0%; p < 0.05) compared to the CCI-Sal group (35.7%). Counts of surviving hippocampal hilar neurons revealed a significant (~40%) loss ipsilateral to CCI (p < 0.001 versus sham), but neuronal loss in the hippocampus was not different in the CCI-Sal and CCI-Glc groups. Taken together, these results indicate that an early elevation of blood glucose may improve some neurological outcomes and, importantly, the induction of hyperglycemia after isolated TBI did not adversely affect any sensorimotor, cognitive or histological outcomes.
创伤性脑损伤(TBI)后高血糖的影响,甚至向头部受伤患者输注含糖溶液的影响,仍然存在争议。在当前研究中,对成年雄性Sprague-Dawley大鼠进行行为任务测试,然后进行手术以诱导假损伤或单侧控制性皮质撞击(CCI)损伤,随后在损伤后0、1、3和6小时腹腔注射50%葡萄糖溶液(Glc;2g/kg)或等体积的0.9%或8%生理盐水(Sal)。生理盐水治疗类型对任何结果指标均无显著影响,因此将这些数据合并。CCI大鼠在走梁穿越时间和评分上有显著缺陷(与假手术组相比,p<0.001),在损伤后1至13天的测试过程中恢复(p<0.001),但这些走梁缺陷不受Glc与Sal治疗的影响。CCI后前肢对侧屈曲评分和前肢触觉放置能力的持续缺陷也不受Glc或Sal治疗的差异影响。然而,肢体伸展后右后肢回缩潜伏期的缺陷在CCI-Glc组中显著减轻(与CCI-Sal组相比,p<0.05)。两个CCI组在术后第4、9和14天的空间工作记忆加迷宫测试中均有显著损伤(与假手术组相比,p<0.001),Glc与Sal对该认知结果指标无影响。术后15天,CCI-Glc组皮质组织体积的损失(与假手术组相比,p<0.001)明显小于CCI-Sal组(30.0%;p<0.05)(35.7%)。存活海马齿状回神经元计数显示,CCI同侧有显著(约40%)损失(与假手术组相比,p<0.001),但CCI-Sal组和CCI-Glc组海马神经元损失无差异。综上所述,这些结果表明,血糖的早期升高可能改善一些神经学结果,重要的是,孤立性TBI后高血糖的诱导并未对任何感觉运动、认知或组织学结果产生不利影响。