Tremblay L E, Bedard P J
Physiotherapy Programme, University of Ottawa, Ontario, Canada.
J Spinal Cord Med. 1995 Jan;18(1):42-6. doi: 10.1080/10790268.1995.11719379.
We investigated the influence of four substances on the excitability of lumbar motoneurons. These substances, three of which coexist in the same bulbospinal descending pathways that end, for the most part, around motoneurons (MNS), are: 5-hydroxytryptamine (5-HT), substance P (SP) and thyrotropin-releasing hormone (TRH). We also studied the effects of clonidine, an alpha 2 noradrenergic (NA) agonist. This study was carried out in rats spinalized at T5 and treated three weeks earlier with 5-7 dihydroxytryptamine (5-7 DHT). Under these conditions, the following responses were observed: 5-HTP (5-HT precursor) intraperitoneally (I.P.), 5-HT intrathecally (I.T.), TRH (I.P. or I.T.) and substance P (I.T.) all elicited strong excitation of MNS as measured by integrated EMG of the hindlimb muscles; substance P reduced by almost half the response to 5-HTP given one hour and 24 hours later; TRH given acutely did not modify the response to 5-HTP, but given chronically for 21 days markedly increased the response to this substance. Clonidine by itself decreased the excitability of MNS and antagonized the excitatory effects of 5-HTP and TRH. In two separate pilot trials, cyproheptadine, a 5-HTP antagonist, decreased the manifestations of spasticity in a patient with a partial spinal lesion. It would appear that clonidine may have potential use in the management of spasticity.
我们研究了四种物质对腰段运动神经元兴奋性的影响。这四种物质中,有三种共存于同一延髓脊髓下行通路中,该通路大部分终止于运动神经元(MNS)周围,它们分别是:5-羟色胺(5-HT)、P物质(SP)和促甲状腺激素释放激素(TRH)。我们还研究了α2肾上腺素能(NA)激动剂可乐定的作用。本研究在T5脊髓横断且三周前用5,7-二羟色胺(5,7-DHT)处理的大鼠中进行。在这些条件下,观察到以下反应:腹膜内(I.P.)注射5-羟色氨酸(5-HTP,5-HT的前体)、鞘内(I.T.)注射5-HT、腹膜内或鞘内注射TRH以及鞘内注射P物质,通过后肢肌肉的肌电图积分测量,均引起MNS强烈兴奋;P物质使1小时和24小时后给予的5-HTP的反应降低了近一半;急性给予TRH不改变对5-HTP的反应,但慢性给予21天则显著增加对该物质的反应。可乐定本身降低MNS的兴奋性,并拮抗5-HTP和TRH的兴奋作用。在两项独立的预试验中,5-HTP拮抗剂赛庚啶减轻了一名部分脊髓损伤患者的痉挛表现。看来可乐定在痉挛的治疗中可能有潜在用途。