Dai Yong, Hu Jiahui, Wang Qianqian, Qiao Jia, Tian Yueqin, Li Chao, Chen Jiemei, Zhao Fei, Li Xinya, Liu Chunyan, Pan Ruihuan, Ou Haining, Xu Nenggui, Wen Hongmei, Dou Zulin, Ye Qiuping
Department of Rehabilitation Medicine, Third Affiliated Hospital of sun Yat-Sen University, Guangzhou, China.
Department of Rehabilitation Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
CNS Neurosci Ther. 2025 Jul;31(7):e70514. doi: 10.1111/cns.70514.
BACKGROUND: Electroacupuncture (EA) has been reported to improve post-stroke dysphagia (PSD) effectively. However, the underlying afferent neural circuit and neurological mechanism involved in improving PSD remain poorly understood. METHODS: A PSD mouse model was established via the photochemical embolization method. Laser scatter contrast imaging was used to evaluate blood perfusion. Videofluoroscopic swallowing study, flexible endoscopic evaluation swallowing, and electromyography were used to assess the swallowing function. Neuronal activities and neuron types were detected by immunofluorescence. Synaptic connections between the nucleus tractus solitarii (NTS), the ventral posteromedial thalamic nucleus (VPM), and the primary sensory cortex (S1) were verified by neural tracing. Finally, photogenetic, chemogenetic, and in vivo electromyography or electrophysiological records were used to explore the possible afferent neural circuits of EA therapy for PSD. RESULTS: EA treatment potentiated the blood perfusion of CV23 and S1, improved the area under the curve, pharyngeal transit time, and vocal fold mobility in PSD model mice. EA also activated neuronal activities in VPM, while chemical genetic inhibition of VPM attenuated the swallowing function of EA enhanced in PSD mice. Neural tracing revealed the presence of direct synaptic connections in the neural circuit of NTS-VPM-S1, and excitatory neurons were the predominant type of synaptic projection. Activation of this circuit improved the swallowing function in PSD mice, whereas its inhibition impaired the swallowing function; this effect was reversible by EA-CV23. CONCLUSION: Our findings uncover the importance of sensory afferent neural circuits NTS-VPM-S1 in driving the protective effect of EA-CV23 against dysphagia and thus reveal a potential strategy for PSD intervention.
背景:据报道,电针(EA)可有效改善脑卒中后吞咽困难(PSD)。然而,改善PSD所涉及的潜在传入神经回路和神经机制仍知之甚少。 方法:通过光化学栓塞法建立PSD小鼠模型。采用激光散斑对比成像评估血液灌注。采用电视荧光吞咽造影研究、软性内镜吞咽功能评估和肌电图评估吞咽功能。通过免疫荧光检测神经元活动和神经元类型。通过神经示踪验证孤束核(NTS)、丘脑腹后内侧核(VPM)和初级感觉皮层(S1)之间的突触连接。最后,采用光遗传学、化学遗传学以及体内肌电图或电生理记录来探索EA治疗PSD的可能传入神经回路。 结果:EA治疗增强了CV23和S1的血液灌注,改善了PSD模型小鼠的曲线下面积、咽部通过时间和声门运动。EA还激活了VPM中的神经元活动,而对VPM进行化学遗传学抑制则减弱了PSD小鼠中EA增强的吞咽功能。神经示踪显示在NTS-VPM-S1神经回路中存在直接突触连接,且兴奋性神经元是突触投射的主要类型。激活该回路可改善PSD小鼠的吞咽功能,而抑制该回路则会损害吞咽功能;EA-CV23可逆转这种效应。 结论:我们的研究结果揭示了感觉传入神经回路NTS-VPM-S1在驱动EA-CV23对吞咽困难的保护作用中的重要性,从而揭示了一种PSD干预的潜在策略。
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