Therapeutic effect of high-frequency and low-frequency repetitive transcranial magnetic stimulation on delayed encephalopathy after acute carbon monoxide poisoning

doi:10.3877/cma.j.issn.2095-123X.2025.04.002

Abstract

Abstract:

Objective

To observe the effects of high-frequency and low-frequency repetitive transcranial magnetic stimulation (rTMS) treatment on the expression of brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB) signalling pathway and MBP content in rats with delayed encephalopathy in acute carbon monoxide poisoning (DEACMP) and to explore the therapeutic effects.

Methods

Cognitively qualified male 24 SD rats were screened by Morris water maze, 6 were randomly selected as the blank group (NC group), and 18 were randomly divided into the sham stimulation group (Sham group), the high frequency 5 Hz group (5 Hz group), and the low frequency 1 Hz group (1 Hz group), each with 6 rats in each group, after the establishment of the DEACMP model. The treatment group was given 5 Hz and 1 Hz rTMS treatment respectively, and the Sham group was given sham stimulation. Cognitive function was assessed by Morris water maze after treatment. Hematoxylin-eosin (HE) staining was used to observe the changes in the hippocampal region of rats; enzyme-linked immunosorbent assay (ELISA) was used to analyse the serum concentration of BDNF, TrkB and myelin basic protein (MBP); immunohistochemical staining (IHC) was used to detect the positive expression of BDNF, TrkB and MBP in each group.

Results

(1) The results of Morris water maze showed that 21 d after CO poisoning, the mean avoidance latency was significantly longer in the Sham group, 1 Hz group and 5 Hz group compared with the NC group (P<0.05); the mean avoidance latency was significantly shorter in the 1 Hz and 5 Hz groups compared with that in the Sham group (P<0.05); and the mean avoidance latency was even shorter in the 5 Hz group compared with that in the 1 Hz group (P<0.05). (2) The results of HE staining showed that the cells in the hippocampus of the NC group were neatly arranged, with clear boundaries and normal cell number, while the cells in the hippocampus of the Sham group were disorganised, with a reduced cell number and some of them showed nuclear necrosis. The hippocampal area of the 1 Hz and 5 Hz groups was more neatly arranged, with occasional cell necrosis. (3) The ELISA results indicated that compared with the NC group, the expression content of BDNF and TrkB in the Sham group decreased, and the expression content of MBP increased (P<0.05); in the 1 Hz and 5 Hz groups, the expression content of BDNF and TrkB increased significantly compared with that of the Sham group, and the expression content of MBP increased significantly compared with that of the Sham group. MBP expression content was significantly lower than that in the Sham group (P<0.05). (4) IHC staining indicated that the mean optical density values of BDNF and TrkB in the Sham group were decreased compared with that in the NC group (P<0.05); the mean optical density values of BDNF and TrkB in both the 1 Hz group and the 5 Hz group were higher than that in the Sham group (P<0.05); the MBP mean optical density values of BDNF and TrkB in the Sham group and the 5 Hz group were higher than those in the Sham group (P<0.05); the mean optical density values of MBP in the Sham group were significantly higher than those in the NC group, and the mean optical density values of MBP in the 1 Hz and 5 Hz groups were lower than those in the Sham group (P<0.05).

Conclusions

Both high-frequency (5 Hz) and low-frequency (1 Hz) rTMS can improve the cognitive function of DEACMP mice, and the possible mechanism is to improve demyelinating lesions by up-regulating the expression of BDNF/TrkB pathway, so as to reduce the expression content of MBP, thus improving cognitive ability.

Key words: Repetitive transcranial magnetic stimulation, Acute carbon monoxide poisoning delayed encephalopathy, Brain-derived neurotrophic factor, Tyrosine kinase receptor B, Myelin basic protein

Yuanyuan Jin, Limei Liu, Yan Huang, Jun Zhang. Therapeutic effect of high-frequency and low-frequency repetitive transcranial magnetic stimulation on delayed encephalopathy after acute carbon monoxide poisoning[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2025, 15(04): 199-207.

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Figures/Tables 7

References 31

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组别	只数	中毒21 d	治疗14 d	t值	P值
NC组	6	11.62±0.98	12.52±0.72	1.623	0.166
Sham组	6	33.96±3.14^a	33.23±3.95^a	0.614	0.566
1 Hz组	6	34.03±2.28^a	29.99±1.84^ab	4.074	0.010
5 Hz组	6	34.02±3.06^a	25.52±1.19^abc	10.026	<0.001
F值		118.291	94.989
P值		<0.001	<0.001

组别	只数	中毒21 d	治疗14 d	t值	P值
NC组	6	11.62±0.98	12.52±0.72	1.623	0.166
Sham组	6	33.96±3.14^a	33.23±3.95^a	0.614	0.566
1 Hz组	6	34.03±2.28^a	29.99±1.84^ab	4.074	0.010
5 Hz组	6	34.02±3.06^a	25.52±1.19^abc	10.026	<0.001
F值		118.291	94.989
P值		<0.001	<0.001

组别	只数	BDNF	TrkB	MBP
NC组	6	18.28±0.66	408.05±23.35	217.20±55.20
Sham组	6	16.84±1.12^a	380.64±16.81^a	337.77±55.52^a
1 Hz组	6	19.32±1.49^b	424.26±20.37^b	243.23±42.18^b
5 Hz组	6	19.20±1.33^b	422.81±24.99^b	253.86±43.81^b
F值		5.539	5.266	6.645
P值		0.006	0.008	0.003

组别	只数	BDNF	TrkB	MBP
NC组	6	18.28±0.66	408.05±23.35	217.20±55.20
Sham组	6	16.84±1.12^a	380.64±16.81^a	337.77±55.52^a
1 Hz组	6	19.32±1.49^b	424.26±20.37^b	243.23±42.18^b
5 Hz组	6	19.20±1.33^b	422.81±24.99^b	253.86±43.81^b
F值		5.539	5.266	6.645
P值		0.006	0.008	0.003

组别	只数	BDNF	TrkB	MBP
NC组	6	31.46±0.45	32.19±1.67	23.75±0.97
Sham组	6	28.21±1.18^a	29.00±1.03^a	26.20±0.99^a
1 Hz组	6	30.42±1.86^b	30.50±1.05^ab	24.91±0.67^ab
5 Hz组	6	30.08±0.74^b	31.44±0.58^b	24.05±0.84^b
F值		7.872	8.592	9.424
P值		0.001	0.001	<0.001

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