Lin Nan, Liu Ming-Sheng, Fan Si-Yuan, Guan Yu-Zhou, Cui Li-Ying
Department of Neurology, Peking Union Medical College Hospital, Beijing 100730, China.
Chin Med J (Engl). 2015 Nov 5;128(21):2919-25. doi: 10.4103/0366-6999.168057.
Motor dysfunction is common in stroke patients. Clinical electrophysiological studies suggest that transsynaptic degeneration occurred in the lower motor neurons, while pathological evidence is lacked. This study aimed to combine the electrophysiological and pathological results to prove the existence of transsynaptic degeneration in the motor system after stroke.
Modified neurologic severity score, electrophysiological, and pathological assessments were evaluated in rats before middle cerebral artery occlusion (MCAO), and at 24 hours, 7 days, and 14 days after MCAO. Paired and independent-sample t-tests were applied to assess the changes of electrophysiological and pathological data.
Compound motor action potential amplitude in the paretic side was significantly lower than the nonparetic side at both 24 hours (61.9 ± 10.4 vs. 66.6 ± 8.9, P < 0.05) and 7 days (60.9 ± 8.4 vs. 67.3 ± 9.6, P < 0.05) after MCAO. Motor unit number estimation of the paretic side was significantly less than the nonparetic side (379.0 ± 84.6 vs. 445.0 ± 89.5, P < 0.05) at 7 days after MCAO. Until 14 days after stroke, the pathological loss of motor neurons was detected. Motor neurons in 14-day MCAO group were significantly decreased, compared with control group (5.3 ± 0.7 vs. 7.3 ± 1.8, P < 0.05).
Both electrophysiological and pathological studies showed transsynaptic degeneration after stroke. This study identified the asynchronization in changes of electrophysiology and pathology. The abnormal physiological changes and function impairment can be detected in the early stage and recovered quickly, while the pathological loss of motor neuron can be detected only in a later stage.
运动功能障碍在中风患者中很常见。临床电生理研究表明,下运动神经元发生了跨突触变性,但缺乏病理证据。本研究旨在结合电生理和病理结果,以证明中风后运动系统中跨突触变性的存在。
在大鼠大脑中动脉闭塞(MCAO)前、MCAO后24小时、7天和14天对其进行改良神经功能缺损评分、电生理和病理评估。采用配对和独立样本t检验来评估电生理和病理数据的变化。
在MCAO后24小时(61.9±10.4对66.6±8.9,P<0.05)和7天(60.9±8.4对67.3±9.6,P<0.05),患侧复合运动动作电位幅度均显著低于健侧。在MCAO后7天,患侧运动单位数量估计值显著少于健侧(379.0±84.6对445.0±89.5,P<0.05)。直到中风后14天,才检测到运动神经元的病理损失。与对照组相比,14天MCAO组的运动神经元显著减少(5.3±0.7对7.3±1.8,P<0.05)。
电生理和病理研究均显示中风后存在跨突触变性。本研究确定了电生理和病理变化的不同步性。异常的生理变化和功能损害在早期即可检测到且恢复迅速,而运动神经元的病理损失仅在后期才能检测到。