Vibration Therapy And Molecular Mechanism Of Lateral Neglect After Stroke

Part? The short-term effect of vibration therapy on hemilateral neglect after strokeObjective To investigate the effectiveness of neck muscle vibration for unilateral spatial neglect after stroke,and to evaluate its short-term effect.Method40 patients of stroke with unilateral spatial neglect in Rehabilitation Department of Qixia District Hospital,Nanjing during Dec.2016 and Oct.2018 were randomly divided into control group(n=20)and neck muscle vibration group(n=20).Both groups accepted normal rehabilitation for unilateral spatial neglect,while neck muscle vibration group accepted neck muscle vibration therapy in addition.The vibrator was set at frequency 108 Hz,and amplitude 1.0mm,and the vibration point was located in left trapezius for once a day,15 minutes at a time.Before and 3 weeks after training,the patients in both groups were assessed by the Chinese behavioral inattention test-Hong Kong version(CBIT-HK)scale,after which we respectively compared routine test score,behavioral test score and total score.The data were compared within and between groups,and the conclusions were drawn.P<0.05 was considered as statistically significant difference.Result:Intra-group comparison of t-test after 3 weeks' treatment: Neck muscle vibration group:routine test score t=-4.784,P<0.05,behavioral test score t=-5.300,P<0.05,and total score t=-2.303,P<0.05;Control group:routine test score t=-3.956,P<0.05;Behavioral test score t=-4.340,P<0.05;Total score t=-2.303,P<0.05.The CBIT-HK scores were significantly increased as compared with those before treatment in both groups(P<0.05).Inter-group comparison of t-test: Behavioral score difference t=3.155,P<0.05 and total score difference t=2.786,P<0.05.The scores in neck muscle vibration group were significantly increased.But there was no statistically significant difference between the routine test score of the two groups(P=0.074).Conclusion The neck muscle vibration treatment combined with conventional rehabilitation treatments can improve short-term symptoms of unilateral spatial neglect after stroke.Part ? The study on the micro regulatory mechanism of unilateral neglect after stroke in miceObjective The purpose of this study is to establish a model of unilateral neglect after stroke in mice.By regulating the level of micro RNA-320 in the cerebral cortex,the effect of micro RNA-320 on the injury of unilateral neglect after stroke is explored,which provides a reference for the treatment of unilateral neglect after stroke.Methods In this study,48 clean grade male mice were randomly divided into four groups:control group(12 mice),model group(12 mice in unilateral neglect group after stroke),micro RNA-320 mimic group(12 mice),micro RNA-320 inhibitor group(12mice).The expression level of target gene(including IGF-1,GAPDH,mi RNA-320-3p)was detected by q-rtpcr,protein expression level(including IGF-1)was detected by Western blot,apoptosis was detected by TUNEL,and the volume of cerebral infarction and cerebral edema was measured by TTC staining.Results(1)Compared with the control group,the expression of micro RNA-320 in the model group was slightly increased(P < 0.05);compared with the model group,the expression of micro RNA-320 in the mimic group was significantly increased(P <0.01),and the expression of micro RNA-320 in the inhibitor group was decreased(P <0.05).(2)Compared with the control group,the expression of IGF-1 m RNA in the injured cortex of the model group increased(P < 0.05);compared with the model group,the expression of IGF-1 m RNA in the mirna-320 mimic group decreased(P <0.05),and the expression of IGF-1 m RNA in the mirna-320 inhibitor group increased significantly(P < 0.01).(3)Compared with the model group,the expression of IGF-1 protein in mirna-320 mimic group decreased(P < 0.05),while the expression of IGF-1 protein in mirna-320 inhibitor group increased significantly(P < 0.01).(4)Compared with the control group,the apoptosis of the peripheral area of the cerebral infarction in the model group was significantly increased(P < 0.05),and the apoptosis level of the peripheral area of the cerebral infarction in the hemilateral neglect mice was further increased by the treatment of mirna-320 analog(P < 0.05),and the apoptosis level of the peripheral area of the cerebral infarction in the hemilateral neglect mice was reduced by the treatment of mirna-320 inhibitor(P <0.05).(5)Compared with the control group,the volume and edema degree of cerebral infarction in the model group increased significantly(P < 0.01);compared with the model group,the volume and edema degree of cerebral infarction in the mirna-320 mimic group increased significantly(P < 0.05);the volume and edema degree of cerebral infarction in the mirna-320 inhibitor group decreased significantly(P < 0.01).Conclusion Mirna-320 may regulate the degree of brain tissue injury through IGF-1 factor,which may be an important mechanism of cerebral ischemia-reperfusion injury and provide a target for the treatment of stroke patients.