Morena Maria, Berardi Andrea, Peloso Andrea, Valeri Daniela, Palmery Maura, Trezza Viviana, Schelling Gustav, Campolongo Patrizia
Dept. of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
Dept. of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
Behav Brain Res. 2017 Jun 30;329:215-220. doi: 10.1016/j.bbr.2017.04.048. Epub 2017 Apr 28.
Intensive Care Unit (ICU) or emergency care patients, exposed to traumatic events, are at increased risk for Post-Traumatic Stress Disorder (PTSD) development. Commonly used sedative/anesthetic agents can interfere with the mechanisms of memory formation, exacerbating or attenuating the memory for the traumatic event, and subsequently promote or reduce the risk of PTSD development. Here, we evaluated the effects of ketamine, dexmedetomidine and propofol on fear memory consolidation and subsequent cognitive and emotional alterations related to traumatic stress exposure. Immediately following an inhibitory avoidance training, rats were intraperitoneally injected with ketamine (100-125mg/kg), dexmedetomidine (0.3-0.4mg/kg) or their vehicle and tested for 48h memory retention. Furthermore, the effects of ketamine (125mg/kg), dexmedetomidine (0.4mg/kg), propofol (300mg/kg) or their vehicle on long-term memory and social interaction were evaluated two weeks after drug injection in a rat PTSD model. Ketamine anesthesia increased memory retention without altering the traumatic memory strength in the PTSD model. However, ketamine induced a long-term reduction of social behavior. Conversely, dexmedetomidine markedly impaired memory retention, without affecting long-lasting cognitive or emotional behaviors in the PTSD model. We have previously shown that propofol anesthesia enhanced 48h memory retention. Here, we found that propofol induced an enduring traumatic memory enhancement and anxiogenic effects in the PTSD model. These findings provide new evidence for clinical studies showing that the use of ketamine or propofol anesthesia in emergency care and ICU might be more likely to promote the development of PTSD, while dexmedetomidine might have prophylactic effects.
重症监护病房(ICU)的患者或接受急诊治疗且经历过创伤性事件的患者,患创伤后应激障碍(PTSD)的风险会增加。常用的镇静/麻醉药物会干扰记忆形成机制,加重或减轻对创伤性事件的记忆,进而增加或降低患PTSD的风险。在此,我们评估了氯胺酮、右美托咪定和丙泊酚对恐惧记忆巩固以及随后与创伤应激暴露相关的认知和情绪改变的影响。在抑制性回避训练后,立即给大鼠腹腔注射氯胺酮(100 - 125mg/kg)、右美托咪定(0.3 - 0.4mg/kg)或其溶剂,并测试其48小时的记忆保持情况。此外,在大鼠PTSD模型中,于药物注射两周后评估氯胺酮(125mg/kg)、右美托咪定(0.4mg/kg)、丙泊酚(300mg/kg)或其溶剂对长期记忆和社交互动的影响。氯胺酮麻醉增加了PTSD模型中的记忆保持,而不改变创伤记忆强度。然而,氯胺酮导致社交行为长期减少。相反,右美托咪定显著损害记忆保持,而不影响PTSD模型中持久的认知或情绪行为。我们之前已经表明丙泊酚麻醉增强了48小时的记忆保持。在此,我们发现丙泊酚在PTSD模型中诱导了持久的创伤记忆增强和致焦虑作用。这些发现为临床研究提供了新证据,表明在急诊治疗和ICU中使用氯胺酮或丙泊酚麻醉可能更易促进PTSD的发生,而右美托咪定可能具有预防作用。