Microglia and Astrocytes Responses Contribute to Alleviating Inflammatory Damage by Repetitive Transcranial Magnetic Stimulation in Rats with Traumatic Brain Injury.

Repetitive transcranial magnetic stimulation (rTMS) is a therapeutic strategy that shows promise in ameliorating the clinical sequelae following traumatic brain injury (TBI). These improvements are associated with neuroplastic changes in neurons and their synaptic connections. However, it has been hypothesized that rTMS may also modulate microglia and astrocytes, potentially potentiating their neuroprotective capabilities. This study aims to investigate the effects of high-frequency rTMS on microglia and astrocytes that may contribute to its neuroprotective effects. Feeney's weight-dropping method was used to establish rat models of moderate TBI. To evaluate the neuroprotective effect of high frequency rTMS on rats by observing the synaptic ultrastructure and the level of neuron apoptosis. The levels of several important inflammation-related proteins within microglia and astrocytes were assessed through immunofluorescence staining and western blot. Our findings demonstrate that injured neurons can be rescued through the modulation of microglia and astrocytes by rTMS. This modulation plays a key role in preserving the synaptic ultrastructure and inhibiting neuronal apoptosis. Among microglia, we observed that rTMS inhibited the levels of proinflammatory factors (CD16, IL-6 and TNF-α) and promoted the levels of anti-inflammatory factors (CD206, IL-10 and TNF-ß). rTMS also reduced the levels of pyroptosis within microglia and pyroptosis-related proteins (NLRP3, Caspase-1, GSDMD, IL-1ß and IL-18). Moreover, rTMS downregulated P75NTR expression and up-regulated IL33 expression in astrocytes. These findings suggest that regulation of microglia and astrocytes is the mechanism through which rTMS attenuates neuronal inflammatory damage after moderate TBI.

Repetitive transcranial magnetic stimulation improves consciousness in some patients with disorders of consciousness.

OBJECTIVE: To investigate the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) in patients with disorders of consciousness. DESIGN AND SETTING: We performed a randomized, double-blinded, sham-controlled trial. PARTICIPANTS: Patients (N = 40) with disorders of consciousness. INTERVENTIONS: Forty patients with disorders of consciousness (time since onset of the disorder 49.0 ± 24.6 days) were enrolled and randomized to groups receiving either active-rTMS or sham-rTMS. The active-TMS protocol had a frequency of 20 Hz, was delivered over the left dorsolateral prefrontal cortex and had a 100% rest motor threshold. The sham-rTMS protocol was the same as the active protocol without magnetic stimulation over the cortex. MAIN OUTCOME MEASURES: Consciousness was evaluated by the Coma Recovery Scale-Revised (CRS-R) before and after the four-week intervention. The ratio of patients that awakened from disorders of consciousness was followed up at discharge. RESULTS: Before rTMS sessions, there were no significant differences in consciousness scores between groups. Compared to sham-rTMS (6.25 ± 1.29), patients with disorders of consciousness treated by active rTMS showed strikingly improved consciousness (8.45 ± 3.55). In-depth analysis revealed that only some patients showed obvious increases in consciousness scores induced by active rTMS. Furthermore, rTMS did not significantly enhance the awakening ratio. CONCLUSIONS: rTMS showed therapeutic efficacy for improving consciousness in some, but not all, patients with disorders of consciousness. It is essential to discern the potential patients whose consciousness can be improved by rTMS.

Antioxidant status of uric acid, bilirubin, albumin and creatinine during the acute phase after traumatic brain injury: sex-specific features.

BACKGROUND: It is known that the alteration of antioxidants can been seen in early phase after traumatic brain injury (TBI) in order to block oxidative damage, but little is known about the influence of sex on antioxidant system in patients with TBI. This study investigates whether there are sex differences in these endogenous antioxidant agents during the acute phase after TBI and their association with the disease. METHODS: Serum levels of uric acid (UA), bilirubin, albumin and creatinine were measured in 421 individuals included 157 female TBI patients, 156 male TBI patients and 108 age- and sex-matched controls. RESULTS: The statistically significant changes were found in UA, bilirubin, albumin and creatinine for both sexes with TBI, but the trend of changes in bilirubin and creatinine was opposite for gender groups. Serum levels of UA, bilirubin, albumin and creatinine were associated with the severity of TBI patients for both sexes. Male patient subgroups with elevated UA, albumin and creatinine had higher frequency of regaining consciousness in a month. Moreover, addition of UA and creatinine to the established clinical model had significantly improved the predictive performance over using clinical model alone in male patients with TBI. However, no similar findings were observed on female TBI patients. CONCLUSION: Our results suggest sex-based differences in the serum endogenous antioxidant response to TBI. Use of serum UA and creatinine could help in the outcome prediction of male patients with TBI in combination with other prognostic factors.

Repetitive transcranial magnetic stimulation promotes neurological functional recovery in rats with traumatic brain injury by upregulating synaptic plasticity-related proteins.

Studies have shown that repetitive transcranial magnetic stimulation (rTMS) can enhance synaptic plasticity and improve neurological dysfunction. However, the mechanism through which rTMS can improve moderate traumatic brain injury remains poorly understood. In this study, we established rat models of moderate traumatic brain injury using Feeney's weight-dropping method and treated them using rTMS. To help determine the mechanism of action, we measured levels of several important brain activity-related proteins and their mRNA. On the injured side of the brain, we found that rTMS increased the protein levels and mRNA expression of brain-derived neurotrophic factor, tropomyosin receptor kinase B, N-methyl-D-aspartic acid receptor 1, and phosphorylated cAMP response element binding protein, which are closely associated with the occurrence of long-term potentiation. rTMS also partially reversed the loss of synaptophysin after injury and promoted the remodeling of synaptic ultrastructure. These findings suggest that upregulation of synaptic plasticity-related protein expression is the mechanism through which rTMS promotes neurological function recovery after moderate traumatic brain injury.

Simultaneously stimulating both brain hemispheres by rTMS in patients with unilateral brain lesions decreases interhemispheric asymmetry.

BACKGROUND: Interhemispheric asymmetry caused by brain lesions is an adverse factor in the recovery of patients with neurological deficits. Repetitive transcranial magnetic stimulation (rTMS) has been shown to modulate cortical oscillation and proposed as an approach to rebalance the symmetry, which has not been documented well. OBJECTIVE: In this study, we investigated the influence of repetitive transcranial magnetic stimulation (rTMS) on EEG power in patients with unilateral brain lesions by simultaneously stimulating both brain hemispheres and to elucidate asymmetrical changes in rTMS-induced neurophysiological activity. METHODS: Fourteen patients with unilateral brain lesions were treated with one active and one sham session of 10 Hz rTMS over the vertex (Cz position). Resting-state EEGs were recorded before and immediately after rTMS. The brain symmetry index (BSI), calculated from a fast Fourier transform, was employed to quantify the power asymmetry in both hemispheres and paired channels over the entire range and five frequency bands (delta, theta, alpha, beta and gamma bands). RESULTS: Comparison between active and sham sessions demonstrated rTMS-induced EEG after-effects. rTMS in the active session significantly reduced the BSI in patients with unilateral brain lesions over the entire frequency range (t = 2.767, P = 0.016). Among the five frequency bands, rTMS only induced a noticeable decrease in the BSI in the delta band (t = 2.254, P = 0.042). Furthermore, analysis of different brain regions showed that significant changes in the BSI of the alpha band were only demonstrated in the posterior parietal lobe. In addition, EEG topographic mapping showed a decreased power of delta oscillations in the ipsilesional hemisphere, whereas distinct cortical oscillations were observed in the alpha band around the parietal-occipital lobe in the contralesional hemisphere. CONCLUSIONS: When both brain hemispheres were simultaneously activated, rTMS decreased interhemispheric asymmetry primarily via reducing the delta band in the lesioned hemisphere.

Differentiating Responders and Non-responders to rTMS Treatment for Disorder of Consciousness Using EEG After-Effects.

Background: It is controversial whether repetitive transcranial magnetic stimulation (rTMS) has potential benefits in improving the awareness of patients with disorder of consciousness (DOC). We hypothesized that rTMS could improve consciousness only in DOC patients who have measurable brain responses to rTMS. Objective: In this study, we aimed to investigate the EEG after-effects induced by rTMS in DOC patients and attempted to propose a prediction algorithm to discriminate between DOC patients who would respond to rTMS treatment from those who would not. Methods: Twenty-five DOC patients were enrolled in this study. Over 4 weeks, each patient received 20 sessions of 20 Hz rTMS that was applied over the left dorsolateral prefrontal cortex (DLPFC). For each patient, resting-state EEG was recorded before and immediately after one session of rTMS to assess the neurophysiologic modification induced by rTMS. The coma recovery scale revised (CRS-R) was used to define responders with improved consciousness. Results: Of the 25 DOC patients, 10 patients regained improved consciousness and were classified as responders. The responders were characterized by more preserved alpha power and a significant reduction of delta power induced by rTMS. The analysis of receiver operating characteristic (ROC) curves showed that the algorithm calculated from the relative alpha power and the relative delta power had a high accuracy in identifying DOC patients who were responders. Conclusions: DOC patients who had more preserved alpha power and a significant reduction in the delta band that was induced by rTMS are likely to regain improved consciousness, which provides a tool to identify DOC patients who may benefit in terms of therapeutic consciousness.

Oxycodone versus dezocine for postoperative analgesia in patients with cervical cancer treated with radical surgery.

OBJECTIVE: The aim of this study was to evaluate oxycodone versus dezocine for postoperative analgesia in patients with cervical cancer treated with radical surgery. MATERIALS AND METHODS: Fifty-one cases of cervical cancer treated with radical surgery were included in the present study and divided into oxycodone group (n = 26) and dezocine group (n = 25). Patients in the oxycodone group were given with oxycodone 1 mg/kg plus tropisetron 0.1 mg/kg diluting to 100 ml by 0.9% saline for patient-controlled intravenous analgesia (PCIA) after surgery. Moreover, patients in the dezocine group were given with dezocine 0.6 mg/kg plus tropisetron 0.1 mg/kg diluting to 100 ml by 0.9% saline for PCIA after surgery. The visual analog scale (VAS) and Ramsay sedation score of the two groups were recorded in the time point of 4, 8, 12, 24, and 48 h after surgery. The adverse event-related drugs were recorded and compared between the two groups. RESULTS: The VAS score was significantly lower in oxycodone group compared to dezocine group in the time point of 4, 8, 12, 24, and 48 h (Pall < 0.05). The Ramsay score at time point of 4, 8, 12, 24 h, and 48 h were obviously higher in oxycodone group than those in dezocine group (P < 0.05) which indicated that the sedative effect in oxycodone group was superior to dezocine. For oxycodone group, there were six cases (23.08%) with nausea and one case (3.85) with vomiting in the treatment procedure. Moreover, for dezocine group, there were one case (4.00%) with nausea, two cases (8.00%) with vomiting, and two cases (8.00%) with dizzy in the treatment procedure. There was no statistical difference of adverse event risk between the two groups (P > 0.05). CONCLUSION: Oxycodone postoperative analgesia is superior to dezocine for patients with cervical cancer treated with radical surgery.

Effects of infrasound on the growth of bone marrow mesenchymal stem cells: a pilot study.

Poor viability of transplanted bone marrow mesenchymal stem cells (BMSCs) is well­known, but developing methods for enhancing the viability of BMSCs requires further investigation. The aim of the present study was to elucidate the effects of infrasound on the proliferation and apoptosis of BMSCs, and to determine the association between survivin expression levels and infrasound on BMSCs. Primary BMSCs were derived from Sprague Dawley rats. The BMSCs, used at passage three, were divided into groups that received infrasound for 10, 30, 60, 90 or 120 min, and control groups, which were exposed to the air for the same durations. Infrasound was found to promote proliferation and inhibit apoptosis in BMSCs. The results indicated that 60 min was the most suitable duration for applied infrasound treatment to BMSCs. The protein and mRNA expression levels of survivin in BMSCs from the two treatment groups that received 60 min infrasound or air, were examined by immunofluorescence and quantitative polymerase chain reaction. Significant differences in survivin expression levels were identified between the two groups, as infrasound enhanced the expression levels of survivin. In conclusion, infrasound promoted proliferation and inhibited apoptosis in BMSCs, and one mechanisms responsible for the protective effects may be the increased expression levels of survivin.

[Effects of dissolved organic matter on napropamide adsorption and transport in soil system].

Dissolved organic matter (DOM) can affect the environmental behaviors of herbicides in soil. Batch adsorption and column experiments were conducted to measure the sorption and leaching of napropamide in soils in the presence of DOM derived from green manure (GM) and sewage sludge (SS). DOM reduced sorption of napropamide significantly onto the tested soils, consequently which facilitated the transport of napropamide exhibited by soil column experiment. The sorption inhibition and the increased mobility of napropamide caused by DOM of GM origin were more significant than that of SS origin for the same soil. Within the selected concentration range of the napropamide and DOM in this study napropamide sorption isotherm could be described well by the Freundlich equation. In comparison with the control, DOM of GM and SS origins could reduce napropamide adsorption by 22.9% and 11.3% in the yellow-brown soil and 9.5% and 6.5% in the calcareous soil, respectively. Correspondingly, in the presence of DOM the leaching losses of napropamide in soil column increased by 73.42% and 26.87% in the yellow-brown soil and 43.54% and 28.29% in the calcareous soil, respectively.