Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto, SP, Brazil.
Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto, SP, Brazil.
Neuroscience. 2022 Apr 15;488:77-95. doi: 10.1016/j.neuroscience.2022.02.006. Epub 2022 Feb 12.
Hydrocephalus is characterized by the accumulation of CSF within the cerebral ventricles and the subarachnoid space. Ventricular volume can progressively increase and generate serious damage to the nervous system, with cerebral hypoxia/ischemia as one of the most important factors involved. Hyperbaric oxygen therapy (HBOT) improves oxygen supply to tissues, which can reduce the progression of lesions secondary to ventricular enlargement. We evaluated whether HBOT associated with CSF diversion can promote neuroprotective effects to structures damaged by ventriculomegaly and understand its role. Seven-day-old male Wistar Hannover rats submitted to hydrocephalus by intracisternal injection of 15% kaolin were used. The animals were divided into six groups, with ten animals in each: control, control associated with hyperbaric therapy, hydrocephalic without treatment, hydrocephalic treated with hyperbaric oxygen therapy, hydrocephalic treated with CSF deviation, and hydrocephalic treated with hyperbaric oxygen therapy associated with CSF deviation. To assess the response to treatment, behavioral tests were performed such as modified Morris water maze and object recognition, evaluation by transcranial ultrasonography, histology by Hematoxylin-Eosin and Luxol Fast Blue, immunohistochemistry for GFAP, Ki-67, Caspase-3, COX-2, NeuN and SOD1, and biochemical ELISA assay for GFAP and MBP. The results show that the association of treatments exerts neuroprotective effects such as neurobehavioral improvement, preservation of periventricular structures, antioxidant effect, and reduction of damage resulting from ischemia and the neuroinflammatory process. We conclude that HBOT has the potential to be used as an adjuvant treatment to CSF deviation surgery in experimental hydrocephalus.
脑积水的特征是脑脊液在脑室内和蛛网膜下腔积聚。脑室容积可逐渐增大，对神经系统造成严重损害，其中脑缺氧/缺血是最重要的因素之一。高压氧治疗（HBOT）可改善组织供氧，从而减少脑室扩大引起的病变进展。我们评估了 HBOT 联合脑脊液分流是否能促进对因脑室扩大而受损的结构的神经保护作用，并了解其作用机制。将 7 日龄雄性 Wistar 汉诺威大鼠通过脑室内注射 15%高岭土诱发脑积水。将动物分为六组，每组 10 只：对照组、高压治疗组、未治疗脑积水组、高压氧治疗组、脑脊液分流组和高压氧治疗联合脑脊液分流组。为了评估治疗反应，进行了行为学测试，如改良 Morris 水迷宫和物体识别测试，经颅超声评估，苏木精-伊红和卢索快速蓝染色组织学评估，GFAP、Ki-67、Caspase-3、COX-2、NeuN 和 SOD1 的免疫组织化学评估，以及 GFAP 和 MBP 的生化 ELISA 测定。结果表明，联合治疗具有神经保护作用，如神经行为改善、室周结构保留、抗氧化作用、减少缺血和神经炎症过程引起的损伤。我们得出结论，HBOT 有可能作为实验性脑积水患者脑脊液分流术的辅助治疗。
