ABSTRACT
Hypertension plays an important role in the pathogenesis of stroke,which,however,is only known at the blood pressure level.The relationship between circadian rhythm of blood pressure(especially the circadian rhythm disorder of blood pressure)and stroke has been a hot research topic.This article reviews the concept of circadian rhythm of blood pressure,classification of circadian rhythm disorder of blood pressure,and the relationship of circadian rhythm disorder of blood pressure with ischemic stroke.
Subject(s)
Humans , Blood Pressure , Brain Ischemia/complications , Chronobiology Disorders/complications , Circadian Rhythm , Hypertension/complications , Ischemic Stroke/complicationsABSTRACT
Objective Endothelin-1 (ET-1) is expected to be a new therapeutic target for cerebral ischemic stroke (CIS). The content of plasma is known to increase after stroke, but the changes in the brain remain unclear. The aim of this study was to investigate the expression and distribution of ET-1 and endothelin receptors (ETR) in the brain after CIS in rats and their relationship with related brain injury. Methods We established a model of middle cerebral artery occlusion (MCAO)-reperfusion in 12 male SD rats, 6 with nylon filament inserted through the left internal carotid artery (the ischemia-reperfusion [IR] group) and the other 6 without (the sham operation group). We observed the distribution of ET-1 and ETRs in different regions of the brain by immunohistochemistry. Results Compared with the sham operation group, the IR group showed significantly higher expressions of ET-1 in the cortex (0.107 ± 0.005 vs 0.230 ± 0.019, P < 0.05), caudate putamen (0.110 ± 0.028 vs 0.198 ± 0.008, P < 0.05) and hippocampus (0.101 ± 0.005 vs 0.183 ± 0.002, P < 0.05), ETR-A in the bilateral choroid plexus (0.086 ± 0.009 vs 0.131 ± 0.001, P < 0.05), pial vessels (0.063 ± 0.003 vs 0.132 ± 0.005, P < 0.05) and middle cerebral arteries (0.079 ± 0.003 vs 0.121 ± 0.008, P < 0.05), and ETR-B in the infarcted cortex (0.032 ± 0.003 vs 0.187 ± 0.025, P < 0.05) and hippocampus (0.029 ± 0.002 vs 0.226 ± 0.019, P < 0.05) of the ischemic hemisphere. Conclusion After cerebral IR, ET-1 and ETRs are selectively expressed in different brain regions, and their distribution may be related to IR-induced brain injury.
ABSTRACT
<p><b>BACKGROUND</b>As a treatment of depression, the efficacy of conventional repetitive transcranial magnetic stimulation (rTMS) is limited, and symptoms recurrence is easy to occur after the treatment. This study aimed to examine the efficacy and safety of sleep electroencephalogram modulated repetitive rTMS (SEM-rTMS) in the treatment of depression.</p><p><b>METHODS</b>After 7 days without psychoactive medication, 164 patients with clinically defined depression were randomly divided into 3 groups: SEM-rTMS group (n = 57), conventional rTMS (C-rTMS, n = 55) group and sham-rTMS group (n = 52). Every patient was treated with the corresponding method for 30 minutes everyday for 10 days. Before and after scores on the 24-item Hamilton rating scale for depression (HAMD-24) and the clinical outcome on the 10th day of therapy for all subjects were analyzed.</p><p><b>RESULTS</b>Twenty-two cases in the SEM-rTMS group obtained improved mood as compared to 6 in the C-rTMS group and 2 in the sham-rTMS group (χ(2) = 15.89, P = 0.0004). After completion of the rTMS phase of the protocol, a (51 ± 5)% reduction of HAMD-24 scores from the baseline in the SEM-rTMS group was found compared with a (34 ± 4)% in the C-rTMS group (q = 26.09, P = 0.001) and a (14 ± 3)% in sham-rTMS group (q = 57.53, P = 0.000). The 88% total effective rate in the SEM-rTMS group was significantly higher than 68% in the C-rTMS group and 20% in the sham-rTMS group (χ(2) = 12.01, P = 0.0025). No significant side effects were noted.</p><p><b>CONCLUSION</b>SEM-rTMS is an effective and safe way for treating depression with repetitive transcranial magnetic stimulation (ChiCTR-TRC-00000438).</p>