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The Effects of Superior Cervical Sympathetic Ganglion Block on the Acute Phase Injury and Long Term Protection against Focal Cerebral Ischemia/Reperfusion Injury in Rats

백서의 국소 뇌허혈/재관류로 인한 신경손상에서 상경부 교감 신경절 블록의 급성기 및 장기 보호효과

  • Jeon, Hae Young (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine) ;
  • Joung, Kyoung Woon (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine) ;
  • Choi, Jae Moon (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine) ;
  • Kim, Yoo Kyung (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine) ;
  • Shin, Jin Woo (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine) ;
  • Leem, Jeong Gill (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine) ;
  • Han, Sung Min (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine)
  • 전혜영 (울산대학교 의과대학 마취통증의학교실) ;
  • 정경운 (울산대학교 의과대학 마취통증의학교실) ;
  • 최재문 (울산대학교 의과대학 마취통증의학교실) ;
  • 김유경 (울산대학교 의과대학 마취통증의학교실) ;
  • 신진우 (울산대학교 의과대학 마취통증의학교실) ;
  • 임정길 (울산대학교 의과대학 마취통증의학교실) ;
  • 한성민 (울산대학교 의과대학 마취통증의학교실)
  • Received : 2008.06.17
  • Accepted : 2008.07.15
  • Published : 2008.08.30

Abstract

Background: Cerebral blood vessels are innervated by sympathetic nerves from the superior cervical ganglia (SCG), and these nerves may influence the cerebral blood flow. The purpose of the present study was to evaluate the neuroprotective effect of superior cervical sympathetic ganglion block in rats that were subjected to focal cerebral ischemia/reperfusion injury. Methods: Eighty male Sprague-Dawley rats (270-320 g) were randomly assigned to one of two groups (the ropivacaine group and a control group). In all the animals, brain injury was induced by middle cerebral artery (MCA) reperfusion that followed MCA occlusion for 2 hours. The animals of the ropivacaine group received $30{\mu}l$ of 0.75% ropivacaine, and their SCG. Neurologic score was assessed at 1, 3, 7 and 14 days after brain injury. Brain tissue samples were then collected. The infarct ratio was measured by 2.3.5-triphenyltetrazolium chloride staining. The terminal deoxynucleotidyl transferase mediated dUTP-biotin nick-end labeled (TUNEL) reactive cells and the cells showing caspase-3 activity were counted as markers of apoptosis at the caudoputamen and frontoparietal cortex. Results: The death rate, the neurologic score and the infarction ratio were significantly less in the ropivacaine group 24 hr after ischemia/reperfusion injury. The number of TUNEL positive cells in the ropivacaine group was significantly lower than those values of the control group in the frontoparietal cortex at 3 days after injury, but the caspase-3 activity was higher in the ropivacaine group than that in the control group at 1 day after injury. Conclusions: The study data indicated that a superior cervical sympathetic ganglion block may reduce the neuronal injury caused by focal cerebral ischemia/reperfusion, but it may not prevent the delayed damage.

Keywords

References

  1. Schatlo B, Pluta RM: Clinical applications of transcranial Doppler sonography. Rev Recent Clin Trials 2007; 2: 49-57 https://doi.org/10.2174/157488707779318125
  2. Morrish W, Grahovac S, Douen A, Cheung G, Hu W, Farb R, et al: Intracranial hemorrhage after stenting and angioplasty of extracranial carotid stenosis. AJNR Am J Neuroradiol 2000; 21: 1911-6
  3. Michel P: Introduction to stroke and its management. Cerebrovasc Dis 2003; 15(Suppl 2): 1-10
  4. Rami A, Agarwal R, Spahn A: Synergetic effects of caspase 3 and mu-calpain in XIAP-breakdown upon focal cerebral ischemia. Neurochem Res 2007; 32: 2072-9 https://doi.org/10.1007/s11064-007-9361-6
  5. Lukic-Panin V, Kamiya T, Zhang H, Hayashi T, Tsuchiya A, Sehara Y, et al: Prevention of neuronal damage by calcium channel blockers with antioxidative effects after transient focal ischemia in rats. Brain Res 2007; 1176: 143-50 https://doi.org/10.1016/j.brainres.2007.07.038
  6. Amantea D, Spagnuolo P, Bari M, Fezza F, Mazzei C, Tassorelli C, et al: Modulation of the endocannabinoid system by focal brain ischemia in the rat is involved in neuroprotection afforded by 17beta-estradiol. FEBS J 2007; 274: 4464-775 https://doi.org/10.1111/j.1742-4658.2007.05975.x
  7. Paulson OB, Strandgaard S, Edvinsson L: Cerebral autoregulation. Cerebrovasc Brain Metab Rev 1990; 2: 161-92
  8. Treggiari MM, Romand JA, Martin JB, Reverdin A, Rüfenacht DA, de Tribolet N: Cervical sympathetic block to reverse delayed ischemic neurological deficits after aneurysmal subarachnoid hemorrhage. Stroke 2003; 34: 961-7 https://doi.org/10.1161/01.STR.0000060893.72098.80
  9. Goyagi T, Kimura T, Nishikawa T, Tobe Y, Masaki Y: Beta-adrenoreceptor antagonists attenuate brain injury after transient focal ischemia in rats. Anesth Analg 2006; 103: 658-63 https://doi.org/10.1213/01.ane.0000228859.95126.69
  10. Culmsee C, Junker V, Kremers W, Thal S, Plesnila N, Krieglstein J: Combination therapy in ischemic stroke: synergistic neuroprotective effects of memantine and clenbuterol. Stroke 2004; 35: 1197-202 https://doi.org/10.1161/01.STR.0000125855.17686.6d
  11. Antier D, Franconi F, Sannajust F: Idazoxan does not prevent but worsens focal hypoxic-ischemic brain damage in neonatal Wistar rats. J Neurosci Res 1999; 58: 690-6 https://doi.org/10.1002/(SICI)1097-4547(19991201)58:5<690::AID-JNR10>3.0.CO;2-L
  12. Harrell LE, Parsons DS, Kolasa K: Pro- and anti-apoptotic evidence for cholinergic denervation and hippocampal sympathetic ingrowth in rat dorsal hippocampus. Exp Neurol 2005; 194: 182-90 https://doi.org/10.1016/j.expneurol.2005.02.009
  13. Dormer KJ, Foreman RD, Ohata CA: Fastigial nucleus stimulation and excitatory spinal sympathetic activity in dog. Am J Physiol 1982; 243: R25-33
  14. Golanov EV, Zhou P: Neurogenic neuroprotection. Cell Mol Neurobiol 2003; 23: 651-63 https://doi.org/10.1023/A:1025088516742
  15. Tuor UI: Local distribution of the effects of sympathetic stimulation on cerebral blood flow in the rat. Brain Res 1990; 529: 224-31 https://doi.org/10.1016/0006-8993(90)90831-U
  16. Cassaglia PA, Griffiths RI, Walker AM: Sympathetic nerve activity in the superior cervical ganglia increases in response to imposed increases in arterial pressure. Am J Physiol Regul Integr Comp Physiol 2008; 294: R1255-61 https://doi.org/10.1152/ajpregu.00332.2007
  17. Kim HH, Leem JG, Shin JW, Shim JY, Lee DM: Superior cervical sympathetic ganglion block may not influence early brain damage induced by permanent focal cerebral ischemia in rats. Korean J Pain 2008; 21: 33-7 https://doi.org/10.3344/kjp.2008.21.1.33
  18. Lee AR, Yoon MO, Kim HH, Choi JM, Jeon HY, Shin JW, et al: Effect of superior cervical sympathetic ganglion block on brain injury induced by focal cerebral ischemia/ reperfusion in a rat model. Korean J Pain 2007; 20: 83-91 https://doi.org/10.3344/kjp.2007.20.2.83
  19. Bederson JB, Pitts LH, Tsuji M, Nishimura MC, Davis RL, Bartkowski H: Rat middle cerebral artery occlusion: evaluation of the model and development of a neurologic examination. Stroke 1986; 17: 472-6 https://doi.org/10.1161/01.STR.17.3.472
  20. Arbab MA, Wiklund L, Svendgaard NA: Origin and distribution of cerebral vascular innervation from superior cervical, trigeminal and spinal ganglia investigated with retrograde and anterograde WGA-HRP tracing in the rat. Neuroscience 1986; 19: 695-708 https://doi.org/10.1016/0306-4522(86)90293-9
  21. Edvinsson L, Nielsen KC, Owman C, West KA: Evidence of vasoconstrictor sympathetic nerves in brain vessels of mice. Neurology 1973; 23: 73-7 https://doi.org/10.1212/WNL.23.1.73
  22. Hamel E: Perivascular nerves and the regulation of cerebrovascular tone. J Appl Physiol 2006; 100: 1059-64 https://doi.org/10.1152/japplphysiol.00954.2005
  23. Gupta MM, Bithal PK, Dash HH, Chaturvedi A, Mahajan RP: Effects of stellate ganglion block on cerebral haemodynamics as assessed by transcranial Doppler ultrasonography. Br J Anaesth 2005; 95: 669-73 https://doi.org/10.1093/bja/aei230
  24. Umeyama T, Kugimiya T, Ogawa T, Kandori Y, Ishizuka A, Hanaoka K: Changes in cerebral blood flow estimated after stellate ganglion block by single photon emission computed tomography. J Auton Nerv Syst 1995; 50: 339-46 https://doi.org/10.1016/0165-1838(94)00105-S
  25. Gotoh F, Fukuuchi Y, Amano T, Tanaka K, Uematsu D, Suzuki N, et al: Comparison between pial and intraparenchymal vascular responses to cervical sympathetic stimulation in cats. Part 1. Under normal resting conditions. J Cereb Blood Flow Metab 1986; 6: 342-7 https://doi.org/10.1038/jcbfm.1986.58
  26. Yokoyama K, Kishida T, Sugiyama K: Stellate ganglion block and regional cerebral blood volume and oxygenation. Can J Anaesth 2004; 51: 515-6 https://doi.org/10.1007/BF03018319
  27. Zhang R, Levine BD: Autonomic ganglionic blockade does not prevent reduction in cerebral blood flow velocity during orthostasis in humans. Stroke 2007; 38: 1238-44 https://doi.org/10.1161/01.STR.0000260095.94175.d0
  28. Reis DJ, Golanov EV, Galea E, Feinstein DL: Central neurogenic neuroprotection: central neural systems that protect the brain from hypoxia and ischemia. Ann N Y Acad Sci 1997; 835: 168-86 https://doi.org/10.1111/j.1749-6632.1997.tb48628.x
  29. Wei L, Ying DJ, Cui L, Langsdorf J, Yu SP: Necrosis, apoptosis and hybrid death in the cortex and thalamus after barrel cortex ischemia in rats. Brain Res 2004; 1022: 54-61 https://doi.org/10.1016/j.brainres.2004.06.080
  30. White BC, Sullivan JM, DeGracia DJ, O'Neil BJ, Neumar RW, Grossman LI, et al: Brain ischemia and reperfusion: molecular mechanisms of neuronal injury. J Neurol Sci 2000; 179: 1-33 https://doi.org/10.1016/S0022-510X(00)00386-5
  31. Piantadosi CA, Zhang J: Mitochondrial generation of reactive oxygen species after brain ischemia in the rat. Stroke 1996; 27: 327-31 https://doi.org/10.1161/01.STR.27.2.327
  32. Okada Y, Copeland BR, Fitridge R, Koziol JA, del Zoppo GJ: Fibrin contributes to microvascular obstructions and parenchymal changes during early focal cerebral ischemia and reperfusion. Stroke 1994; 25: 1847-53 https://doi.org/10.1161/01.STR.25.9.1847
  33. Abumiya T, Lucero J, Heo JH, Tagaya M, Koziol JA, Copeland BR, et al: Activated microvessels express vascular endothelial growth factor and integrin alpha(v)beta3 during focal cerebral ischemia. J Cereb Blood Flow Metab 1999; 19: 1038-50 https://doi.org/10.1097/00004647-199909000-00012