Experiments on Motor Nerve Regeneration and the Direct Neurotization of Paralyzed Muscles by Their Own and by Foreign Nerves

Elsberg, Charles A.

doi:10.1126/science.45.1161.318

Cited by 135 publications

(52 citation statements)

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“…Cross-innervation of the immature soleus muscle took place only after disruption of the original nerve supply, just as in adult muscle (Elsberg 1917;Jansen, Lomo, Nicolaysen & Westgaard, 1973). In three new-born rats the superficial branch of the fibular nerve was transplanted on to the soleus muscle without interrupting the original nerve.…”

Section: Cross-innervation By a Foreign Nervementioning

confidence: 99%

Polyneuronal innervation of skeletal muscle in new‐born rats and its elimination during maturation.

Brown¹,

Jansen²,

Essen³

1976

The Journal of Physiology

751

462

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SUMMARY1. The events taking place during the elimination of polyneuronal innervation in the soleus muscle of new-born rats have been studied using a combination of electrophysiological and anatomical techniques.2. Each immature muscle fibre is supplied by two or more motor axons which converge on to a single end-plate. There was no sign of electrical coupling between muscle fibres receiving multiple synaptic inputs. By the end of the second week after birth virtually all muscle fibres are innervated by only a single motor axon.3. The average tension produced by individual motor units, measured in terms of the percentage of the total muscle twitch tension, declined dramatically during the first 2 weeks after birth. During this period there was no significant change in the number of motor neurones innervating the soleus muscle. Thus, the disappearance of polyneuronal innervation reflects a decrease in the number of peripheral synapses made by each motor neurone.4. The decline in motor unit size was delayed, but not ultimately prevented, by the early surgical removal of all but a few motor axons to the soleus muscle. This procedure also caused a delay in the removal of polyneuronal innervation involving the remaining motor units.5. Following a crush of the soleus nerve in neonatal animals, regenerating axons usually returned to the original end-plates. Polyneuronal innervation was extensive at early stages of re-innervation and it disappeared during the second week after birth just as in normal muscles. 388 M. C. BROWN, J. K. S. JANSEN AND D. VAN ESSEN end-plates and in most fibres prevented re-innervation by the original nerve. In the small proportion of fibres that did become innervated through both the foreign and original nerves the end-plates were more than 1 mm apart, and both foreign and original nerve end-plates could persist indefinitely.7. Many cross-innervated fibres received multiple inputs through the foreign nerve. Some foreign end-plates were separated by distances ranging up to 1 mm. Polyneuronal innervation through the foreign nerve was completely eliminated during maturation but over a slightly longer period than in normal muscles. Apparently the elimination process can act over a distance up to but not much more than 1 mm.8. These observations suggest that there are several factors influencing the elimination of redundant inputs in immature muscles. Individual motor neurones appear to have an inherent tendency to withdraw the majority of their original complement of peripheral terminals. The determination of which particular synapses are to survive, however, seems to be made in the periphery by a selection among all the synapses that innervate a limited region of each muscle fibre. There may be a competitive interaction among synapses in which those belonging to smaller motor units are less likely to be eliminated, thereby leading to a relatively uniform size of the motor units in the soleus.

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Section: Cross-innervation By a Foreign Nervementioning

confidence: 99%

Polyneuronal innervation of skeletal muscle in new‐born rats and its elimination during maturation.

Brown¹,

Jansen²,

Essen³

1976

The Journal of Physiology

751

462

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“…Another change in the extrajunctional region is the appearance of the ability to make new n.m.j.s. with experimentally introduced nerves (Elsberg, 1917; Aitken, 1950;Fex & Thesleff, 1967). In contrast to ACh sensitivity, nothing is known about the molecular basis of this property.…”

Section: Introductionmentioning

confidence: 99%

Control of acetylcholine sensitivity and synapse formation by muscle activity.

Lømo¹,

Slater²

1978

The Journal of Physiology

102

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SUMMARY1. The formation of ectopic junctions between the 'foreign' superficial fibular nerve and the soleus muscle of adult rats, and its relation to changes in extrajunctional sensitivity to acetylcholine (ACh), has been studied by denervating the muscle 3-6 weeks after implanting the foreign nerve.2. The earliest signs of nerve-muscle transmission were seen 25-3 days after denervation, in those fibres where the extrajunctional ACh sensitivity first reached its full post-denervation level. The number of innervated fibres continued to increase throughout the first week after denervation until 70-100 % of fibres underlying the foreign nerve growth were innervated.3. Direct stimulation of muscles with chronically implanted electrodes from the time of denervation prevents the formation of functional neuromuscular junctions (n.m.j.s). If stimulation begins 2 or 4 days after denervation, some functional n.m.j.s are formed which can be detected 7-9 days after denervation, though not as many as in the absence of stimulation.4. Direct stimulation of muscles from the time of denervation prevents the development of detectable extrajunctional ACh sensitivity. If stimulation begins 2 days after denervation nearly maximal sensitivity develops during the third day and then rapidly declines to undetectable levels by the beginning of the eighle day after denervation.

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“…Renewed focus on nerve transfer procedures has provided peripheral nerve surgeons with more reliable treatment options, along with improved patient outcomes. Utilizing a nerve transfer for the treatment of brachial plexus injuries is not a new concept [6,11,27], however an improved understanding of peripheral nerve biology, along with increasing clinical experience, has transformed the current treatment of complex brachial plexus injuries [2,4,15,21,26]. The medial pectoral nerve (MPN) can be surgically approached from either the infraclavicular route or from the supraclavicular approach at the level of the medial cord.…”

Section: Introductionmentioning

confidence: 99%

Medial Pectoral Nerve to Axillary Nerve Neurotization following Traumatic Brachial Plexus Injuries: Indications and Clinical Outcomes

Ray

Murphy

Santosa

et al. 2011

Hand (New York, N,Y.)

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Introduction The medial pectoral nerve (MPN) represents a viable donor nerve for neurotization procedures for restoration of shoulder function following upper trunk brachial plexus injuries. Materials and MethodsWe report an eight-case series, single-surgeon experience of patients with upper trunk brachial plexus injuries who underwent MPN to axillary nerve (AXN) transfer from 2001-2007 for shoulder stability and abduction. Results The mean patient age was 31.5 (range, 19-51 years). The mean follow-up for all patients was 22.25±7.4 months. Surgery was performed at a mean of 5.8±2.9 months postinjury. On initial evaluation, all eight patients had no deltoid function (M0). Of the eight patients examined postoperatively, we observed excellent recovery in four, good recovery in two, fair recovery in one, and poor functional recovery in the remaining patient. Discussion MPN to AXN neurotization is a valid surgical option in the restoration of shoulder stability and shoulder abduction following trauma-related upper trunk brachial plexus injury.

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Experiments on Motor Nerve Regeneration and the Direct Neurotization of Paralyzed Muscles by Their Own and by Foreign Nerves

Cited by 135 publications

References 0 publications

Polyneuronal innervation of skeletal muscle in new‐born rats and its elimination during maturation.

Polyneuronal innervation of skeletal muscle in new‐born rats and its elimination during maturation.

Control of acetylcholine sensitivity and synapse formation by muscle activity.

Medial Pectoral Nerve to Axillary Nerve Neurotization following Traumatic Brachial Plexus Injuries: Indications and Clinical Outcomes

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