Teletón Rehabilitation Institute, Santiago, Chile
Biology Department, Universidad de Chile, Santiago, Chile.
Arch Clin Neuropsychol. 2016 Jun;31(4):332-42. doi: 10.1093/arclin/acw012. Epub 2016 Apr 15.
There is a critical need for new therapeutic strategies to restore motor function in patients with spinal cord injuries (SCIs), without unwanted effects. Intermittent hypoxia (IH) induces plasticity in spared synaptic pathways to motor neurons below the level of injury, which can be harnessed to elicit motor recovery in incomplete SCI patients. However, there is conflicting evidence regarding the effects of IH on memory function. The aim of this study was to assess episodic verbal and visual memory function with the Complutense verbal learning test (TAVEC) and the Rey-Osterrieth Complex Figure Test (ROCF), respectively, before and after a 4-week protocol of repetitive IH combined with body weight-supported treadmill training (BWSTT) in incomplete ASIA C and D SCI subjects. Subjects received either IH (cycling 9%/21% FiO2 every 1.5 min, 15 cycles per day) or continued normoxia (Nx, 21% FiO2) combined with 45 min of BWSTT for 5 consecutive days, followed by 3 times per week IH and BWSTT for 3 additional weeks. ROCF Z scores between IH plus BWSTT and Nx plus BWSTT were not significantly different (p = .43). Compared with baseline, IH and BWSTT group showed a significantly greater (p < .05) verbal memory performance for immediate, short-term, and long-term recall; however, it was not different from Nx plus BWSTT group in all verbal memory components (p > .05). Our results suggest that a 4-week protocol of moderate IH does not elicit visual or verbal memory impairment. Thus, repetitive IH may be a safe therapeutic approach to incomplete spinal cord injury patients, without deleterious cognitive effects.
目前非常需要新的治疗策略来恢复脊髓损伤（SCI）患者的运动功能，且不能有不良反应。间歇性低氧（IH）会诱导损伤水平以下运动神经元的未受损突触通路产生可塑性，这可以被利用来诱发不完全性 SCI 患者的运动功能恢复。然而，间歇性低氧对记忆功能的影响存在相互矛盾的证据。本研究旨在使用 Complutense 语言学习测试（TAVEC）和 Rey-Osterrieth 复杂图形测试（ROCF）分别评估 4 周重复 IH 联合减重支持跑步机训练（BWSTT）前后不完全性 ASIA C 和 D SCI 患者的情景语言和视觉记忆功能。受试者接受 IH（9%/21% FiO2 每 1.5 分钟循环，每天 15 个周期）或继续常氧（21% FiO2）联合 45 分钟 BWSTT，连续 5 天，然后每周 3 次 IH 和 BWSTT 再进行 3 周。IH 联合 BWSTT 和 Nx 联合 BWSTT 之间的 ROCF Z 评分无显著差异（p=.43）。与基线相比，IH 和 BWSTT 组在即时、短期和长期回忆的语言记忆表现上均有显著改善（p<.05）；然而，在所有语言记忆成分上，与 Nx 联合 BWSTT 组均无差异（p>.05）。我们的研究结果表明，4 周的中度 IH 方案不会引起视觉或语言记忆障碍。因此，重复 IH 可能是一种安全的治疗不完全性脊髓损伤患者的方法，不会产生认知损害。
