Abstract：
The majority of patients simultaneously develop motor dysfunction and spastic hypertonia after ischemic strokes, which can be associated with an increasing trend in motor impairments, seriously impeding the rehabilitation process. Evidence suggests that some deficits in the KCC2 expression in the spinal cord along with maladaptive endogenous plasticity via GABAA receptors are often involved in the pathology of spastic hypertonia after a stroke. In this respect, acupuncture has been commonly used in clinical settings for post-stroke patients\' rehabilitation. Nevertheless, the mechanism of the modulating activity of this alternative medicine in the spinal pathways to relieve spasticity and improve functional recovery after a stroke has still remained unclear. Utilizing laser speckle imaging, functional assessments (viz. neurologic function scale, muscular tension scale, foot balance test, and gait analysis), H-reflex recording, TTC, Western blotting, RT-qPCR, ELISA, and immunofluorescence molecular assay, the study results illustrated that acupuncture could significantly alleviate the spinal hyperreflexia, decrease muscle tone, and enhance locomotor function by elevating the GABA, KCC2, and GABAAγ2 expressions in the lumbar spine of a rat model of post-ischemic stroke with spastic hypertonia. Furthermore, the KCC2 antagonist DIOA abolished the benefits induced by this practice. Overall, the data revealed that acupuncture is a promising therapeutic approach for spastic hypertonia after a stroke, and the positive outcomes in this sense could be achieved via activating the KCC2-mediated spinal GABAA signaling pathway.
摘要：
大多数患者在缺血性中风后同时出现运动功能障碍和痉挛性高张力，这可能与运动障碍的增加趋势有关，严重阻碍康复进程。有证据表明，脊髓中KCC2表达的某些缺陷以及通过GABAA受体的适应性内源性可塑性不良通常与中风后痉挛性高张力的病理有关。在这方面,针灸已普遍用于中风后患者的临床康复。然而，这种替代药物在脊髓通路中调节缓解痉挛和改善中风后功能恢复的机制仍不清楚。利用激光散斑成像，功能评估(即神经功能量表，肌张力量表,脚平衡测试,和步态分析)，H反射录音,TTC,西方印迹,RT-qPCR,ELISA,和免疫荧光分子分析，研究结果表明，针刺可以明显缓解脊柱反射亢进，减少肌肉张力，并通过提高GABA来增强运动功能，KCC2和GABAAγ2在缺血性中风后痉挛型高张力大鼠模型腰椎中的表达。此外，KCC2拮抗剂DIOA取消了这种做法引起的益处。总的来说,数据显示，针灸是中风后痉挛性高张力的一种有前途的治疗方法，在这个意义上,通过激活KCC2介导的脊髓GABAA信号通路可以获得积极的结果.
