The effect of sciatic nerve transection on myelinated fibers in the L5 dorsal root and lumbar dorsal column. A Marchi study in the rat

Reimplantation of avulsed lumbosacral ventral roots in the rat ameliorates injury-induced degeneration of primary afferent axon collaterals in the spinal dorsal columns

Injuries to the cauda equina/conus medullaris portion of the spinal cord can result in motor, sensory, and autonomic dysfunction, and neuropathic pain. In rats, unilateral avulsion of the motor efferents from the lumbosacral spinal cord results in at-level allodynia, along with a corresponding glial and inflammatory response in the dorsal horn of the spinal cord segments immediately rostral to the lesion. Here, we investigated the fate of intramedullary primary sensory projections following a motor efferent lesion. The lumbosacral (L6 and S1) ventral roots were unilaterally avulsed from the rat spinal cord (VRA; n=9). A second experimental group had the avulsed roots acutely reimplanted into the lateral funiculus (Imp; n=5), as this neural repair strategy is neuroprotective, and promotes the functional reinnervation of peripheral targets. A laminectomy-only group served as controls (Lam; n=7). At 8 weeks post-lesion, immunohistochemical examination showed a 42% reduction (P<0.001) in the number of RT97-positive axons in the ascending tracts of the dorsal funiculus of the L4-5 spinal segment in VRA rats. Evidence for degenerating myelin was also present. Reimplantation of the avulsed roots ameliorated axon and myelin degeneration. Axons in the descending dorsal corticospinal tract were unaffected in all groups, suggesting a specificity of this lesion for spinal primary sensory afferents. These results show for the first time that a lesion restricted to motor roots can induce the degeneration of intramedullary sensory afferents. Importantly, reimplantation of the lesioned motor roots ameliorated sensory axon degeneration. These data further support the therapeutic potential for reimplantation of avulsed ventral roots following trauma to the cauda equina/conus medullaris.

Central changes in primary afferent fibers following peripheral nerve lesions

Cutting or crushing rat sciatic nerve does not significantly reduce the number of central myelinated sensory axons in the dorsal roots entering the fourth and fifth lumbar segments even over very extended periods of time. Unmyelinated axons were reduced by approximately 50%, but only long after sciatic nerve lesions (four to eight months), and reinnervation of the peripheral target did not rescue these axons. This indicates that a peripheral nerve lesion sets up a slowly developing but major shift towards large afferent fiber domination of primary afferent input into the spinal cord. In addition, since myelinated axons are never lost, this is good evidence that the cells that give rise to these fibers are also not lost. If this is the case, this would indicate that adult primary sensory neurons with myelinated axons do not depend on peripheral target innervation for survival.

Axon and ganglion cell injury in rabbits after percutaneous trigeminal balloon compression

New Zealand white rabbits were used to determine whether the changes in the Vth cranial nerve sensory root after compression were associated with the loss of a specific subclass of Vth cranial nerve ganglion cells, the disappearance of a distinct subset of primary afferent terminals in Vth cranial nerve nucleus caudalis, and/or injury to a specific axonal fiber type. There was no significant difference in the size of surviving ganglion cells after Vth cranial nerve compression, as measured 2 to 3 months after injury (P > 0.5, n = 4). Densitometric analysis of the nerves of rabbits that survived > 2 months after compression showed no significant difference in the immunoreactivity of substance P and calcitonin gene-reactive protein between compressed and control sides (P > 0.1, n = 4). Fink-Heimer staining of the Vth cranial nerve subnucleus caudalis revealed that transganglionic degeneration was most dense in the deeper layers, which are the sites of termination of large myelinated fibers. Ultrastructural evaluation of the type of myelinated axons injured by Vth cranial nerve compression in rabbits killed 7, 14, 37, and 270 days after injury was studied, and morphometric analysis was performed. The frequency distribution of axon diameters was significantly different for injured and control areas. The injured areas had higher ratios of small (< 3-microns diameter) to large-diameter axons compared to control distribution. These data indicate that balloon compression results in loss of fibers from the Vth cranial nerve sensory root and extensive transganglionic degeneration in the Vth cranial nerve brain stem complex. Cell size measurements and immunocytochemical data suggest that there is no specific loss of small ganglion cells or fine-caliber primary afferents. These experiments suggest that balloon compression relieves trigeminal pain by injuring the myelinated axons involved in the sensory trigger to the pain.

Plasticity of cutaneous primary afferent projections to the spinal dorsal horn

Reorganization of the somatotopic map in the spinal dorsal horn may be elicited by a variety of deafferenting lesions, including transection of peripheral nerves or dorsal roots, or the application of neurotoxins. While such lesions give rise to a variety of neurochemical and morphological changes in the dorsal horn, collateral sprouting of intact primary afferents appears to be minimal. Recently, intraaxonal injection of neurobiotin has allowed visualization of the entire spinal arborization of single A beta primary afferent fibers in animals where the somatotopy of the relevant region of dorsal horn has also been mapped. In contrast to the somatotopic precision of the terminal fields of peripheral nerves suggested by transganglionic tracing, these studies have shown that afferents make connections many millimeters rostral and caudal to the region where their receptive field is represented in the somatotopic map. Intracellular recording from dorsal horn neurons has further shown that these long-ranging projections make functional, but weak, synaptic connections. Thus the functional somatotopic reorganization that follows nerve lesions in mature animals might be explained simply by an increased synaptic efficacy of these existing projections. In contrast to the negligible sprouting of intact A beta primary afferents, those undergoing axonal regeneration exhibit dense collateral sprouting into deafferented regions of the dorsal horn, particularly the superficial laminae, where the terminal arbors of many small (A delta and C) nociceptive afferent fibres degenerate following peripheral nerve lesions. The inappropriate connections made by these collateral sprouts may partly underlie the painful sequelae of nerve injury in man.

Aspects of the protein and the lipid composition of myelinoid Marchi-positive bodies from mammalian spinal cord

The fraction floating on 0.32 M sucrose was isolated from normal mammalian spinal cord and analyzed with regard to protein and lipid composition. Comparisons were made with the myelin fraction isolated from the same spinal cord. A close relationship between the two fractions was indicated by a similar protein banding on SDS-polyacrylamide gel electrophoresis. The relative amounts of various proteins however were different and some high molecular weight proteins appeared unique to the floating fraction. The phospho- and galactolipid patterns, as revealed by thin-layer chromatography, were similar in the floating and the myelin fractions. The proportion of hydrophobic lipids, such as sterols and isoprenyl derivatives, was higher in the floating fraction. Bands co-migrating with cholesterol esters were detected only in the floating fraction from guinea pigs. Marchi-positive material of possible paranodal origin is enriched in the floating fraction. The present findings of a biochemical composition of the floating fraction closely resembling that of myelin is in line with the view that myelin turnover includes a step of degradation localized to the paranodal regions.

Cortical organization after treatment of a peripheral nerve with ricin: an evaluation of the relationship between sensory neuron death and cortical adjustments after nerve injury

The present study was designed to assess whether cortical changes after peripheral nerve damage are related to the degree of death of primary sensory neurons in the damaged nerve. The cytotoxin ricin was injected into the sciatic nerves of adult rats to kill primary sensory neurons with axons through the injection site. Following periods of 6-101 days, the S-I hindpaw map was evaluated with neurophysiological techniques and compared with the hindpaw maps of previously studied normal adult rats and adult rats that had undergone adult or neonatal sciatic section at a comparable level of the nerve. These comparisons allowed evaluation of cortical functional organization following different degrees of sensory neuron loss after sciatic nerve injury. There were three main results. 1) The comparison of ricin-treated and normal adult rats indicated that ricin treatment interrupted inputs from the sciatic skin territory on the hindpaw and caused a limited increase in the size of the cortical area that was activated by stimulation of hindpaw skin innervated by the remaining saphenous nerve. 2) The cortical maps of rats that had undergone adult ricin treatment (relatively large primary neuron loss) or section during adulthood (small to moderate primary neuron loss) were similar. In both groups, only the saphenous hindpaw skin was represented in cortex, and the cortical area that was activated by stimulation of the saphenous hindpaw skin had undergone a comparable limited enlargement. 3) The comparison of ricin-treated adult rats (relatively large primary neuron loss) and adult rats that had undergone neonatal section (relatively large primary neuron loss) indicated that cortical organization differed after these treatments. In particular, after ricin treatment the cortical area that was activated by stimulation of the saphenous hindpaw skin was larger than the comparable area in neonatal denervates, and the topographical progressions between the hindpaw and adjacent body representations were not as variable as after neonatal section. These findings indicate that cortical maps are altered after injection of ricin into a nerve. The similarity in cortical organization after ricin treatment (relatively large sensory neuron loss) and nerve section in adults (relatively small sensory neuron loss) and the differences in cortical organization after ricin treatment and nerve section in neonates (both relatively large sensory neuron loss) indicate cortical changes do not covary as a simple function of the degree of peripheral neuron death.

Isolation of myelinoid Marchi-positive bodies from normal rabbit spinal cord

Normal rabbit spinal cord was homogenized in sucrose and fractionated by centrifugation in a sucrose density gradient system slightly modified after the Norton-Poduslo method for the isolation of myelin. The following fractions were recovered: the fraction floating on 0.32 M sucrose, the myelin fraction at the 0.32 M/0.85 M interface and the pellet. After fixation in glutaraldehyde the fractions were subjected to Marchi staining, a histochemical method used for the demonstration of degenerating myelin. The floating fraction was enriched in Marchi-positive bodies as compared to the homogenate while the myelin fraction and the pellet contained low amounts. No esterified cholesterol was found in the floating fraction. Since histochemical and electron microscopical studies have shown that Marchi-positive myelinoid bodies in the normal CNS are associated with node-paranode regions our results indicate a possibility to isolate and biochemically characterize a presumably closely myelin-related fraction of known anatomical origin. The absence of esterified cholesterol in the floating fraction shows that biochemical or biophysical properties other than a content of esterified cholesterol may give rise to a positive Marchi reaction.

The reaction of primary sensory neurons to peripheral nerve injury with particular emphasis on transganglionic changes

This paper reviews light- and electron microscopic, histochemical and physiological evidence which demonstrate that peripheral nerve injury in mammals is followed by profound structural and functional changes in the central terminals of the affected primary sensory neurons. Available evidence indicates that at least some of these so-called transganglionic changes are the result of ganglion cell degeneration and death, although other mechanisms are probably in effect as well. Existing data suggest that this ganglion cell death does not effect all types of ganglion cells equally, but do not permit a clearcut answer to the question of which kinds of ganglion cells are affected more than others. Results from studies with microtubule inhibitors and antibodies to nerve growth factor are compatible with the notion that depletion of retrogradely transported trophic factors is involved in the production of certain transganglionic changes. This issue needs further examination, however. Physiological studies indicate marked alterations in certain primary afferent synaptic connections after peripheral nerve lesions. So far, these changes have not been satisfactorily correlated with the structural changes induced by similar lesions. Further studies on the structural and functional response of primary sensory neurons to peripheral nerve injury are likely to contribute to the understanding of the frequent failure to regain normal sensory functions after peripheral nerve lesions in man, as well as of the basic aspects of lesion-induced changes in general in the peripheral and central nervous system.