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  • 學位論文

脈衝電刺激調變於小鼠出血性中風模型的效能評估

Efficacy Study of Pulsed Stimulation on The Intracerebral Hemorrhage Mice Model

指導教授 : 林啟萬

摘要


現行對於中風治療多以藥物或手術來進行,若是缺血性中風是以取栓或溶栓,缺血性中風則是利用手術引流血塊來達到醫療的行為,但藥物或手術有其執行的黃金時期,若超過則治療效果大大降低,對於往後的治療方式就要依賴冗長且枯燥的復健行為了。 在文獻探討中,發現Transcranial Direct Current Stimulation (tDCS)在臨床上對於中風病患在復健過程中,有明顯的行為上治療效果;此外根據文獻探討,2Hz方波對於缺血性中風小鼠的凋亡細胞,具有明顯的抑制效果,因此我想探討2Hz方波是否在出血性中風上也具有類似的效果;另外,由我們實驗室開發的脈衝式射頻電刺激,目前應用於止痛治療,而利用脈衝式射頻電刺激來探討對於中風的療效,目前仍未有相關的研究。因此本實驗的電刺激參數有三種:2Hz方波、2Hz弦波與200KHz PRF,並進一步進行動物實驗,驗證這三組參數的有效性與可行性。 本實驗結果發現,在電刺激的第五天,單純執行出血性腦中風老鼠在Neurological Severity Scores的行為表現上,進步比例為20.66%,而200KHz PRF組別為30.8%,比例明顯較高,再利用one-way ANOVA統計方式,之間P值也都小於0.05;而200KHz PRF與2Hz方波間也有明顯的差異,這有兩種原因,第一,200KHz PRF在Neurological Severity Scores的行為評估中,確實有改善的效果;第二,相較於控制組,在2Hz方波的電刺激下,小鼠的行為有退步的情形。此外在切片染色的結果中,200KHz PRF組別在抑制星狀細胞上有明顯的效果,進而減少中風後的腦部發炎情形。綜上所述,證明200KHz PRF在出血中風後的Neurological Severity Scores行為表現上,具有改善效果,且有術後發炎反應的抑制效果。

並列摘要


Nowadays, there are two most used treatments for the acute patients, Drugs and Surgery. An ischemic stroke patients can go through thrombolysis and hemicraniectomy, and a intracerebral hemorrhage stroke can use surgery to relieve the brain pressure. However, there are a time window for the drug and surgery. If you miss the golden window, you will experience a long and boring rehabilitation. According to literatures, Transcranial Direct Current Stimulation (tDCS) has the clinical effect for the stroke patients during the rehabilitation process. And 2Hz square wave can decrease the apoptosis in the ischemic rats. Therefore, I want to study whether there will have the same effect for applying 2Hz square stimulation on the intracerebral hemorrhage rats. Besides, I will discuss the effect of pulsed-radiofrequency stimulation originated from my lab on the intracerebral hemorrhage rats cause of there are still no research talking about high frequency stimulations on stroke animal models. As a result, I will use three different stimulus parameters to verify their efficacy and feasibility. In line with the experiment results, 200KHz PRF group have better performance compared to the control groups in the Neurological Severity Scores tests(P < 0.05). 200KHz PRF group also have critically effects on suppressing astrocytes proliferation, then creating the anti-inflammatory response. In summary, it proves the efficacy of 200KHz PRF on the stroke mices’ behavior and suppressing the inflammatory cells.

參考文獻


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