Yu Jie, Li Yunshan, Yang Lu, Li Yi, Zhang Shibin, Yang Shengbo
Department of Anatomy, Zunyi Medical University, Zunyi, China.
Department of Clinical Medicine, Zunyi Medical University, Zunyi, China.
Front Neurol. 2023 Feb 23;14:1061849. doi: 10.3389/fneur.2023.1061849. eCollection 2023.
The effective relief of muscle spasticity requires prompt solutions in rehabilitation medicine. This study aimed to reveal that the highest region of muscle spindle abundance is the optimal target of botulinum toxin A (BTX-A) injections for relieve muscle spasm.
Sixty adult, male Sprague-Dawley rats with lower limbs spasm caused by stroke after modeling, weighing (200 ± 20) g, were included in this study. The modelrats were divided into four groups: muscle spasm model group (group A), model rats treated with BTX-A injections into the middle of the muscle belly (group B), model rats treated with BTX-A injections into the center of the intramuscular nerve-dense region (INDR) (group C), and model rats treated with BTX-A injection into the center of the highest region of muscle spindle abundance (HRMSA) (group D). Groups B, C, and D were further divided into two subgroups: the 3rd and 6th days after BTX-A injection. The rats in each group were assigned modified Ashworth scale scores (MAS), and the changes in gastrocnemius muscle tone, wet muscle weight, and cross-sectional area of muscle fiber were detected.
Muscle spindle abundance was the highest in the upper part of the INDR. Group B experienced no significant changes in MAS, muscle tone, wet muscle weight, or cross-sectional area of the muscle fiber. Conversely, groups C and D experienced a decrease in these indicators. Group C experienced the most significant decrease in wet muscle weight and cross-sectional area of muscle fibers. Group D experienced the most notable decrease in MAS and muscle tone. There were no significant differences in the indicators between the 3rd and 6th days after BTX-A injections in group B and there were significant differences in the improvement in the indicators between the two subgroups in groups C and D, with group D experiencing more notable intersubgroup differences.
The efficacy of BTX-A injections into the HRMSA is significantly superior to that of conventional BTX-A injections into the middle of the belly muscle or the INDR in the treatment of muscle spasms. Hence, HRMSA should be the optimal target of BTX-A to relieve muscle spasms.
在康复医学中,有效缓解肌肉痉挛需要迅速找到解决方案。本研究旨在揭示肌梭丰度最高的区域是肉毒杆菌毒素A(BTX - A)注射以缓解肌肉痉挛的最佳靶点。
本研究纳入60只成年雄性Sprague - Dawley大鼠,建模后出现下肢痉挛,体重(200±20)g。将模型大鼠分为四组:肌肉痉挛模型组(A组)、在肌腹中部注射BTX - A的模型大鼠(B组)、在肌内神经密集区(INDR)中心注射BTX - A的模型大鼠(C组)、在肌梭丰度最高区域(HRMSA)中心注射BTX - A的模型大鼠(D组)。B、C、D组进一步分为两个亚组:BTX - A注射后第3天和第6天。对每组大鼠进行改良Ashworth量表评分(MAS),并检测腓肠肌肌张力、湿肌肉重量和肌纤维横截面积的变化。
INDR上部的肌梭丰度最高。B组的MAS、肌张力、湿肌肉重量或肌纤维横截面积无显著变化。相反,C组和D组的这些指标有所下降。C组的湿肌肉重量和肌纤维横截面积下降最为显著。D组的MAS和肌张力下降最为明显。B组在BTX - A注射后第3天和第6天的指标无显著差异,C组和D组的两个亚组在指标改善方面存在显著差异,D组的亚组间差异更明显。
在治疗肌肉痉挛方面,在HRMSA注射BTX - A的疗效明显优于在腹肌中部或INDR进行传统BTX - A注射的疗效。因此,HRMSA应是BTX - A缓解肌肉痉挛的最佳靶点。