Plasticity of the Central Nervous System Involving Peripheral Nerve Transfer

Abstract

Peripheral nerve injury can lead to partial or complete loss of limb function, and nerve transfer is an effective surgical salvage for patients with these injuries. The inability of deprived cortical regions representing damaged nerves to overcome corresponding maladaptive plasticity after the reinnervation of muscle fibers and sensory receptors is thought to be correlated with lasting and unfavorable functional recovery. However, the concept of central nervous system plasticity is rarely elucidated in classical textbooks involving peripheral nerve injury, let alone peripheral nerve transfer. This article is aimed at providing a comprehensive understanding of central nervous system plasticity involving peripheral nerve injury by reviewing studies mainly in human or nonhuman primate and by highlighting the functional and structural modifications in the central nervous system after peripheral nerve transfer. Hopefully, it will help surgeons perform successful nerve transfer under the guidance of modern concepts in neuroplasticity.

Nerve Transfers for Brachial Plexus Reconstruction in Patients over 60 Years

“…Furthermore, innovative rehabilitation concepts, such as early structured motor training using surface electromyography biofeedback (Figure 2), have demonstrated an ability to facilitate and fasten the cognitive adaption and relearning following nerve transfer procedures after brachial plexus injuries, making them a promising treatment method for otherwise healthy individuals who have sustained a lesion of their brachial plexus, in order to enable faster recovery of key upper extremity functions [13,27,28]. Compared to younger individuals, post-surgical rehabilitation is more demanding for older patients and hence requires higher frequency training.…”

“…for otherwise healthy individuals who have sustained a lesion of their brachial plexus, in order to enable faster recovery of key upper extremity functions [13,27,28]. Compared to younger individuals, post-surgical rehabilitation is more demanding for older patients and hence requires higher frequency training.…”

Diabetic peripheral neuropathy: pathogenetic mechanisms and treatment

“…Under the influence of hyperglycemia and hyperlipidemia, and through various signaling pathways, the regulatory functions of SCs, such as cell autophagy and cell metabolism, are damaged and dysfunction of mitochondria ( Figure 1 ) ( 17 , 29 , 30 ). Without the protection and support of glial cells, such as SCs, sensory neurons are more vulnerable to injury than motor neurons, especially neurons in the dorsal root ganglion ( 31 , 32 ). The structure and function of sensory neurons are particularly vulnerable.…”

Preconditions for the Successful Segmental Step-Wise Reconstruction of the Global Function of the Upper Extremity in Case of the Complete Brachial Plexus Injury (Case Report)

“…Реіннервація м'язів скапуло-гумеральної групи та відстрочене заміщення м'язів передньої поверхні передпліччя за допомогою трансплантації / реіннервації MCF із використанням одного НД (гілок додаткового нерва) не суперечить принципу один донор -одна функція [20], оскільки процеси перенавчання будуть рознесені у часі, який буде цілком достатнім для реалізації пластичності [28,29] * -у загальному стовбурі додаткового нерва [25,26]; ** -на рівні верхнього краю ключиці [25,26]; *** -в одному міжреберному нерві [27] Висновки 1. Відновлення глобальної функції верхньої кінцівки передбачає етапну реконструкцію сегментарного апарату, що пов'язано із відсутністю достатньої кількості нервів-донорів рухової функції в безпосередній близькості до бажаного м'яза-ефектора.…”