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Transcranial magnetic stimulation facilitates neurorehabilitation after pediatric traumatic brain injury

机译:经颅磁刺激促进小儿脑外伤后的神经康复

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摘要

Traumatic brain injury (TBI) is the leading cause of death and disability among children in the United States. Affected children will often suffer from emotional, cognitive and neurological impairments throughout life. In the controlled cortical impact (CCI) animal model of pediatric TBI (postnatal day 16–17) it was demonstrated that injury results in abnormal neuronal hypoactivity in the non-injured primary somatosensory cortex (S1). It materializes that reshaping the abnormal post-injury neuronal activity may provide a suitable strategy to augment rehabilitation. We tested whether high-frequency, non-invasive transcranial magnetic stimulation (TMS) delivered twice a week over a four-week period can rescue the neuronal activity and improve the long-term functional neurophysiological and behavioral outcome in the pediatric CCI model. The results show that TBI rats subjected to TMS therapy showed significant increases in the evoked-fMRI cortical responses (189%), evoked synaptic activity (46%), evoked neuronal firing (200%) and increases expression of cellular markers of neuroplasticity in the non-injured S1 compared to TBI rats that did not receive therapy. Notably, these rats showed less hyperactivity in behavioral tests. These results implicate TMS as a promising approach for reversing the adverse neuronal mechanisms activated post-TBI. Importantly, this intervention could readily be translated to human studies.
机译:脑外伤(TBI)是美国儿童死亡和残疾的主要原因。患病的儿童终生往往会遭受情绪,认知和神经方面的损害。在儿童TBI(出生后第16-17天)的受控皮质撞击(CCI)动物模型中,研究表明,损伤会导致未受伤的原代体感皮层(S1)的神经元功能异常。它证实,重塑异常的损伤后神经元活动可能提供增强康复的合适策略。我们测试了在四个星期的时间内每周两次进行的高频无创经颅磁刺激(TMS)是否可以挽救神经元活动并改善小儿CCI模型的长期功能性神经生理和行为结果。结果显示,接受TMS治疗的TBI大鼠显示诱发的fMRI皮质反应显着增加(189%),诱发的突触活性(46%),诱发的神经元放电(200%)并增加了神经可塑性细胞标记物的表达与未接受治疗的TBI大鼠相比,未受伤的S1受伤。值得注意的是,这些大鼠在行为测试中显示出较少的活动过度。这些结果表明,TMS是逆转TBI后激活的不良神经元机制的有前途的方法。重要的是,这种干预很容易转化为人类研究。

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