CBF oscillations induced by trigeminal nerve stimulation protect the pericontusional penumbra in traumatic brain injury complicated by hemorrhagic shock.
CBF oscillations induced by trigeminal nerve stimulation protect the pericontusional penumbra in traumatic brain injury complicated by hemorrhagic shock.
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DOI：
10.1038/s41598-021-99234-8
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发表时间：
2021-10-04
影响因子：
4.6
通讯作者：
Narayan RK
中科院分区：
文献类型：
--
作者：
Li C;Shah KA;Powell K;Wu YC;Chaung W;Sonti AN;White TG;Doobay M;Yang WL;Wang P;Becker LB;Narayan RK
创伤性挫伤周围半暗带代表创伤性脑损伤（TBI）后治疗干预的关键目标。目前的复苏方法可能无法充分缓解受损的脑微循环，因此，损害了对挫伤周围区域的氧气输送。脑血流（CBF）的低频振荡可以改善缺氧环境下的脑氧合。然而，目前还没有报道诱导CBF可控振荡的方法，也没有将其作为一种治疗策略。电刺激三叉神经（TNS）在调节脑血管张力和脑灌注方面起着关键作用。我们假设TNS可以通过三叉神经-脑血管网络在目标频带调节CBF，并且TNS诱导的CBF振荡将改善挫伤周围区域的脑氧合。在大鼠创伤性脑损伤合并失血性休克模型中，TNS诱导的脑血流振荡显著保护了挫伤周围组织，导致损伤体积减小，缺氧损伤和神经炎症减轻，eNOS表达增加，神经功能恢复改善，10天生存率提高，尽管与立即和延迟复苏动物相比，脑血流没有显著增加。我们的研究结果表明，低频CBF振荡增强脑挫伤周围地区的脑氧合，并发挥更显着的保护作用比改善非振荡脑灌注或容量扩张单独。
Traumatic peri-contusional penumbra represents crucial targets for therapeutic interventions after traumatic brain injury (TBI). Current resuscitative approaches may not adequately alleviate impaired cerebral microcirculation and, hence, compromise oxygen delivery to peri-contusional areas. Low-frequency oscillations in cerebral blood flow (CBF) may improve cerebral oxygenation in the setting of oxygen deprivation. However, no method has been reported to induce controllable oscillations in CBF and it hasn’t been applied as a therapeutic strategy. Electrical stimulation of the trigeminal nerve (TNS) plays a pivotal role in modulating cerebrovascular tone and cerebral perfusion. We hypothesized that TNS can modulate CBF at the targeted frequency band via the trigemino-cerebrovascular network, and TNS-induced CBF oscillations would improve cerebral oxygenation in peri-contusional areas. In a rat model of TBI complicated by hemorrhagic shock, TNS-induced CBF oscillations conferred significant preservation of peri-contusional tissues leading to reduced lesion volume, attenuated hypoxic injury and neuroinflammation, increased eNOS expression, improved neurological recovery and better 10-day survival rate, despite not significantly increasing CBF as compared with those in immediate and delayed resuscitation animals. Our findings indicate that low-frequency CBF oscillations enhance cerebral oxygenation in peri-contusional areas, and play a more significant protective role than improvements in non-oscillatory cerebral perfusion or volume expansion alone.
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影响因子：
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