Acute intermittent hypoxia boosts spinal plasticity in humans with tetraplegia.
Acute intermittent hypoxia boosts spinal plasticity in humans with tetraplegia.
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DOI：
10.1016/j.expneurol.2020.113483
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发表时间：
2021-01
影响因子：
5.3
通讯作者：
Perez, Monica A.
中科院分区：
文献类型：
--
作者：
Christiansen, Lasse;Chen, Bing;Lei, Yuming;Urbin, M. A.;Richardson, Michael S. A.;Oudega, Martin;Sandhu, Milap;Rymer, W. Zev;Trumbower, Randy D.;Mitchell, Gordon S.;Perez, Monica A.
成对皮质脊髓运动神经元刺激（PCMS）增强慢性脊髓损伤（SCI）患者的脊髓突触可塑性。在这里，我们研究了PCMS诱导的可塑性是否可以通过急性间歇性缺氧（AIH）来增强，这种治疗也被认为可以诱导慢性不完全性颈脊髓损伤患者的脊髓突触可塑性。在PCMS过程中，我们使用了180对刺激，其中通过经颅磁刺激诱发的皮质脊髓齐射超过初级运动皮层的手代表定时到达第一背侧骨间（FDI）肌肉的皮质脊髓-运动神经元突触~1-2 ms之前，通过电刺激尺神经在运动神经元中引起逆行电位。在AIH期间，参与者暴露于短暂的低氧吸入气体（9%O2 1分钟）和室内空气（20.9%O2 1分钟）交替发作。我们通过测量皮质和皮质下刺激皮质脊髓轴突引起的运动诱发电位（MEP）和FDI肌肉的自主运动输出，在PCMS联合AIH（PCMS+AIH）或假AIH（PCMS+sham-AIH）30分钟之前和之后检测皮质脊髓功能。磁刺激和电刺激诱发的MEP的幅度在两种方案后均增加，但大多数在PCMS+AIH后增加，这与它们的联合作用来自脊髓可塑性的假设一致。两种方案增加了肌电活动在FDI肌肉到类似的程度。因此，AIH可以增强PCMS在手运动神经元脊髓突触上的作用。在组合治疗期间，需要考虑生理与行为增益的不同阈值的可能性。
Paired corticospinal-motoneuronal stimulation (PCMS) elicits spinal synaptic plasticity in humans with chronic spinal cord injury (SCI). Here, we examined whether PCMS-induced plasticity could be potentiated by acute intermittent hypoxia (AIH), a treatment also known to induce spinal synaptic plasticity in humans with chronic incomplete cervical SCI. During PCMS, we used 180 pairs of stimuli where corticospinal volleys evoked by transcranial magnetic stimulation over the hand representation of the primary motor cortex were timed to arrive at corticospinal-motoneuronal synapses of the first dorsal interosseous (FDI) muscle ~1–2 ms before antidromic potentials were elicited in motoneurons by electrical stimulation of the ulnar nerve. During AIH, participants were exposed to brief alternating episodes of hypoxic inspired gas (1 min episodes of 9% O2) and room air (1 min episodes of 20.9% O2). We examined corticospinal function by measuring motor evoked potentials (MEPs) elicited by cortical and subcortical stimulation of corticospinal axons and voluntary motor output in the FDI muscle before and after 30 min of PCMS combined with AIH (PCMS+AIH) or sham AIH (PCMS+sham-AIH). The amplitude of MEPs evoked by magnetic and electrical stimulation increased after both protocols, but most after PCMS+AIH, consistent with the hypothesis that their combined effects arise from spinal plasticity. Both protocols increased electromyographic activity in the FDI muscle to a similar extent. Thus, PCMS effects on spinal synapses of hand motoneurons can be potentiated by AIH. The possibility of different thresholds for physiological vs behavioral gains needs to be considered during combinatorial treatments.
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影响因子：
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