ABSTRACT
The purpose of this study was to evaluate the roles of different housing environments in neurological function,cerebral metabolism,cerebral infarction and neuron apoptosis after focal cerebral ischemia.Twenty-eight Sprague-Dawley rats were divided into control group (CG) and cerebral ischemia group,and the latter was further divided into subgroups of different housing conditions:standard environment (SE) subgroup,individual living environment (IE) subgroup,and enriched environment (EE) subgroup.Focal cerebral ischemia was induced by the middle cerebral artery occlusion (MCAO).Beam walking test was used to quantify the changes of overall motor function.Cerebral infarction and cerebral metabolism were studied by in vivo magnetic resonance imaging and 1H-magnetic resonance spectra,respectively.Neuron necrosis and apoptosis were detected by hematoxylin-eosin and TUNEL staining methods,respectively.The results showed that performance on the beam-walk test was improved in EE subgroup when compared to SE subgroup and IE subgroup.Cerebral infarct volume in IE subgroup was significantly larger than that in SE subgroup (P＜0.05) and EE subgroup (P＜0.05) on day 14 after MCAO.NAA/Cr and Cho/Cr ratios were lower in MCAO groups under different housing conditions as compared to those in CG (P＜0.05).NAA/Cr ratio was lower in IE subgroup (P＜0.05) and higher in EE subgroup (P＜0.05) than that in SE subgroup.NAA/Cr ratio in EE was significantly higher than that in IE subgroup (P＜0.05).Cho/Cr ratio was decreased in MCAO groups as compared to that in CG (P＜0.05).A significant decrease in normal neurons in cerebral cortex was observed in MCAO groups as compared to CG (P＜0.05).The amount of normal neurons was less in IE subgroup (P＜0.05),and more in EE subgroup (P＜0.05) than that in SE subgroup after MCAO.The amount of normal neurons in EE subgroup was significantly more than that in IE subgroup after MCAO (P＜0.05).The ratio of TUNEL-positive neurons in EE was significantly lower than that in SE subgroup (P＜0.05) and IE subgroup (P＜0.05).Correlation analysis showed that the beam walking test was negatively correlated with NAA/Cr ratio (P＜0.05).Cerebral infarct volume was negatively correlated with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.01).The amount of normal cortical neurons was positively correlated with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.05).The TUNEL-positive neurons showed a negative correlation with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.01).This study goes further to show that EE may improve neurological functional deficit and cerebral metabolism,decrease cerebral infarct volume,neuron necrosis and apoptosis,while IE may aggravate brain damage after MCAO.
ABSTRACT
The purpose of this study was to evaluate the roles of different housing environments in neurological function,cerebral metabolism,cerebral infarction and neuron apoptosis after focal cerebral ischemia.Twenty-eight Sprague-Dawley rats were divided into control group (CG) and cerebral ischemia group,and the latter was further divided into subgroups of different housing conditions:standard environment (SE) subgroup,individual living environment (IE) subgroup,and enriched environment (EE) subgroup.Focal cerebral ischemia was induced by the middle cerebral artery occlusion (MCAO).Beam walking test was used to quantify the changes of overall motor function.Cerebral infarction and cerebral metabolism were studied by in vivo magnetic resonance imaging and 1H-magnetic resonance spectra,respectively.Neuron necrosis and apoptosis were detected by hematoxylin-eosin and TUNEL staining methods,respectively.The results showed that performance on the beam-walk test was improved in EE subgroup when compared to SE subgroup and IE subgroup.Cerebral infarct volume in IE subgroup was significantly larger than that in SE subgroup (P＜0.05) and EE subgroup (P＜0.05) on day 14 after MCAO.NAA/Cr and Cho/Cr ratios were lower in MCAO groups under different housing conditions as compared to those in CG (P＜0.05).NAA/Cr ratio was lower in IE subgroup (P＜0.05) and higher in EE subgroup (P＜0.05) than that in SE subgroup.NAA/Cr ratio in EE was significantly higher than that in IE subgroup (P＜0.05).Cho/Cr ratio was decreased in MCAO groups as compared to that in CG (P＜0.05).A significant decrease in normal neurons in cerebral cortex was observed in MCAO groups as compared to CG (P＜0.05).The amount of normal neurons was less in IE subgroup (P＜0.05),and more in EE subgroup (P＜0.05) than that in SE subgroup after MCAO.The amount of normal neurons in EE subgroup was significantly more than that in IE subgroup after MCAO (P＜0.05).The ratio of TUNEL-positive neurons in EE was significantly lower than that in SE subgroup (P＜0.05) and IE subgroup (P＜0.05).Correlation analysis showed that the beam walking test was negatively correlated with NAA/Cr ratio (P＜0.05).Cerebral infarct volume was negatively correlated with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.01).The amount of normal cortical neurons was positively correlated with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.05).The TUNEL-positive neurons showed a negative correlation with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.01).This study goes further to show that EE may improve neurological functional deficit and cerebral metabolism,decrease cerebral infarct volume,neuron necrosis and apoptosis,while IE may aggravate brain damage after MCAO.
ABSTRACT
Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction (stroke group) in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers (control group) were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90 (SCL-90), the social support by the Social Support Rating Scale (SSRS), and medication adherence by Morisky's self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group (P<0.01). Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions (including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety) of SCL-90 were significantly higher in the stroke group than those in the control group (P<0.05, or P<0.01). The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group (P<0.05, or P<0.01). Those in the "SCL-90 total scores >150 group" were significantly higher than in the "SCL-90 total scores <100 group" and the "SCL-90 total scores between 100 to 150 group" (P<0.05, or P<0.01). Those in the "SCL-90 total scores between 100 to 150 group" were significantly higher than in the "SCL-90 total scores <100 group" (P<0.05). In 90 patients with ischemic stroke, 26 (28.89%) patients obtained high medication adherence, 47 (52.22%) patients medium medication adherence, and 17 (18.89%) patients low medication adherence, respectively. Among these stroke patients, there were 17 (50.00%) patients with high medication adherence in the "SCL-90 total scores >150 group", 28 (75.67%) patients with medium medication adherence in the "SCL-90 total scores between 100 to 150 group", and 12 (61.16%) patients with low medication adherence in the "SCL-90 total scores <100 group", respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients (P<0.05 or P<0.01). It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Asian People , Psychology , China , Infarction, Middle Cerebral Artery , Drug Therapy , Psychology , Medication Adherence , Social Support , Stress, Psychological , Psychology , Surveys and QuestionnairesABSTRACT
Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction (stroke group) in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers (control group) were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90 (SCL-90), the social support by the Social Support Rating Scale (SSRS), and medication adherence by Morisky's self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group (P150 group" were significantly higher than in the "SCL-90 total scores 150 group", 28 (75.67%) patients with medium medication adherence in the "SCL-90 total scores between 100 to 150 group", and 12 (61.16%) patients with low medication adherence in the "SCL-90 total scores <100 group", respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients (P<0.05 or P<0.01). It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.