Effects of cervical spinal cord stimulation on cerebral blood flow in the rat
Effects of cervical spinal cord stimulation on cerebral blood flow in the rat
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DOI：
10.3171/spi.2000.93.1.0071
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发表时间：
2000-07-01
影响因子：
4.1
通讯作者：
Huang, DL
中科院分区：
文献类型：
--
作者：
Sagher, O;Huang, DL
Object.脊髓刺激（SCS）常用于治疗慢性疼痛。尽管SCS减轻疼痛的机制尚不清楚，但据信它们涉及脊髓背角内的变化。还发现脊髓刺激引起外周血管系统中的显著血管舒张。这种效应的机制被认为涉及交感神经阻滞。也描述了嘴侧血管扩张作用，但脑血流量（CBF）的变化描述不佳。采用激光多普勒血流仪（LDF），研究了颈部脊髓刺激对大鼠脑血流的影响。发现颈椎SCS导致皮质LDF值显著增加（83 +/- 11% [平均值+/-平均值的标准误]）。皮质LDF值的增加并不伴随着全身血压的显著增加。刺激上颈髓比刺激下颈髓更有效地诱导LDF的变化。SDS诱导的LDF值的变化在颈髓交界处脊髓横断后和交感神经阻滞剂六甲铵给药后显著减弱。这些结果表明，颈部脊髓刺激可能会引起脑血管舒张，这种影响可能涉及对脑干血管中枢的间接影响以及交感神经张力的改变。
Object. Spinal cord stimulation (SCS) is frequently used for the treatment of chronic pain. Although the mechanisms by which SCS alleviates pain are unclear, they are believed to involve changes within the dorsal horn of the spinal cord. Spinal cord stimulation has also been found to cause significant vasodilation in the peripheral vasculature. The mechanisms underlying this effect are thought to involve sympathetic blockade. A rostral vasodilatory effect has also bean described, but changes in cerebral blood flow (CBF) have been poorly delineated. Using laser Doppler flowmetry (LDF), the authors examined the effects of cervical SCS on CBF in rats.Methods. Cervical SCS was found to result in a significant increase in cortical LDF values (83 +/- 11% [mean +/- standard error of the mean]). The increase in cortical LDF values was not accompanied by a significant increase in systemic blood pressure. Stimulation of the upper cervical spinal cord was more effective in inducing LDF changes than was that of the lower cervical cord. Changes in SDS-induced LDF values were significantly attenuated after spinal cord transection at the cervicomedullary junction and by the administration of the sympathetic blocker hexamethonium.Conclusions. These results indicate that cervical SCS may induce cerebral vasodilation and that this effect may involve indirect effects on vasomotor centers in the brainstem as well as an alteration in sympathetic tone.