低频和高频重复经颅磁刺激对大鼠神经病理性疼痛及背根神经节内nNOS的影响

被引：4

作者：

郭铁成 ^{[1
]}

许惊飞 ^{[1
,2
]}

机构：

[1] 华中科技大学同济医学院附属同济医院康复科

[2] 四川大学华西医院康复医学科

来源：

中华物理医学与康复杂志 | 2014年 / 36卷 / 11期

关键词：

神经病理性疼痛; 重复经颅磁刺激; 疼痛测定; 痛阈; 一氧化氮合酶;

D O I：

暂无

中图分类号：

R402 [];

学科分类号：

摘要：

目的观察不同频率的重复经颅磁刺激(rTMS)治疗神经病理性疼痛的疗效,同时通过测定神经病理性疼痛大鼠背根神经节(DRG)内神经型一氧化氮合酶(nNOS)的表达,探讨rTMS治疗神经病理性疼痛的作用机制。方法共28只雄性SD大鼠,随机分为假手术组和手术组,假手术组7只大鼠仅暴露和游离坐骨神经,不予结扎;手术组21只大鼠经手术结扎坐骨神经制作神经病理性疼痛模型,造模成功后又随机分为假治疗组、低频rTMS组(1 Hz)、高频rTMS组(20 Hz),每组7只。术后第3天开始进行rTMS治疗,连续10 d,刺激疼痛对侧大脑初级运动皮质(M1)。治疗前及治疗10 d后,对大鼠疼痛行为学表现及DRG内nNOS表达进行测量比较。结果造模后第3天,手术组大鼠均出现明显的疼痛行为学表现,机械痛缩爪阈值较假手术组均明显降低(P<0.05)。rTMS治疗后,高频rTMS组机械痛缩爪阈值较假治疗组升高(P<0.05),而低频rTMS组无明显变化。与假手术组比较,假治疗组和低频rTMS组损伤侧DRG内nNOS阳性表达明显增加,J主要位于中、小细胞,少量表达于大细胞。与假治疗组比较,高频rTMS组DRG内nNOS阳性表达显著下调(P<0.05),而低频rTMS组无此改变。高频rTMS组大鼠疼痛改善程度与相应水平DRG内nNOS的表达呈负相关关系。结论外周神经损伤后引起的神经病理性疼痛伴有DRG内nNOS的表达增加;高频rTMS可以通过降低DRG内nNOS的表达而缓解疼痛,低频rTMS则无明显效果。

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