Subaraknoid Kanamaya Bağlı Parkinson Hastalığının Karanlık Bir Nedeni Olarak Subtalamik Çekirdek Dejenerasyonu: Deneysel Bir Ön Çalışma

Year 2023, Volume: 13 Issue: 2, 215 - 220, 22.03.2023

Mete Zeynal , Mehmet Hakan Şahin

https://doi.org/10.16899/jcm.1239008

Abstract

Arka plan: Subtalamik çekirdek dejenerasyonu Parkinson hastalığı ile suçlanmış olsa da, subaraknoid kanamaların neden olduğu subtalamik çekirdek dejenerasyonunun belirsiz rolleri yeterince çalışılmamıştır. Bu çalışmanın amacı, subaraknoid kanama sonrası subtalamik çekirdekte meydana gelen histopatolojik değişiklikleri incelemektir.
Gereç ve Yöntemler: Bu çalışmaya 21 adet yabani erkek sağlıklı tavşan dahil edildi. Denekler şu şekilde ayrıldı: kontrol (GI, n=5); SHAM 1.2 cc salin enjekte edildi (GII, n=6) ve sisterna magnaya 1.2 cc otolog kan enjeksiyonu (GIII, n=10). Üç hafta takip edildiler ve genel anestezi altında sakrifiye edildiler. Vazospazm indeksi (VSI) daire yüzey tahmin yöntemi ile, subtalamik çekirdeğin dejenere nöron yoğunlukları Stereolojik yöntemlerle tahmin edildi ve Mann Witney U testi ile analiz edildi.
Bulgular: Çalışma grubunda ölen iki tavşan meningeal iritasyon bulguları ve bilinç kaybı ile temsil edildi. GIII hayvanlarında uzamış QT aralıkları, ST çöküntüleri ve düşük voltajlı QRS'ler fark edildi. Kalp-solunum hızlarının (n/dk), VSI değerlerinin ve subtalamik çekirdeğin dejenere nöron yoğunluklarının (n/mm3) sayısal belgeleri aşağıdaki gibidir: GI'de 1,05±0,03/ 219±324/21±4/8±3; GII'de 1,75±0,23/209±14/15±4/16±4; ve 2,03±0,14/175±19/19±5/123±21 GIII. Subtalamik çekirdeğin VSI değerleri ile dejenere nöron yoğunlukları arasındaki P değerleri hemen hemen eşitti: GI/GII'de p<0.005; GII/GIII'de p<0,0005 ve GI/GIII'de p<0,00001.
Tartışmaç: Subaraknoid kanama, subtalamik çekirdeği besleyen arterlerin spazmına neden olarak iskemik yaralanmaya, hidrosefali ise mekanik stres yaralanmasına neden olur.

Keywords

Subarachnoid hemorrhage, Subthalamic nucleus, Parkinson’s disease, Neuronal degeneration

Thanks

Prof. Dr. Mehmet Dumlu Aydın

Subthalamic Nucleus Degeneration As A Dark Cause of Parkinson’s Disease Due to Subarachnoid Hemorrhage: A Preliminary Experimental Study

Abstract

Background: Although the subtahalamic nucleus degeneration has been accused of Parkinson’s disease, the obscure roles of subtalamic nucleus degeneration induced by subarachnoid hemorrhages has not been adequately studied. The aim of the study is to examine the histopathological changes in the subthalamic nucleus after subarachnoid hemorrhage.
Materials and Methods: Twenty-one wild male healthy rabbits were included in this study. The test subjects were divided as: control (GI, n=5); SHAM 1.2 cc of saline injected (GII, n=6) and 1.2 cc of autologous blood injection into cisterna magna (GIII, n=10). They followed up for three weeks and sacrificed under general anesthesia. Vasospasm index (VSI) was estimated by the circle surface estimation method, degenerated neuron densities of the subthalamic nucleus were estimated by Stereological methods and analyzed by Mann Witney U test.
Results: Two rabbits dead in the study group were represented by meningeal irritation signs and unconsciousness. Prolonged QT intervals, ST depressions, and low voltage QRSs were noticed in GIII animals. Numerical documents of heart-respiratory rates (n/min), VSI values, and degenerated neuron densities of the subthalamic nucleus (n/mm3) as follows: 1.05±0.03/ 219±324/21±4/8±3 in GI; 1.75±0.23/209±14/15±4/16±4 in GII; and 2.03±0.14/175±19/19±5/123±21 GIII. P values between the VSI values and degenerated neuron densities of the subthalamic nucleus were nearly eqund: p<0.005 in GI/GII; p<0.0005 in GII/GIII and p<0.00001 in GI/GIII.
Conclusion: Subarachnoid hemorrhage causes spasm of the arteries supplying the subthalamic nucleus, leading to ischemic injury, and hydrocephalus leading to mechanical stress injury.

Keywords

Subarachnoid hemorrhage, Subthalamic nucleus, Parkinson’s disease, Neuronal degeneration

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