关键词: 脑梗死; 康复; 经皮神经电刺激; 突触; 神经元可塑性

Abstract: Objective To explore the ultrastructure and texture parameters changes of the synapses dueto cortical electrical stimulation combined with rehabilitative training following focal corticalischemia in rats.Methods Thirty rats reached for single food pellets in a box made of clear plexiglas. When thesuccess rate was more 30% in three consecutive days, rats were admitted. There were eighteen ratsinto the group and the skilled forelimb was recorded after seven days training.Locating the brainmotor area by the rat brain stereotactic atlas, and then Endothelin was injected into the startingpoint of the middle cerebral artery to block the blood supply of the middle cerebral artery to makeinfarction rat model. And then put the stimulating electrode outside the scleromeninx correspondinginfarct. After operation, rats were randomly divided into two groups:stimulating group receivedcortical electrical stimulation combined with rehabilitative training; control group, only therehabilitative training, which last for two weeks. The ultrastucture changes of the synapses wereobserved with electron microscopy. The number of synapses and Width of synaptic cleft werestudied with image analysis.Results There were three death after operation due to postoperative infection; There was nostatistical significance between the two groups before operation(P =0.144). The stimulation grouphad significantly greater rates of improvement with the impaired forelimb in comparison to controlgroup(P =0.021). Image J software using electron microscopy image analysis results showed thatstimulation of cerebral ischemia in rat motor cortex than in the control group increased the numberof synapses, a statistically significant difference(P <0.05). Width of synaptic cleft was no significantdifference between the two groups(P >0.05).Conclusion Cortical electrical stimulation combined with rehabilitative training following focalcortical ischemia can promote synaptic growth and enhancs plasticity of synaptic structure, thuscontributing to the rehabilitation of the hemiplegic limb function.

Key words: Brain infarction; Rehabilitation; Transcutaneous electric nerve stimulation; Synapses; Neuronal plasticity