Study On The Relationship Between Cervical Sympathetic Nerve And Spinal Nerve And Correlation Between SNPs And Cervical Vertigo

ThtroauctionCervical vertigo is usually defined as vertigo syndrome caused by various cervical degeneration factors,and is one of the most common diseases in clinic.With the arrival and rapid popularization of the modern electronic age,"bow head" is the most popular way of work,life and entertainment,accompanied by accelerated neck degeneration,so the incidence of cervical vertigo is rising rapidly and the trend of younger is increasing year by year,seriously affecting the life,work and learning of patients.However,the pathogenesis of the disease is still controversial,which leads to the clinical treatment of cervical vertigo can not be targeted,the efficacy is not good,although there are many treatment measures including traditional Chinese medicine,still a large proportion of patients with unsatisfactory efficacy or frequent recurrence of symptoms.Therefore,to explore and clarify the pathogenesis of cervical vertigo,to find new indicators for clinical diagnosis and prognosis of cervical vertigo,so as to provide experimental basis and theoretical basis for the treatment of the disease is the purpose of this topic,which has great social value and practical significance.In 1926,Barre and Lieou first mentioned clinically a series of transient episodes of dizziness,headache,visual impairment,neck pain,nausea,tinnitus and even tripping,known as Barre-Lieou syndrome.In 1933,Dekley et al.showed through clinical studies that vertigo may have a causal relationship with vertebrobasilar insufficiency.In 1957,Tatlow and other scholars believed that the onset of cervical vertigo and the osteophyte tissue around the vertebral body had an important relationship with the compression of the vertebral artery,which was the main cause of the disease.In the same year,Denny-Brown and other scholars first proposed the "vertebral-basal artery insufficiency"(VBI)theory,that the vertebrobasilar insufficiency caused by various causes(including compression,stenosis,dysplasia,etc.)is the root cause of cervical vertigo.Since then,vertebral artery compression stenosis or/and obstruction as the main cause of cervical vertigo has been gradually accepted by the medical community.So for the early stages of the study of the mechanism of the disease,the research on the pathogenesis of cervical vertigo focused on vascular factors(vertebral artery factors).However,with the development of imaging medicine,there is no clear consistency between vertebral artery stenosis,compression obstruction and vertigo.Therefore,the theory of vertebral artery in the pathogenesis of cervical vertigo has gradually been questioned by the medical community.In clinic,cervical bracket fixation,traction,physiotherapy,acupuncture and moxibustion,local closure of pain points can be used to alleviate neck muscle tension and analgesia,and obtain satisfactory clinical efficacy.Therefore,the role of cervical nerve factors in the pathogenesis of cervical vertigo is gradually recognized.It has been found that vertigo symptoms are positively correlated with neck symptoms and degree.Some scholars have speculated that there is a nerve reflex arc in the neck.At home and abroad,a lot of related studies have been done on the relationship between thoracolumbar spinal nerve and sympathetic nerve,and it is speculated that sympathetic nerve may exist in some parts of the spinal ganglion.However,the relationship between the neck and neck is mostly in the speculative stage,and there is no definite experimental evidence to confirm the relationship between cervical spinal nerve and cervical sympathetic nerve.The purpose of this project is to confirm the anatomical relationship between cervical sympathetic ganglion and cervical spinal ganglion in New Zealand rabbits by fluorescent gold retrograde tracing technique,to study the functional relationship between them by neuroelectrophysiological method,and to further explore the role of single nucleotide polymorphisms secreting major neurotransmitter neuropeptide Y(NPY)and adrenergic receptor(ADR)in the diagnosis and treatment of cervical vertigo.To study the pathogenesis of cervical vertigo and guide clinical diagnosis and treatment.Objective1.The correlation between cervical sympathetic ganglion and cervical spinal ganglion in New Zealand white rabbits was studied using FG as tracer,and to provide the experimental basis of neuroanatomy for the existence of extraspinal nerve reflex arc in cervical spine.2.The changes of NPY in cervical sympathetic ganglion were detected by electrical stimulation of cervical spinal ganglion in New Zealand white rabbits,which provided experimental basis for the existence of cervical extraspinal nerve reflex arc.3.To explore the relationship between single nucleotide polymorphisms of ADRB2,ADRB1,NPY and ADRA1A and the risk and prognosis of cervical vertigo.Methods1.Nerve distribution in the cervical ganglion to the cervical sympathetic ganglion48 New Zealand rabbits were randomly divided into superior cervical sympathetic ganglion(SCG)group,inferior cervical sympathetic ganglion(ICG)group and corresponding control group.4%fluorescent gold solution or saline was injected into superior cervical or inferior cervical sympathetic ganglion respectively,and bilateral cervical spinal ganglion C2-C8 was excised on 4 and 8 days after survival,frozen sections were made and observed and analyzed by fluorescence microscope.2.Nerve distribution in the cervical sympathetic ganglion to the cervical spinal ganglionSeventy New Zealand white rabbits were randomly divided into upper cervical spine group(C2,C3 spinal ganglion group)and lower cervical spine group(C4,C5,C6 spinal ganglion group)and corresponding control group.After 4 days of survival,the superior and inferior cervical sympathetic ganglia were frozen and observed under fluorescence microscope.3.Changes of NPY in cervical sympathetic ganglion after stimulation of cervical spinal ganglion96 New Zealand rabbits were randomly divided into C2,C3,C4,C5,C6,C7 groups and corresponding control group(8 rabbits in each group).After anesthesia,the corresponding spinal ganglia of each group were exposed,and the corresponding spinal ganglion was given 0.5 ms wave width,30 Hz,5V electrical stimulation,5 seconds each time,repeated once every minute for 5 times.After 30 minutes,the upper and lower cervical sympathy was perfused and fixed.The ganglion was sliced,immunoreactive,stained and observed.4.Correlation between SNPs in adrenergic receptor and neuropeptide Y gene and risk of cervical vertigo216 patients with cervical vertigo and 204 healthy controls were collected.DNA was extracted by whole blood DNA extraction kit.In addition,TaqManR single nucleotide polymorphism(SNP)genotyping method was used for PCR reaction,and SNP was detected on 7900HT real-time fluorescence quantitative polymerase chain reaction(PCR)instrument.Finally,the severity of cervical vertigo was classified according to the JOA score,and the recovery rate(RR)of cervical vertigo was calculated according to the formula:(JOA-preoperative JOA)/(17-preoperative JOA)*100%.Results1.In the experimental group,FG-labeled neurons were found in injection side SCG,in C2 and C3 spinal ganglion groups;in C4 spinal ganglion group,FG-labeled neurons were found in injection side SCG and ICG,and more FG-labeled neurons were found in ICG;and in C5 and C6 spinal ganglion groups,FG-labeled neurons were found in injection side ICG.2.In the upper cervical spine group,fluorescence imaging was found in the superior cervical sympathetic ganglion on the experimental side,but not in the contralateral superior cervical sympathetic ganglion and bilateral inferior cervical sympathetic ganglion.In the lower cervical spine group,fluorescence imaging was found in the inferior cervical sympathetic ganglion on the experimental side,but not in the contralateral inferior cervical sympathetic ganglion and bilateral superior cervical sympathetic ganglion.3.After electrical stimulation of cervical spinal ganglion,the content of NPY in ipsilateral cervical sympathetic ganglion was significantly higher than that in the control group and the opposite side(P<0.05).After electrical stimulation of C2 and C3 spinal ganglia,the changes of NPY content were mainly ipsilateral superior cervical sympathetic ganglia;after electrical stimulation of C4 and C5 spinal ganglia,the contents of NPY in ipsilateral superior cervical sympathetic ganglia and inferior cervical sympathetic ganglia were significantly changed;after electrical stimulation of C6 and C7 spinal ganglia,the changes of NPY content were mainly ipsilateral inferior cervical sympathetic ganglion.4.The SNPs within ADRAIA[rs1048101(T>C)and rs3802241(C>T)],NPY[rs16476(A>C),rs16148(T>C),and rs5574(C>T)],ADRB1[rs28365031(A>G)]and ADRB2[rs2053044(A>G)]were all significantly associated with regulated risk of cervical vertigo(all P<.05).Haplotypes of ADRA1A[CT and TC]and NPY[CCT and ATT]were also suggested as the susceptible factors of cervical vertigo in comparison with other haplotypes.Furthermore,the SNPs within ADRA1A[rs1048101(T>C)],NPY[rs16476(A>C),rs16148(T>C)],as well as ADRB1[rs28365031(A>G)]all appeared to predict the prognosis of cervical vertigo in a relatively accurate way(all P<.05).Ultimately,the haplotypes of ADRA1A(CC)and NPY(CCT)tended to decrease the RR.Conclusion1.In New Zealand white rabbits,there are direct nerve fiber connections between the cervical spinal ganglion and the cervical sympathetic ganglion,and the nerve fiber connections have segmental characteristics,which provide an experimental basis for the existence of cervical extraspinal nerve reflex arc and elucidation of the pathogenesis of cervical vertigo.2.It was confirmed that electrical stimulation in cervical spinal ganglion could reach the corresponding cervical sympathetic ganglion through some conduction pathway,which provided an experimental basis for the existence of cervical extraspinal nerve reflex arc and elucidation of the pathogenesis of cervical vertigo.4.The SNPs within ADRB2,ADRB1,NPY,and ADRA1A might act as the diagnostic biomarkers and treatment targets for cervical vertigo.