1 Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania.
2 Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Neurotrauma. 2019 May 15;36(10):1606-1614. doi: 10.1089/neu.2018.6212. Epub 2019 Jan 9.
The administration of haloperidol (HAL) once-daily for 19 days after experimental traumatic brain injury (TBI) impedes recovery and attenuates the efficacy of environmental enrichment (EE). However, it is unknown how intermittent administration of HAL affects the recovery process when paired with EE. Addressing the uncertainty is relevant because daily HAL is not always warranted to manage TBI-induced agitation in the clinic, and indeed intermittent therapy may be a more common approach. Hence, the aim of the study was to test the hypothesis that intermittent HAL would neither impair recovery in standard (STD)-housed controls nor attenuate the efficacy of EE. Anesthetized adult male rats received a cortical impact or sham injury and then were housed in STD or EE conditions. Beginning 24 h later, HAL (0.5 mg/kg; intraperitoneally [i.p.]) was administered either once-daily for 19 days or once every other day, whereas vehicle (VEH; 1 mL/kg; i.p.) was administered once daily. Motor performance and cognition were assessed on post-injury days 1-5 and 14-19, respectively. Cortical lesion volume was quantified on day 21. SHAM controls performed better than all TBI groups on motor and spatial learning [ < 0.05], but did not differ from the TBI + EE + daily VEH group on memory retention [ > 0.05]. The TBI + EE + daily VEH and TBI + EE + intermittent HAL groups did not differ from one another on beam-walk or spatial learning [ > 0.05], and both performed better than all other TBI groups [ < 0.05]. In contrast, the TBI + STD + daily HAL group performed worse than all TBI groups on spatial learning [ < 0.05]. No difference in any endpoint was revealed between the TBI + STD + intermittent HAL and TBI + STD + daily VEH groups [ > 0.05]. The results support the hypothesis that HAL is not detrimental when provided intermittently. If translatable to the clinic, intermittent HAL may be used to control TBI-induced agitation without negatively affecting spontaneous recovery or rehabilitative efficacy.
反复给予氟哌啶醇(HAL)治疗 19 天会阻碍创伤性脑损伤(TBI)后的恢复,并减弱环境富集(EE)的疗效。然而,当与 EE 联合使用时,间歇性给予 HAL 如何影响恢复过程尚不清楚。解决这一不确定性是相关的,因为在临床上并不总是需要每天给予 HAL 来治疗 TBI 引起的激越,事实上,间歇性治疗可能是一种更为常见的方法。因此,本研究的目的是检验以下假设,即间歇性给予 HAL 既不会损害标准(STD)饲养对照动物的恢复,也不会减弱 EE 的疗效。麻醉成年雄性大鼠接受皮质撞击或假损伤,然后分别在 STD 或 EE 条件下饲养。从 24 小时后开始,给予 HAL(0.5mg/kg;腹腔内[ip]),每日一次连续 19 天,或每隔一天一次,而给予 VE(1ml/kg;ip),每日一次。在受伤后第 1-5 天和第 14-19 天分别评估运动和认知表现。在第 21 天定量评估皮质损伤体积。SHAM 对照组在运动和空间学习方面的表现优于所有 TBI 组[<0.05],但在记忆保留方面与 TBI+EE+每日 VE 组无差异[>0.05]。TBI+EE+每日 VE 和 TBI+EE+间歇性 HAL 组在走棒和空间学习方面彼此之间没有差异[>0.05],且两者的表现均优于所有其他 TBI 组[<0.05]。相反,TBI+STD+每日 HAL 组在空间学习方面的表现比所有 TBI 组都差[<0.05]。TBI+STD+间歇性 HAL 和 TBI+STD+每日 VE 组在任何终点上均无差异[>0.05]。结果支持以下假设,即间歇性给予 HAL 并不有害。如果可转化为临床应用,间歇性给予 HAL 可能用于控制 TBI 引起的激越,而不会对自发恢复或康复疗效产生负面影响。