Thomas Theresa Currier, Stockhausen Ellen Magee, Law L Matthew, Khodadad Aida, Lifshitz Jonathan
Barrow Neurological Institute at Phoenix Children's Hospital - Phoenix, AZ, USA.
Department of Child Health, University of Arizona College of Medicine - Phoenix, AZ, USA.
Restor Neurol Neurosci. 2017;35(6):611-629. doi: 10.3233/RNN-170753.
As rehabilitation strategies advance as therapeutic interventions, the modality and onset of rehabilitation after traumatic brain injury (TBI) are critical to optimize treatment. Our laboratory has detected and characterized a late-onset, long-lasting sensory hypersensitivity to whisker stimulation in diffuse brain-injured rats; a deficit that is comparable to visual or auditory sensory hypersensitivity in humans with an acquired brain injury.
We hypothesize that the modality and onset of rehabilitation therapies will differentially influence sensory hypersensitivity in response to the Whisker Nuisance Task (WNT) as well as WNT-induced corticosterone (CORT) stress response in diffuse brain-injured rats and shams.
After midline fluid percussion brain injury (FPI) or sham surgery, rats were assigned to one of four rehabilitative interventions: (1) whisker sensory deprivation during week one or (2) week two or (3) whisker stimulation during week one or (4) week two. At 28 days following FPI and sham procedures, sensory hypersensitivity was assessed using the WNT. Plasma CORT was evaluated immediately following the WNT (aggravated levels) and prior to the pre-determined endpoint 24 hours later (non-aggravated levels).
Deprivation therapy during week two elicited significantly greater sensory hypersensitivity to the WNT compared to week one (p < 0.05), and aggravated CORT levels in FPI rats were significantly lower than sham levels. Stimulation therapy during week one resulted in low levels of sensory hypersensitivity to the WNT, similar to deprivation therapy and naïve controls, however, non-aggravated CORT levels in FPI rats were significantly higher than sham.
These data indicate that modality and onset of sensory rehabilitation can differentially influence FPI and sham rats, having a lasting impact on behavioral and stress responses to the WNT, emphasizing the necessity for continued evaluation of modality and onset of rehabilitation after TBI.
随着康复策略作为治疗干预手段的不断发展,创伤性脑损伤(TBI)后康复的方式和开始时间对于优化治疗至关重要。我们的实验室已经检测并描述了弥漫性脑损伤大鼠对触须刺激的迟发性、长期感觉超敏反应;这种缺陷与后天性脑损伤人类的视觉或听觉感觉超敏反应相当。
我们假设康复治疗的方式和开始时间将对弥漫性脑损伤大鼠和假手术大鼠对触须骚扰任务(WNT)的感觉超敏反应以及WNT诱导的皮质酮(CORT)应激反应产生不同影响。
在进行中线流体冲击性脑损伤(FPI)或假手术后,将大鼠分配到四种康复干预措施之一:(1)在第一周或(2)第二周进行触须感觉剥夺,或(3)在第一周或(4)第二周进行触须刺激。在FPI和假手术程序后28天,使用WNT评估感觉超敏反应。在WNT(加剧水平)后立即以及在预定终点24小时前(非加剧水平)评估血浆CORT。
与第一周相比,第二周的剥夺疗法对WNT引起的感觉超敏反应明显更强(p<0.05),并且FPI大鼠中加剧的CORT水平明显低于假手术组。第一周的刺激疗法导致对WNT的感觉超敏反应水平较低,类似于剥夺疗法和未处理的对照组,然而,FPI大鼠中未加剧的CORT水平明显高于假手术组。
这些数据表明,感觉康复的方式和开始时间可以对FPI大鼠和假手术大鼠产生不同影响,对WNT的行为和应激反应产生持久影响,强调了持续评估TBI后康复方式和开始时间的必要性。