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心室颤动性心脏骤停会产生一种慢性纹状体多巴胺能亢进状态,而哌甲酯治疗会使这种状态恶化。

Ventricular fibrillation cardiac arrest produces a chronic striatal hyperdopaminergic state that is worsened by methylphenidate treatment.

作者信息

Nora Gerald J, Harun Rashed, Fine David F, Hutchison Daniel, Grobart Adam C, Stezoski Jason P, Munoz Miranda J, Kochanek Patrick M, Leak Rehana K, Drabek Tomas, Wagner Amy K

机构信息

Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

出版信息

J Neurochem. 2017 Jul;142(2):305-322. doi: 10.1111/jnc.14058. Epub 2017 Jun 1.

DOI:10.1111/jnc.14058
PMID:28445595
Abstract

Cardiac arrest survival rates have improved with modern resuscitation techniques, but many survivors experience impairments associated with hypoxic-ischemic brain injury (HIBI). Currently, little is understood about chronic changes in striatal dopamine (DA) systems after HIBI. Given the common empiric clinical use of DA enhancing agents in neurorehabilitation, investigation evaluating dopaminergic alterations after cardiac arrest (CA) is necessary to optimize rehabilitation approaches. We hypothesized that striatal DA neurotransmission would be altered chronically after ventricular fibrillation cardiac arrest (VF-CA). Fast-scan cyclic voltammetry was used with median forebrain bundle (MFB) maximal electrical stimulations (60Hz, 10s) in rats to characterize presynaptic components of DA neurotransmission in the dorsal striatum (D-Str) and nucleus accumbens 14 days after a 5-min VF-CA when compared to Sham or Naïve. VF-CA increased D-Str-evoked overflow [DA], total [DA] released, and initial DA release rate versus controls, despite also increasing maximal velocity of DA reuptake (V ). Methylphenidate (10 mg/kg), a DA transporter inhibitor, was administered to VF-CA and Shams after establishing a baseline, pre-drug 60 Hz, 5 s stimulation response. Methylphenidate increased initial evoked overflow [DA] more-so in VF-CA versus Sham and reduced D-Str V in VF-CA but not Shams; these findings are consistent with upregulated striatal DA transporter in VF-CA versus Sham. Our work demonstrates that 5-min VF-CA increases electrically stimulated DA release with concomitant upregulation of DA reuptake 2 weeks after brief VF-CA insult. Future work should elucidate how CA insult duration, time after insult, and insult type influence striatal DA neurotransmission and related cognitive and motor functions.

摘要

随着现代复苏技术的发展,心脏骤停的存活率有所提高,但许多幸存者仍经历与缺氧缺血性脑损伤(HIBI)相关的功能障碍。目前,对于HIBI后纹状体多巴胺(DA)系统的慢性变化了解甚少。鉴于DA增强剂在神经康复中常见的经验性临床应用,有必要进行研究以评估心脏骤停(CA)后的多巴胺能改变,从而优化康复方法。我们假设心室颤动性心脏骤停(VF-CA)后纹状体DA神经传递会发生慢性改变。在大鼠中,使用快速扫描循环伏安法结合前脑内侧束(MFB)最大电刺激(60Hz,10s),以表征在5分钟VF-CA后14天,与假手术组或正常组相比,背侧纹状体(D-Str)和伏隔核中DA神经传递的突触前成分。与对照组相比,VF-CA增加了D-Str诱发的溢出[DA]、释放的总[DA]以及初始DA释放速率,尽管同时也增加了DA再摄取的最大速度(V)。在建立基线、给药前60Hz、5s刺激反应后,对VF-CA组和假手术组给予DA转运体抑制剂哌甲酯(10mg/kg)。与假手术组相比,哌甲酯在VF-CA组中更显著地增加了初始诱发的溢出[DA],并降低了VF-CA组D-Str的V,但在假手术组中未降低;这些发现与VF-CA组相比假手术组纹状体DA转运体上调一致。我们的研究表明,短暂的VF-CA损伤2周后,5分钟的VF-CA会增加电刺激的DA释放,并伴随DA再摄取的上调。未来的工作应阐明CA损伤持续时间、损伤后时间以及损伤类型如何影响纹状体DA神经传递以及相关的认知和运动功能。

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