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相对于典型抗精神病药物,阿立哌唑是缓解实验性脑外伤后行为障碍的更安全选择。

Relative to Typical Antipsychotic Drugs, Aripiprazole Is a Safer Alternative for Alleviating Behavioral Disturbances After Experimental Brain Trauma.

作者信息

Phelps Thomas I, Bondi Corina O, Mattiola Vincent V, Kline Anthony E

机构信息

University of Pittsburgh, Pittsburgh, PA, USA.

Case Western/MetroHealth Medical Center, Cleveland OH, USA.

出版信息

Neurorehabil Neural Repair. 2017 Jan;31(1):25-33. doi: 10.1177/1545968316650281. Epub 2016 May 24.

Abstract

BACKGROUND

Antipsychotic drugs (APDs) are used to manage traumatic brain injury (TBI)-induced behavioral disturbances, such as agitation and aggression. However, APDs exhibiting D receptor antagonism impede cognitive recovery after experimental TBI. Hence, empirical evaluation of APDs with different mechanistic actions is warranted. Aripiprazole (ARIP) is a D and 5-hydroxytryptamine (5-HT) receptor agonist; pharmacotherapies with these properties enhance cognition after TBI.

OBJECTIVE

To test the hypothesis that ARIP would increase behavioral performance and decrease histopathology after TBI.

METHODS

Adult male rats were subjected to either a controlled cortical impact (CCI) or sham injury and then randomly assigned to ARIP (0.1 or 1.0 mg/kg) or VEH (1.0 mL/kg, saline vehicle) groups. Treatments began 24 hours after surgery and were administered once daily for 19 days. Motor (beam-balance/beam-walk) and cognitive (Morris water maze) performance was assessed on postoperative days 1 to 5 and 14 to 19, respectively, followed by quantification of hippocampal CA neuron survival and cortical lesion volume.

RESULTS

Beam-balance was significantly improved in the CCI + ARIP (1.0 mg/kg) group versus CCI + ARIP (0.1 mg/kg) and CCI + VEH (P < .05). Spatial learning and memory retention were significantly improved in the CCI + ARIP (0.1 mg/kg) group versus the CCI + ARIP (1.0 mg/kg) and CCI + VEH groups (P < .05). Both doses of ARIP reduced lesion size and CA cell loss versus VEH (P < .05). Importantly, neither dose of ARIP impeded functional recovery as previously reported with other APDs.

CONCLUSION

These findings support the hypothesis and endorse ARIP as a safer APD for alleviating behavioral disturbances after TBI.

摘要

背景

抗精神病药物(APDs)用于管理创伤性脑损伤(TBI)引起的行为障碍,如激越和攻击行为。然而,表现出D受体拮抗作用的APDs会阻碍实验性TBI后的认知恢复。因此,有必要对具有不同作用机制的APDs进行实证评估。阿立哌唑(ARIP)是一种D和5-羟色胺(5-HT)受体激动剂;具有这些特性的药物疗法可增强TBI后的认知能力。

目的

检验ARIP可提高TBI后行为表现并减少组织病理学损伤这一假设。

方法

成年雄性大鼠接受控制性皮质撞击(CCI)或假手术损伤,然后随机分为ARIP(0.1或1.0 mg/kg)或VEH(1.0 mL/kg,生理盐水载体)组。术后24小时开始治疗,每天给药1次,持续19天。分别在术后第1至5天和第14至19天评估运动(平衡木/走平衡木)和认知(莫里斯水迷宫)表现,随后对海马CA神经元存活情况和皮质损伤体积进行量化。

结果

与CCI + ARIP(0.1 mg/kg)和CCI + VEH组相比,CCI + ARIP(1.0 mg/kg)组的平衡木表现显著改善(P < .05)。与CCI + ARIP(1.0 mg/kg)和CCI + VEH组相比,CCI + ARIP(0.1 mg/kg)组的空间学习和记忆保持能力显著改善(P < .05)。与VEH组相比,两种剂量的ARIP均减小了损伤大小并减少了CA细胞损失(P < .05)。重要的是,与之前报道的其他APDs不同,两种剂量的ARIP均未阻碍功能恢复。

结论

这些发现支持了该假设,并认可ARIP是一种更安全的APD,可用于减轻TBI后的行为障碍。

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