Learning and memory impairment is a common dysfunction after stroke, which seriously affects the overall recovery of patients. Electroacupuncture at Shenting and Baihui has definite efficacy in patients with cognitive dysfunction after stroke, but its mechanism of action remains uncertain.

To observe the effect of electroacupuncture on hippocampal neuronal protection and brain-derived nerve growth factor (BDNF) /tyrosine receptor kinase B (TrkB) /phosphatidylinositol-3-hydroxykinase (PI3K) /protein kinase B (Akt) signaling pathway in rats with learning and memory impairment after middle cerebral artery occlusion reperfusion (MCAO/R) .

A total of 60 8-week-old healthy male SD rats were selected from May 2021 to March 2022, and 24 rats were divided into the blank group (n=12) and sham operation group (n=12), and the other 36 rats were constructed as MCAO/R model. The 24 rats with successful modeling were randomly divided into the model group (n=12) and electroacupuncture group (n=12). The electroacupuncture treatment was performed at Shenting and Baihui points in the electroacupuncture group. Zea-Longa score was used to observe the degree of neurological impairment in each group. Spatial probe test was used to evaluate the spatial learning and memory ability of the rats. TTC staining was used to observe the volume of brain infarction in rats. RT-PCR was used to measure the mRNA levels of BDNF, TrkB, PI3K and Akt, Western blotting was used to detect the protein levels of BDNF and TrkB and the levels of p-PI3K/PI3K and p-Akt/Akt.

Zea-Longa score of the model group and electroacupuncture group was significantly different from the blank group and sham operation group at 2 h after surgery (P<0.05), and Zea-Longa score of the model group was significantly different from the blank group, sham operation group and electroacupuncture group at 7 and 14 days after treatment (P<0.05). During the 9th to 13th day of treatment, the escape latency in the model group was higher than the sham operation group (P<0.05), and lower in the electroacupuncture group than the model group (P<0.05). The frequency of crossing the effective region of the platform in the model group was lower than the blank group and sham operation group (P<0.05), and higher in the electroacupuncture group than the model group (P<0.05). The volume of cerebral infarction in blank group, sham operation group, model group and electroacupuncture group was 0, 0, (36.7±6.3) % and (24.0±2.2) %, respectively, and the volume of cerebral infarction in the electroacupuncture group was lower than the model group (P<0.05). The mRNA levels of BDNF, TrkB, PI3K and Akt in the model group were lower than the blank group and sham operation group (P<0.05), and higher in the electroacupuncture group than the model group (P<0.05). Compared with sham operation group, the protein levels of BDNF and TrkB (P<0.01, P<0.001), the levels of p-PI3K/PI3K and p-Akt/Akt (P<0.01, P<0.05) in model group were decreased; compared with the model group, the protein levels of BDNF and TrkB and the levels of p-PI3K/PI3K and p-Akt/Akt in electroacupuncture group were increased (P<0.05) .

Electroacupuncture may reduce the symptom of neurological function deficits and improve the learning and memory ability of rats after cerebral ischemia reperfusion by upregulating the expression of BDNF/TrkB/PI3K/Akt pathway related proteins.

学习记忆障碍是脑卒中后常见的功能障碍之一，严重影响患者的整体康复。电针神庭、百会对脑卒中后认知功能障碍患者具有确切疗效，但其作用机制尚未十分明确。

观察电针对大脑中动脉缺血再灌注（MCAO/R）后学习记忆障碍大鼠海马神经元保护作用及对脑源性神经生长因子（BDNF）/酪氨酸受体激酶B（TrkB）/磷脂酰肌醇3羟激酶（PI3K）/蛋白激酶B（Akt）信号通路的影响。

2021年5月—2022年3月选取60只8周龄健康雄性、SPF级SD大鼠，取24只大鼠分为空白组（n=12）、假手术组（n=12），其余36只大鼠构建MCAO/R模型。将造模成功的24只大鼠随机分为模型组（n=12）和电针组（n=12）。电针组于神庭、百会穴进行电针治疗，采用进行Zea-Longa评分观察各组大鼠神经功能缺损程度，采用空间探索实验评价大鼠空间学习记忆能力，采用TTC染色观察大鼠脑梗死体积。采用实时荧光定量PCR（RT-PCR）测定BDNF、TrkB、PI3K、Akt mRNA水平，Western blotting检测BDNF、TrkB蛋白水平及PI3K、Akt蛋白磷酸化水平。

术后2 h模型组、电针组Zea-Longa评分与空白组、假手术组比较，差异有统计学意义（P<0.05），治疗第7天、治疗第14天模型组Zea-Longa评分与空白组、假手术组、电针组比较，差异有统计学意义（P<0.05）。治疗第9~13天模型组逃避潜伏期均大于假手术组（P<0.05），电针组均低于模型组（P<0.05）。模型组穿越平台有效区域次数低于空白组、假手术组（P<0.05），电针组高于模型组（P<0.05）。空白组、假手术组、模型组、电针组大鼠脑梗死体积占比分别为0、0、（36.7±6.3）%、（24.0±2.2）%，电针组大鼠脑梗死体积低于模型组（P<0.05）。模型组BDNF、TrkB、PI3K、Akt mRNA水平低于空白组、假手术组（P<0.05），电针组BDNF、TrkB、PI3K、Akt mRNA水平高于模型组（P<0.05）。与假手术组相比，模型组BDNF、TrkB蛋白水平均下降（P<0.01，P<0.001），p-PI3K/PI3K、p-Akt/Akt蛋白水平下降（P<0.01，P<0.05）；与模型组相比，电针组BDNF、TrkB蛋白水平和p-PI3K/PI3K、p-Akt/Akt蛋白水平均升高（P<0.05）。

电针可能通过上调BDNF/TrkB/PI3K/Akt通路相关蛋白表达，减轻神经功能缺损症状，改善脑缺血再灌注后学习记忆能力。