Phelps Thomas I, Bondi Corina O, Mattiola Vincent V, Kline Anthony E
University of Pittsburgh, Pittsburgh, PA, USA.
Case Western/MetroHealth Medical Center, Cleveland OH, USA.
Neurorehabil Neural Repair. 2017 Jan;31(1):25-33. doi: 10.1177/1545968316650281. Epub 2016 May 24.
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.
To test the hypothesis that ARIP would increase behavioral performance and decrease histopathology after TBI.
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.
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.
These findings support the hypothesis and endorse ARIP as a safer APD for alleviating behavioral disturbances after TBI.
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。
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。
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。
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。
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。