Proteomic analysis of trans-hemispheric motor cortex reorganization following contralateral C<sub>7</sub> nerve transfer

Yuan, Yin; Xu, Xiu-Yue; Lao, Jie; Zhao, Xin

doi:10.4103/1673-5374.226429

Cited by 2 publications

(2 citation statements)

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“…Studies on brain plasticity postcontralateral C7 transfer have shown a dynamic motor representation shift from ipsilateral hemisphere to the other, indicating the brain’s ability to control limbs bilaterally through enhanced cortico-cortical connectivity. This underscores the brain’s adaptability and the surgery’s potential in facilitating comprehensive motor recovery 67 – 69 .…”

Section: Discussionmentioning

confidence: 95%

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

Xiang,

Wu,

et al. 2024

International Journal of Surgery

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Background: The review highlights recent advancements and innovative uses of nerve transfer surgery in treating dysfunctions caused by central nervous system (CNS) injuries, with a particular focus on spinal cord injury (SCI), stroke, traumatic brain injury, and cerebral palsy. Methods: A comprehensive literature search was conducted regarding nerve transfer for restoring sensorimotor functions and bladder control following injuries of spinal cord and brain, across PubMed and Web of Science from January 1920 to May 2023. Two independent reviewers undertook article selection, data extraction, and risk of bias assessment with several appraisal tools, including the Cochrane Risk of Bias Tool, the JBI Critical Appraisal Checklist, and SYRCLE’s ROB tool. The study protocol has been registered and reported following PRISMA and AMSTAR guidelines. Results: Nine hundred six articles were retrieved, of which 35 studies were included (20 on SCI and 15 on brain injury), with 371 participants included in the surgery group and 192 in the control group. These articles were mostly low-risk, with methodological concerns in study types, highlighting the complexity and diversity. For SCI, the strength of target muscle increased by 3.13 of Medical Research Council grade, and the residual urine volume reduced by more than 100 ml in 15 of 20 patients. For unilateral brain injury, the Fugl-Myer motor assessment (FMA) improved 15.14–26 score in upper extremity compared to 2.35–26 in the control group. The overall reduction in Modified Ashworth score was 0.76–2 compared to 0–1 in the control group. Range of motion (ROM) increased 18.4–80° in elbow, 20.4–110° in wrist and 18.8–130° in forearm, while ROM changed −4.03°−20° in elbow, −2.08°−10° in wrist, −2.26°−20° in forearm in the control group. The improvement of FMA in lower extremity was 9 score compared to the presurgery. Conclusion: Nerve transfer generally improves sensorimotor functions in paralyzed limbs and bladder control following CNS injury. The technique effectively creates a ‘bypass’ for signals and facilitates functional recovery by leveraging neural plasticity. It suggested a future of surgery, neurorehabilitation and robotic-assistants converge to improve outcomes for CNS.

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Section: Discussionmentioning

confidence: 95%

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

Xiang,

Wu,

et al. 2024

International Journal of Surgery

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“…The healthy cerebral hemisphere eventually gained control of both upper limbs after the functional rearrangement of the cerebral hemispheres. The paralysis limbs’ stiffness and motor function were both improved ( 23 , 24 ). Numerous articles have analyzed the CC7 transfer’s prognosis since its inception, but there has been no consensus on its effectiveness and safety ( 25 , 26 ).…”

Section: Discussionmentioning

confidence: 99%

Contralateral seventh cervical nerve transfer for central spastic arm paralysis: a systematic review and meta-analysis

Luo,

Yan,

Guo

et al. 2023

Front. Neurol.

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ObjectivesThe specific benefits of a contralateral cervical 7 nerve transplant in people with spastic paralysis of the upper extremity caused by cerebral nerve injury are unclear. To evaluate the efficacy and safety of contralateral C7 nerve transfer for central spastic paralysis of the upper extremity, we conducted a comprehensive literature search and meta-analysis.Materials and methodsPRISMA guidelines were used to search the databases for papers comparing the efficacy of contralateral cervical 7 nerve transfer vs. rehabilitation treatment from January 2010 to August 2022. The finishing indications were expressed using SMD ± mean. A meta-analysis was used to assess the recovery of motor function in the paralyzed upper extremity.ResultsThe meta-analysis included three publications. One of the publications offers information about RCTs and non-RCTs. A total of 384 paralyzed patients were included, including 192 who underwent CC7 transfer and 192 who received rehabilitation. Results from all patients were combined and revealed that patients who had CC7 transfer may have regained greater motor function in the Fugl-Meyer score (SMD 3.52, 95% CI = 3.19–3.84, p < 0.00001) and had superior improvement in range of motion compared to the rehabilitation group (SMD 2.88, 95% CI = 2.47–3.29, p < 0.00001). In addition, the spasticity in the paralyzed upper extremity significantly improved in patients with CC7 transfer (SMD −1.42, 95% CI = −1.60 to −1.25, p < 0.00001).ConclusionOur findings suggested that a contralateral C7 nerve transfer, which has no additional adverse effects on the healthy upper limb, is a preferable method to restore motor function.

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Proteomic analysis of trans-hemispheric motor cortex reorganization following contralateral C₇ nerve transfer

Cited by 2 publications

References 57 publications

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

Contralateral seventh cervical nerve transfer for central spastic arm paralysis: a systematic review and meta-analysis

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Proteomic analysis of trans-hemispheric motor cortex reorganization following contralateral C7 nerve transfer

Cited by 2 publications

References 57 publications

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

Contralateral seventh cervical nerve transfer for central spastic arm paralysis: a systematic review and meta-analysis

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Proteomic analysis of trans-hemispheric motor cortex reorganization following contralateral C₇ nerve transfer