Distal sensory to distal motor nerve anastomosis can protect lower extremity muscle atrophy in a murine model

Hosseinian, Mohammad Ali; Shirian, Sadegh; Loron, Ali Gharibi; Ebrahimy, Abdul Ali; Hayatolah, Gholam Hossein

doi:10.1007/s00238-017-1313-z

Cited by 5 publications

(6 citation statements)

References 22 publications

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“…Using a sensory nerve as a preliminary muscular innervation for subsequent motor reinnervation is a surgically feasible concept, but its fundamental neurobiological processes are not understood. Therefore, this concept is scarcely applied in the clinical routine, but some experimental studies showed sensory protection results in successful muscle atrophy prevention or facilitates motor muscle reinnervation (Hynes et al, 1997;Wang et al, 2001;Li et al, 2013;Placheta et al, 2015;Hosseinian et al, 2018). Because all cutaneous nerves contain autonomic fibers (Roosterman et al, 2006), our findings suggest a possible neurobiological explanation of the sensory protection phenomenon, which is because of the parasympathetic reinnervation.…”

Section: Discussionmentioning

confidence: 84%

Autonomic Nerve Fibers Aberrantly Reinnervate Denervated Facial Muscles and Alter Muscle Fiber Population

Luft

Dotzauer²,

Ortmayr³

et al. 2022

J. Neurosci.

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The surgical redirection of efferent neural input to a denervated muscle via a nerve transfer can reestablish neuromuscular control after nerve injuries. The role of autonomic nerve fibers during the process of muscular reinnervation remains largely unknown. Here, we investigated the neurobiological mechanisms behind the spontaneous functional recovery of denervated facial muscles in male rodents. Recovered facial muscles demonstrated an abundance of cholinergic axonal endings establishing functional neuromuscular junctions. The parasympathetic source of the neuronal input was confirmed to be in the pterygopalatine ganglion. Furthermore, the autonomically reinnervated facial muscles underwent a muscle fiber change to a purely intermediate muscle fiber population myosin heavy chain type IIa. Finally, electrophysiological tests revealed that the postganglionic parasympathetic fibers travel to the facial muscles via the sensory infraorbital nerve. Our findings demonstrated expanded neuromuscular plasticity of denervated striated muscles enabling functional recovery via alien autonomic fibers. These findings may further explain the underlying mechanisms of sensory protection implemented to prevent atrophy of a denervated muscle.SIGNIFICANCE STATEMENTNerve injuries represent significant morbidity and disability for patients. Rewiring motor nerve fibers to other target muscles has shown to be a successful approach in the restoration of motor function. This demonstrates the remarkable capacity of the CNS to adapt to the needs of the neuromuscular system. Yet, the capability of skeletal muscles being reinnervated by nonmotor axons remains largely unknown. Here, we show that under deprivation of original efferent input, the neuromuscular system can undergo functional and morphologic remodeling via autonomic nerve fibers. This may explain neurobiological mechanisms of the sensory protection phenomenon, which is because of parasympathetic reinnervation.

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Section: Discussionmentioning

confidence: 84%

Autonomic Nerve Fibers Aberrantly Reinnervate Denervated Facial Muscles and Alter Muscle Fiber Population

Luft

Dotzauer²,

Ortmayr³

et al. 2022

J. Neurosci.

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“…Sensory protection provides a temporal protective effect on the denervated muscle before nerve repair and reinnervation procedures can be performed. Sensory protection techniques have been investigated in animal models [55][56][57][58][59][60][61][62] and applied to humans. 63 A donor sensory nerve can be coapted to the distal motor nerve stump or directly implanted into the denervated muscle (neurotization) for the maintenance of muscle bulk.…”

Section: Discussionmentioning

confidence: 99%

“…The donor sensory nerve is thought to provide trophic support to denervated muscle, thereby retarding and preventing irreversible denervation atrophy and preserving muscle volume and myofiber structures, and improving muscle function following denervation. [55][56][57][58][59][60][61][62][63][64] In the sensory protected muscle, an increased number of MEPs has been also observed. 62 More work is needed to reveal specific therapeutic strategies for preventing MEP degradation following PNI.…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical Detection of Motor Endplates in the Long-Term Denervated Muscle

Chen

et al. 2018

J reconstr Microsurg

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“…Static toe spread analysis (STSA) described by Bervar 26 was performed just before muscle force measurement because it is a useful method for evaluating limb motor function. [27][28][29][30] For STSA, the rat was placed in an acrylic 40 × 20 × 20 cm container on a transparent base plate for observing footprints on the plantar view. A camera was positioned underneath the base plate to photograph the plantar surface of the rat hind limb paws.…”

Section: Postoperative Evaluations Static Toe Spread Analysismentioning

confidence: 99%

Reinnervation of Paralyzed Limb Muscle by Nerve-Muscle-Endplate Grafting Technique

Sobotka

Chen

et al. 2023

Neurosurgery

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BACKGROUND:We have developed a novel reinnervation technique called nerve-muscle-endplate grafting in the native motor zone (NMEG-NMZ). However, it remains unknown whether the NMEG-NMZ is effective for limb reinnervation.OBJECTIVE:To evaluate the efficacy of the NMEG-NMZ in limb muscle reinnervation.METHODS:Forty-five adult rats were divided into 3 groups: NMEG, end-to-end anastomosis (EEA, technique control), and denervation control (DC). The left tibialis anterior muscle was denervated by resecting its nerve. For NMEG-NMZ, the denervated tibialis anterior was reinnervated by transferring a NMEG pedicle from the lateral gastrocnemius muscle. Three months after surgery, static toe spread analysis was performed for all rats and muscle force was measured for the rats treated with NMEG and EEA. Muscle weight, myofiber morphology, regenerated axons, and reinnervated motor endplates in the treated muscles were also quantified and compared with those in the DC group.RESULTS:NMEG-NMZ technique resulted in better muscle force recovery (79% of the control) compared with EEA (51% of the control, P = .048). Toe spread analysis in NMEG-NMZ reinnervated muscles showed static sciatic index = −16.8, whereas −41.4 in EEA, P < .0001). The average weight of the NMEG-NMZ reinnervated muscles (86%) was greater than those of the EEA treated (71%) and DC (26%) muscles (all P < .0001). The mean count of the regenerated axons in the muscles with NMEG-NMZ was 76% of the control, which was larger than that in the muscles with EEA (46%), P < .0001.CONCLUSION:NMEG-NMZ technique has unique advantages and is superior to EEA for muscle reinnervation and functional recovery.

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Distal sensory to distal motor nerve anastomosis can protect lower extremity muscle atrophy in a murine model

Cited by 5 publications

References 22 publications

Autonomic Nerve Fibers Aberrantly Reinnervate Denervated Facial Muscles and Alter Muscle Fiber Population

Autonomic Nerve Fibers Aberrantly Reinnervate Denervated Facial Muscles and Alter Muscle Fiber Population

Immunohistochemical Detection of Motor Endplates in the Long-Term Denervated Muscle

Reinnervation of Paralyzed Limb Muscle by Nerve-Muscle-Endplate Grafting Technique

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