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Hendry JM, Head LK. Alternative Nerve Coaptations: End-To-Side and Beyond. Hand Clin 2024; 40:369-377. [PMID: 38972681 DOI: 10.1016/j.hcl.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Modern end-to-side (ETS) nerve transfers have undergone several permutations since the early 1990's. Preclinical data have revealed important mechanisms and patterns of donor axon outgrowth into the recipient nerves and target reinnervation. The versatility of ETS nerve transfers can also potentially address several processes that limit functional recovery after nerve injury by babysitting motor end-plates and/or supporting the regenerative environment within the denervated nerve. Further clinical and basic science work is required to clarify the ideal clinical indications, contraindications, and mechanisms of action for these techniques in order to maximize their potential as reconstructive options.
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Affiliation(s)
- J Michael Hendry
- Division of Plastic and Reconstructive Surgery, Queen's University, Kingston, Ontario K7L 5G2, Canada; Centre for Neuroscience Studies, Queens University, 18 Stuart Street, Kingston, Ontario, K7L3N6, Canada
| | - Linden K Head
- Division of Plastic and Reconstructive Surgery, Queen's University, Kingston, Ontario K7L 5G2, Canada.
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Czarnecki P, Huber J, Szymankiewicz-Szukała A, Górecki M, Romanowski L. End-to-Side vs. Free Graft Nerve Reconstruction-Experimental Study on Rats. Int J Mol Sci 2023; 24:10428. [PMID: 37445608 DOI: 10.3390/ijms241310428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/11/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The long history of regeneration nerve research indicates many clinical problems with surgical reconstruction to be resolved. One of the promising surgical techniques in specific clinical conditions is end-to-side neurorrhaphy (ETS), described and then repeated with different efficiency in the 1990s of the twentieth century. There are no reliable data on the quality of recipient nerve regeneration, possible donor nerve damage, and epineural window technique necessary to be performed. This research attempts to evaluate the possible regeneration after end-to-side neurorrhaphy, its quality, potential donor nerve damage, and the influence of epineural windows on regeneration efficiency. Forty-five female Wistar rats were divided into three equal groups, and various surgical technics were applied: A-ETS without epineural window, B-ETS with epineural window, and C-free graft reconstruction. The right peroneal nerve was operated on, and the tibial nerve was selected as a donor. After 24 weeks, the regeneration was evaluated by (1) footprint analysis every two weeks with PFI (peroneal nerve function index), TFI (tibial nerve function index), and SFI (sciatic nerve function index) calculations; (2) the amplitude and latency measurements of motor evoked potentials parameters recorded on both sides of the peroneal and tibial nerves when electroneurography with direct sciatic nerve electrical stimulation and indirect magnetic stimulation were applied; (3) histomorphometry with digital conversion of a transverse semithin nerve section, with axon count, fibers diameter, and calculation of axon area with a semiautomated method were performed. There was no statistically significant difference between the groups investigated in all the parameters. The functional indexes stabilized after eight weeks (PFI) and six weeks (TFI and SFI) and were positively time related. The lower amplitude of tibial nerve potential in groups A and B was proven compared to the non-operated side. Neurophysiological parameters of the peroneal nerve did not differ significantly. Histomorphometry revealed significantly lower diameter and area of axons in operated peroneal nerves compared to non-operated nerves. The axon count was at a normal level in every group. Tibial nerve parameters did not differ from non-operated values. Regeneration of the peroneal nerve after ETS was ascertained to be at the same level as in the case of free graft reconstruction. Peroneal nerves after ETS and free graft reconstruction were ascertained to have a lower diameter and area than non-operated ones. The technique of an epineural window does not influence the regeneration result of the peroneal nerve. The tibial nerve motor evoked potentials were characterized by lower amplitudes in ETS groups, which could indicate axonal impairment.
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Affiliation(s)
- Piotr Czarnecki
- Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Sciences, 61-545 Poznań, Poland
| | - Juliusz Huber
- Department of Pathophysiology of Locomotor Organs, Poznań University of Medical Sciences, 61-545 Poznań, Poland
| | | | - Michał Górecki
- Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Sciences, 61-545 Poznań, Poland
| | - Leszek Romanowski
- Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Sciences, 61-545 Poznań, Poland
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Sensory Neurotization of the Ulnar Nerve, Surgical Techniques and Functional Outcomes: A Review. J Clin Med 2022; 11:jcm11071903. [PMID: 35407511 PMCID: PMC8999486 DOI: 10.3390/jcm11071903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/17/2022] Open
Abstract
When ulnar nerve lesions happen above the wrist level, sensation recovery after acute repair or nerve grafting is often challenging. Distal sensory nerve transfers may be an option for overcoming these sequelae. However, little data has been published on this topic. This study aims to review the surgical procedures currently proposed, along with their functional results. Six donor nerves have been described at the wrist level: the palmar branch of the median nerve, the cutaneous branch of the median nerve to the palm with or without fascicles of the ulnar digital nerve of the index finger, the posterior interosseous nerve, the third palmar digital nerve, the radial branch of the superficial radial nerve, the median nerve, and the fascicule for the third web space. Three donor nerves have been reported at the hand level: the ulnar digital nerves of the index, and the radial or ulnar digital nerves of the long finger. Three target sites were used: the superficial branch of the ulnar nerve, the dorsal branch of the ulnar nerve, and the ulnar digital branch of the fifth digit. All the technical points have been illustrated with anatomical dissection pictures. After assessing sensory recovery using the British Medical Research Council scale, a majority of excellent recoveries scaled S3+ or S4 have been reported in the targeted territory for each technique.
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Kubiak CA, Svientek SR, Dehdashtian A, Lawera NG, Nadarajan V, Bratley JV, Kung TA, Cederna PS, Kemp SWP. Physiologic signaling and viability of the muscle cuff regenerative peripheral nerve interface (MC-RPNI) for intact peripheral nerves. J Neural Eng 2021; 18. [PMID: 34359056 DOI: 10.1088/1741-2552/ac1b6b] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/06/2021] [Indexed: 11/11/2022]
Abstract
Background. Robotic exoskeleton devices have become a promising modality for restoration of extremity function in individuals with limb loss or functional weakness. However, there exists no consistent or reliable way to record efferent motor action potentials from intact peripheral nerves to control device movement. Peripheral nerve motor action potentials are similar in amplitude to that of background noise, producing an unfavorable signal-to-noise ratio (SNR) that makes these signals difficult to detect and interpret. To address this issue, we have developed the muscle cuff regenerative peripheral nerve interface (MC-RPNI), a construct consisting of a free skeletal muscle graft wrapped circumferentially around an intact peripheral nerve. Over time, the muscle graft regenerates, and the intact nerve undergoes collateral axonal sprouting to reinnervate the muscle. The MC-RPNI amplifies efferent motor action potentials by several magnitudes, thereby increasing the SNR, allowing for higher fidelity signaling and detection of motor intention. The goal of this study was to characterize the signaling capabilities and viability of the MC-RPNI over time.Methods. Thirty-seven rats were randomly assigned to one of five experimental groups (Groups A-E). For MC-RPNI animals, their contralateral extensor digitorum longus (EDL) muscle was harvested and trimmed to either 8 mm (Group A) or 13 mm (Group B) in length, wrapped circumferentially around the intact ipsilateral common peroneal (CP) nerve, secured, and allowed to heal for 3 months. Additionally, one 8 mm (Group C) and one 13 mm (Group D) length group had an epineurial window created in the CP nerve immediately preceding MC-RPNI creation. Group E consisted of sham surgery animals. At 3 months, electrophysiologic analyses were conducted to determine the signaling capabilities of the MC-RPNI. Additionally, electromyography and isometric force analyses were performed on the CP-innervated EDL to determine the effects of the MC-RPNI on end organ function. Following evaluation, the CP nerve, MC-RPNI, and ipsilateral EDL muscle were harvested for histomorphometric analysis.Results. Study endpoint analysis was performed at 3 months post-surgery. All rats displayed visible muscle contractions in both the MC-RPNI and EDL following proximal CP nerve stimulation. Compound muscle action potentials were recorded from the MC-RPNI following proximal CP nerve stimulation and ranged from 3.67 ± 0.58 mV to 6.04 ± 1.01 mV, providing efferent motor action potential amplification of 10-20 times that of a normal physiologic nerve action potential. Maximum tetanic isometric force (Fo) testing of the distally-innervated EDL muscle in MC-RPNI groups producedFo(2341 ± 114 mN-2832 ± 102 mN) similar to controls (2497 ± 122 mN), thus demonstrating that creation of MC-RPNIs did not adversely impact the function of the distally-innervated EDL muscle. Overall, comparison between all MC-RPNI sub-groups did not reveal any statistically significant differences in signaling capabilities or negative effects on distal-innervated muscle function as compared to the control group.Conclusions. MC-RPNIs have the capability to provide efferent motor action potential amplification from intact nerves without adversely impacting distal muscle function. Neither the size of the muscle graft nor the presence of an epineurial window in the nerve had any significant impact on the ability of the MC-RPNI to amplify efferent motor action potentials from intact nerves. These results support the potential for the MC-RPNI to serve as a biologic nerve interface to control advanced exoskeleton devices.
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Affiliation(s)
- Carrie A Kubiak
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Shelby R Svientek
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Amir Dehdashtian
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Nathan G Lawera
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Vidhya Nadarajan
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Jarred V Bratley
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Theodore A Kung
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Paul S Cederna
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America.,Department of Biomedical Engineering, The University of Michigan, Ann Arbor, MI, United States of America
| | - Stephen W P Kemp
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America.,Department of Biomedical Engineering, The University of Michigan, Ann Arbor, MI, United States of America
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Bernal L, Cisneros E, Roza C. Activation of the regeneration-associated gene STAT3 and functional changes in intact nociceptors after peripheral nerve damage in mice. Eur J Pain 2021; 25:886-901. [PMID: 33345380 DOI: 10.1002/ejp.1718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In the context of neuropathic pain, the contribution of regeneration to the development of positive symptoms is not completely understood. Several efforts have been done to described changes in axotomized neurons, however, there is scarce data on changes occurring in intact neurons, despite experimental evidence of functional changes. To address this issue, we analysed by immunohistochemistry the presence of phosphorylated signal transducer and activator of transcription 3 (pSTAT3), an accepted marker of regeneration, within DRGs where axotomized neurons were retrogradely labelled following peripheral nerve injury. Likewise, we have characterized abnormal electrophysiological properties in intact fibres after partial nerve injury. METHODS/RESULTS We showed that induction of pSTAT3 in sensory neurons was similar after partial or total transection of the sciatic nerve and to the same extent within axotomized and non-axotomized neurons. We also examined pSTAT3 presence on non-peptidergic and peptidergic nociceptors. Whereas the percentage of neurons marked by IB4 decrease after injury, the proportion of CGRP neurons did not change, but its expression switched from small- to large-diameter neurons. Besides, the percentage of CGRP+ neurons expressing pSTAT3 increased significantly 2.5-folds after axotomy, preferentially in neurons with large diameters. Electrophysiological recordings showed that after nerve damage, most of the neurons with ectopic spontaneous activity (39/46) were non-axotomized C-fibres with functional receptive fields in the skin far beyond the site of damage. CONCLUSIONS Neuronal regeneration after nerve injury, likely triggered from the site of injury, may explain the abnormal functional properties gained by intact neurons, reinforcing their role in neuropathic pain. SIGNIFICANCE Positive symptoms in patients with peripheral neuropathies correlate to abnormal functioning of different subpopulations of primary afferents. Peripheral nerve damage triggers regenerating programs in the cell bodies of axotomized but also in non-axotomized nociceptors which is in turn, develop abnormal spontaneous and evoked discharges. Therefore, intact nociceptors have a significant role in the development of neuropathic pain due to their hyperexcitable peripheral terminals. Therapeutical targets should focus on inhibiting peripheral hyperexcitability in an attempt to limit peripheral and central sensitization.
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Affiliation(s)
- Laura Bernal
- Department of System's Biology, Medical School, University of Alcala, Alcalá de Henares, Spain
| | - Elsa Cisneros
- Department of System's Biology, Medical School, University of Alcala, Alcalá de Henares, Spain.,Health Sciences School, Centro Universitario Internacional de Madrid (CUNIMAD), Madrid, Spain.,Health Sciences School, Universidad Internacional de La Rioja (UNIR), Logroño, Spain
| | - Carolina Roza
- Department of System's Biology, Medical School, University of Alcala, Alcalá de Henares, Spain
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Assessment of axonal sprouting and motor performance after hypoglossal-facial end-to-side nerve repair: experimental study in rats. Exp Brain Res 2020; 238:1563-1576. [PMID: 32488325 DOI: 10.1007/s00221-020-05835-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
Hypoglossal-facial nerve anastomosis (HFA) aims to reanimate denervated mimic muscles with hypoglossal axons when the transected facial nerve is not accessible. The aim of this study was to evaluate the recovery of HFA using a "Y" tube in two variants: (1) the proximal stump of the hypoglossal nerve was entubulated to the "Y" tube (classic "Y" tube HFA) and (2) the "Y" tube was sutured to an epineurial window of a slightly damaged hypoglossal nerve (end-to-side "Y" tube HFA). A total of 48 adult female rats were divided into four groups: intact controls (group 1), sham operated (group 2), classic "Y" tube HFA (group 3) and end-to-side "Y" tube HFA (group 4). The abdominal aorta with both common iliac arteries of isogeneic male rats served as the Y-tube conduit. Animals from group 4 recovered better than those from group 3: the degree of collateral axonal branching (3 ± 1%) was significantly lower than that determined in group 3 (13 ± 1%). The mean deviation of the tongue from the midline was significantly smaller in group 4 (6 ± 4°) than that measured in animals from group 3 (41 ± 6°). In the determination of vibrissal motor function in group 3 and group 4, a decrease in amplitude was found to be - 66% and - 92%, respectively. No differences in the reinnervation pattern of the target muscles were detected. As a result, these surgical models were not determined to be able to improve vibrissal movements. It was concluded that performance of end-to-side "Y" tube HFA diminishes collateral axonal branching at the lesion site, which in turn, promotes better recovery of tongue- and vibrissal-motor performance.
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Tognon-Miguel V, Nascimento-Elias AH, Schiavoni MCL, Barreira AA. Plasticity of Unmyelinated Fibers in a Side-to-end Tubulization Model. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e1993. [PMID: 30859022 PMCID: PMC6382236 DOI: 10.1097/gox.0000000000001993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 09/14/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Histomorphometric studies of unmyelinated fibers of the rat fibular nerves are uncommon, and side-to-end neurorrhaphy studies using the fibular nerve investigate primarily motor fibers. We investigated side-to-end tubulization (SET) technique, in which occurs collateral sprouting from the intact donor nerve fibers to the distal stump of receptor nerve, with muscle reinnervation and functional rehabilitation, to assess whether there is a successful growth of unmyelinated fibers in this model. METHODS Adult Wistar rats fibular nerves were sectioned to create a 5-mm gap. A 6-mm silicone tube was attached between a side of the intact tibial nerve and the sectioned fibular nerve distal stump (SET group), with the left fibular nerve as normal (sham group). Seventy days postsurgery, unmyelinated fibers from the distal segment of the fibular nerve were quantified using light and transmission electron microscopy and their diameters were measured. RESULTS The number of unmyelinated fibers was similar between sham (1,882 ± 270.9) and SET (2,012 ± 1,060.8), but axons density was significantly greater in the SET (18,733.3 ± 5,668.6) than sham (13,935.0 ± 1,875.8). Additionally, the axonal diameters differed significantly between groups with mean measures in sham (0.968 ± 0.10) > SET (0.648 ± 0.08). CONCLUSIONS Unmyelinated fiber growth occurred even with a 5-mm distance between the donor and receptor nerves, reaching similar axonal number to the normal nerve, demonstrating that the SET is a reliable technique that can promote a remarkable plasticity of unmyelinated axons.
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Affiliation(s)
- Vânia Tognon-Miguel
- Department of Neurosciences and Behavioral Sciences, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Adriana H Nascimento-Elias
- Department of Neurosciences and Behavioral Sciences, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Maria C L Schiavoni
- Department of Neurosciences and Behavioral Sciences, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Amilton A Barreira
- Department of Neurosciences and Behavioral Sciences, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Liu P, Liao C, Zhong W, Yang M, Li P, Zhang W. Comparison of 4 Different Methods for Direct Hypoglossal-Facial Nerve Anastomosis in Rats. World Neurosurg 2018; 112:e588-e596. [PMID: 29410339 DOI: 10.1016/j.wneu.2018.01.094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/11/2018] [Accepted: 01/12/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Classic hypoglossal-facial nerve anastomosis inevitably causes hemitongue atrophy and dysfunction. Thus, many variants have been developed to reduce tongue-related morbidities. A comparative study concerning these techniques was conducted in rats to systematically evaluate long-term functional and histologic outcomes of the recipient and donor systems. METHODS Rats (8 per group) were treated by end-to-end neurorrhaphy (EEN), EEN using the hemisectioned and longitudinally split donor nerve (EEN-Hemi), end-to-side neurorrhaphy through a perineurial window (ESN-PW), or 30% to 40% partial neurotomy (ESN-PN). Four additional rats were left intact. At 8 months postoperatively, behavioral, electrophysiologic, and morphologic studies were carried out to compare the groups. RESULTS All techniques resulted in partial functional recovery, but complete restoration was not obtained. There were no significant differences between the experimental groups in axon diameter or myelin thickness. The facial nerve fiber count after ESN-PN, but not after EEN-Hemi or ESN-PW, was comparable with that after EEN, which agreed with the behavioral and electrophysiologic results. The hypoglossal nerve fiber count after ESN-PN was slightly less than that after ESN-PW, but markedly more than that after EEN-Hemi, corresponding to the electrophysiologic examination. Quantitative measures of muscle fiber cross-sectional area and connective tissue area density of the tongue demonstrated severe muscle atrophy on the operated side after EEN and EEN-Hemi when compared with ESN-PW and ESN-PN. CONCLUSIONS ESN with 30% to 40% partial donor neurotomy offers the best balance between motor reinnervation and donor deficits. The method of nerve split for provision of hemihypoglossal nerve stump may not effectively preserve the tongue function.
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Affiliation(s)
- Pengfei Liu
- Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chenlong Liao
- Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Wenxiang Zhong
- Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Min Yang
- Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Pengyang Li
- Peking University Aerospace School of Clinical Medicine, Peking University Health Science Center, Beijing, China
| | - Wenchuan Zhang
- Department of Neurosurgery, XinHua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China.
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Civi S, Durdag E, Aytar MH, Kardes O, Kaymaz F, Aykol S. Usefulness of End-to-Side Bridging Anastomosis of Sural Nerve to Tibial Nerve: An Experimental Research. J Korean Neurosurg Soc 2017; 60:417-423. [PMID: 28689390 PMCID: PMC5544376 DOI: 10.3340/jkns.2016.1010.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/17/2016] [Accepted: 02/13/2017] [Indexed: 01/28/2023] Open
Abstract
Objective Repair of sensorial nerve defect is an important issue on peripheric nerve surgery. The aim of the present study was to determine the effects of sensory-motor nerve bridging on the denervated dermatomal area, in rats with sensory nerve defects, using a neural cell adhesion molecule (NCAM). Methods We compared the efficacy of end-to-side (ETS) coaptation of the tibial nerve for sural nerve defect repair, in 32 Sprague-Dawley rats. Rats were assigned to 1 of 4 groups: group A was the sham operated group, group B rats had sural nerves sectioned and buried in neighboring muscles, group C experienced nerve sectioning and end-to-end (ETE) anastomosis, and group D had sural nerves sectioned and ETS anastomosis was performed using atibial nerve bridge. Neurological evaluation included the skin pinch test and histological evaluation was performed by assessing NCAM expression in nerve terminals. Results Rats in the denervated group yielded negative results for the skin pinch tests, while animals in the surgical intervention groups (group C and D) demonstrated positive results. As predicted, there were no positively stained skin specimens in the denervated group (group B); however, the surgery groups demonstrated significant staining. NCAM expression was also significantly higher in the surgery groups. However, the mean NCAM values were not significantly different between group C and group D. Conclusion Previous research indicates that ETE nerve repair is the gold standard for peripheral nerve defect repair. However, ETS repair is an effective alternative method in cases of sensorial nerve defect when ETE repair is not possible.
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Affiliation(s)
- Soner Civi
- Department of Neurosurgery, Başkent University Faculty of Medicine, Adana, Turkey
| | - Emre Durdag
- Department of Neurosurgery, Başkent University Faculty of Medicine, Adana, Turkey
| | - Murat Hamit Aytar
- Department of Neurosurgery, Acibadem University Vocational School of Health Services, İstanbul, Turkey
| | - Ozgur Kardes
- Department of Neurosurgery, Başkent University Faculty of Medicine, Adana, Turkey
| | - Figen Kaymaz
- Department of Histology and Embryology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sukru Aykol
- Department of Neurosurgery, Gazi University Faculty of Medicine, Ankara, Turkey
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Tognon-Miguel V, Nascimento-Elias AHD, Schiavoni MCL, Barreira AA. A histomorphometric study of unmyelinated fibers of the fibular nerve in Wistar rats. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:367-72. [PMID: 27191231 DOI: 10.1590/0004-282x20160051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/16/2016] [Indexed: 11/21/2022]
Abstract
There are few histomorphometric studies on the unmyelinated fibers of the fibular nerve in rats, and the number of experimental studies using this nerve has been increasing in the last years. Sixty-two percent of the endoneurial area from 10 fibular nerves of adult Wistar rats was scanned by electron microscopy, and digitized. The total number of unmyelinated axons (1.882 ± 271) was significantly lesser, and their axon diameters (0.2 µm to 2.8 µm) significantly higher than that determined in previous studies. The histogram peaked at 1 µm. The differences could be due to the nerve sampled area, the number and the age of the animals evaluated, and the laboratory techniques used. This study brings new and referential data to be used in experimental investigations involving histomorphometric evaluation of the rat fibular nerve.
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Affiliation(s)
- Vânia Tognon-Miguel
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Adriana Helena do Nascimento-Elias
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Maria Cristina Lopes Schiavoni
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Amilton Antunes Barreira
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Bernal L, Lopez-Garcia JA, Roza C. Spontaneous activity in C-fibres after partial damage to the saphenous nerve in mice: Effects of retigabine. Eur J Pain 2016; 20:1335-45. [PMID: 27061852 DOI: 10.1002/ejp.858] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Spontaneous pain is the most devastating positive symptom in neuropathic pain patients. Recent data show a direct relationship between spontaneous discharges in C-fibres and spontaneous pain in neuropathic patients. Unfortunately, to date there is a lack of experimental animal models for drug testing. METHODS We recorded afferent fibres from a new experimental model in vitro. The preparation contains a neuroma formed in a peripheral branch of the saphenous nerve together with the undamaged branches, which maintain intact terminals in a skin flap. RESULTS Fibres with stable rates of ectopic spontaneous discharges were found among axotomized (5 A- and 18 C-fibres, mean discharge 0.48 ± 0.08 Hz) and 'putative intact' fibres (12 C-fibres, mean discharge 0.28 ± 0.08 Hz). A proportion (~9%) of axotomized fibres had mechanical receptive fields in the skin far beyond the site of injury. Collision experiments demonstrated that action potentials evoked from neuroma and skin travelled by the same fibre, indicating functional cross-talk between neuromatose and putative intact fibres. Retigabine, the specific Kv7 channel opener, depressed spontaneous discharges by 70% in 15/18 units tested. In contrast, responses to mechanical stimulation of the skin were unaltered by retigabine. CONCLUSIONS Partial damage to a peripheral nerve may increase the incidence of spontaneous activity in C-fibres. Retigabine reduced spontaneous activity but not stimulus-evoked activity, suggesting an important role for ion channels in the control of spontaneous pain and demonstrating the utility of the model for the testing of compounds in clinically relevant variables. WHAT DOES THIS STUDY ADD?: Our in vitro experimental model of peripheral neuropathy allows for pharmacological characterization of spontaneously active fibres. Using this model, we show that retigabine inhibits aberrant spontaneous discharges without altering physiological responses in primary afferents.
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Affiliation(s)
- L Bernal
- Dpto. Biología de Sistemas, Edificio de Medicina Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - J A Lopez-Garcia
- Dpto. Biología de Sistemas, Edificio de Medicina Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - C Roza
- Dpto. Biología de Sistemas, Edificio de Medicina Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
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12
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Papalia I, Magaudda L, Righi M, Ronchi G, Viano N, Geuna S, Colonna MR. Epineurial Window Is More Efficient in Attracting Axons than Simple Coaptation in a Sutureless (Cyanoacrylate-Bound) Model of End-to-Side Nerve Repair in the Rat Upper Limb: Functional and Morphometric Evidences and Review of the Literature. PLoS One 2016; 11:e0148443. [PMID: 26872263 PMCID: PMC4752340 DOI: 10.1371/journal.pone.0148443] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 01/18/2016] [Indexed: 12/27/2022] Open
Abstract
End-to-side nerve coaptation brings regenerating axons from the donor to the recipient nerve. Several techniques have been used to perform coaptation: microsurgical sutures with and without opening a window into the epi(peri)neurial connective tissue; among these, window techniques have been proven more effective in inducing axonal regeneration. The authors developed a sutureless model of end-to-side coaptation in the rat upper limb. In 19 adult Wistar rats, the median and the ulnar nerves of the left arm were approached from the axillary region, the median nerve transected and the proximal stump sutured to the pectoral muscle to prevent regeneration. Animals were then randomly divided in two experimental groups (7 animals each, 5 animals acting as control): Group 1: the distal stump of the transected median nerve was fixed to the ulnar nerve by applying cyanoacrylate solution; Group 2: a small epineurial window was opened into the epineurium of the ulnar nerve, caring to avoid damage to the nerve fibres; the distal stump of the transected median nerve was then fixed to the ulnar nerve by applying cyanoacrylate solution. The grasping test for functional evaluation was repeated every 10-11 weeks starting from week-15, up to the sacrifice (week 36). At week 36, the animals were sacrificed and the regenerated nerves harvested and processed for morphological investigations (high-resolution light microscopy as well as stereological and morphometrical analysis). This study shows that a) cyanoacrylate in end-to-side coaptation produces scarless axon regeneration without toxic effects; b) axonal regeneration and myelination occur even without opening an epineurial window, but c) the window is related to a larger number of regenerating fibres, especially myelinated and mature, and better functional outcomes.
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Affiliation(s)
- Igor Papalia
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Ludovico Magaudda
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Maria Righi
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Giulia Ronchi
- Department of Clinical and Biological Sciences, University of Torino, Orbassano (Torino), Italy
- Neuroscience Institute of the “Cavalieri Ottolenghi” Foundation (NICO), University of Torino, Orbassano (Torino), Italy
| | - Nicoletta Viano
- Department of Clinical and Biological Sciences, University of Torino, Orbassano (Torino), Italy
| | - Stefano Geuna
- Department of Clinical and Biological Sciences, University of Torino, Orbassano (Torino), Italy
- Neuroscience Institute of the “Cavalieri Ottolenghi” Foundation (NICO), University of Torino, Orbassano (Torino), Italy
- * E-mail:
| | - Michele Rosario Colonna
- Department of Experimental and Clinical Surgical and Medical Specialties, University of Messina, Messina, Italy
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13
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Czaja K, Fornaro M, Geuna S. Neurogenesis in the adult peripheral nervous system. Neural Regen Res 2015; 7:1047-54. [PMID: 25722694 PMCID: PMC4340017 DOI: 10.3969/j.issn.1673-5374.2012.14.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 02/24/2012] [Indexed: 12/21/2022] Open
Abstract
Most researchers believe that neurogenesis in mature mammals is restricted only to the subgranular zone of the dentate gyrus and the subventricular zone of the lateral ventricle in the central nervous system. In the peripheral nervous system, neurogenesis is thought to be active only during prenatal development, with the exception of the olfactory neuroepithelium. However, sensory ganglia in the adult peripheral nervous system have been reported to contain precursor cells that can proliferate in vitro and be induced to differentiate into neurons. The occurrence of insult-induced neurogenesis, which has been reported by several investigators in the brain, is limited to a few recent reports for the peripheral nervous system. These reports suggest that damage to the adult nervous system induces mechanisms similar to those that control the generation of new neurons during prenatal development. Understanding conditions under which neurogenesis can be induced in physiologically non-neurogenic regions in adults is one of the major challenges for developing therapeutic strategies to repair neurological damage. However, the induced neurogenesis in the peripheral nervous system is still largely unexplored. This review presents the history of research on adult neurogenesis in the peripheral nervous system, which dates back more than 100 years and reveals the evidence on the under estimated potential for generation of new neurons in the adult peripheral nervous system.
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Affiliation(s)
- Krzysztof Czaja
- Department of Veterinary and Comparative Anatomy, Pharmacology and Physiology (VCAPP), College of Veterinary Medicine, Washington State University, Pullman, WA 99163-6520, USA
| | - Michele Fornaro
- Department of Anatomy, Chicago College of Osteopathic Medicine (CCOM), Midwestern University, Downers Grove, IL 60515, USA
| | - Stefano Geuna
- Neuroscience Institute of the Cavalieri Ottolenghi Foundation (NICO) & Department of Clinical and Biological Sciences, University of Turin, Orbassano 10043, Italy
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14
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Li Y, Lao J, Zhao X, Tian D, Zhu Y, Wei X. The optimal distance between two electrode tips during recording of compound nerve action potentials in the rat median nerve. Neural Regen Res 2014; 9:171-8. [PMID: 25206798 PMCID: PMC4146167 DOI: 10.4103/1673-5374.125346] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2013] [Indexed: 11/25/2022] Open
Abstract
The distance between the two electrode tips can greatly influence the parameters used for recording compound nerve action potentials. To investigate the optimal parameters for these recordings in the rat median nerve, we dissociated the nerve using different methods and compound nerve action potentials were orthodromically or antidromically recorded with different electrode spacings. Compound nerve action potentials could be consistently recorded using a method in which the middle part of the median nerve was intact, with both ends dissociated from the surrounding fascia and a ground wire inserted into the muscle close to the intact part. When the distance between two stimulating electrode tips was increased, the threshold and supramaximal stimulating intensity of compound nerve action potentials were gradually decreased, but the amplitude was not changed significantly. When the distance between two recording electrode tips was increased, the amplitude was gradually increased, but the threshold and supramaximal stimulating intensity exhibited no significant change. Different distances between recording and stimulating sites did not produce significant effects on the aforementioned parameters. A distance of 5 mm between recording and stimulating electrodes and a distance of 10 mm between recording and stimulating sites were found to be optimal for compound nerve action potential recording in the rat median nerve. In addition, the orthodromic compound action potential, with a biphasic waveform that was more stable and displayed less interference (however also required a higher threshold and higher supramaximal stimulus), was found to be superior to the antidromic compound action potential.
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Affiliation(s)
- Yongping Li
- Department of Hand Surgery of HuaShan Hospital, Fudan University; Key Laboratory of Hand Reconstruction, Ministry of Healthy; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China ; Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Jie Lao
- Department of Hand Surgery of HuaShan Hospital, Fudan University; Key Laboratory of Hand Reconstruction, Ministry of Healthy; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
| | - Xin Zhao
- Department of Hand Surgery of HuaShan Hospital, Fudan University; Key Laboratory of Hand Reconstruction, Ministry of Healthy; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
| | - Dong Tian
- Department of Hand Surgery of HuaShan Hospital, Fudan University; Key Laboratory of Hand Reconstruction, Ministry of Healthy; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
| | - Yi Zhu
- Department of Hand Surgery of HuaShan Hospital, Fudan University; Key Laboratory of Hand Reconstruction, Ministry of Healthy; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
| | - Xiaochun Wei
- Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
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15
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Kovačič U, Zele T, Tomšič M, Sketelj J, Bajrović FF. Influence of breaching the connective sheaths of the donor nerve on its myelinated sensory axons and on their sprouting into the end-to-side coapted nerve in the rat. J Neurotrauma 2012; 29:2805-15. [PMID: 22873667 DOI: 10.1089/neu.2011.2298] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The influence of breaching the connective sheaths of the donor sural nerve on axonal sprouting into the end-to-side coapted peroneal nerve was examined in the rat. In parallel, the effect of these procedures on the donor nerve was assessed. The sheaths of the donor nerve at the coaptation site were either left completely intact (group A) or they were breached by epineurial sutures (group B), an epineurial window (group C), or a perineurial window (group D). In group A, the compound action potential (CAP) of sensory axons was detected in ~10% and 40% of the recipient nerves at 4 and 8 weeks, respectively, which was significantly less frequently than in group D at both recovery periods. In addition, the number of myelinated axons in the recipient nerve was significantly larger in group D than in other groups at 4 weeks. At 8 weeks, the number of axons in group A was only ~15% of the axon numbers in other groups (p<0.05). Focal subepineurial degenerative changes in the donor nerves were only seen after 4 weeks, but not later. The average CAP area and the total number of myelinated axons in the donor nerves were not different among the experimental groups. In conclusion, myelinated sensory axons are able to penetrate the epiperineurium of donor nerves after end-to-side nerve coaption; however, their ingrowth into recipient nerves is significantly enhanced by breaching the epiperineurial sheets at the coaptation site. Breaching does not cause permanent injury to the donor nerve.
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Affiliation(s)
- Uroš Kovačič
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Slovenia.
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16
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Penna V, Bjoern Stark G, Leibig N, Boyle V, Sakalidou M. Rho-inhibition by local application of c3-toxin for enhancement of axonal sprouting in a rat end-to-side nerve repair model. Microsurgery 2012; 32:207-12. [DOI: 10.1002/micr.20978] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 10/21/2011] [Indexed: 01/15/2023]
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17
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Sakalidou M, Leibig N, Boyle V, Koulaxouzidis G, Penna V. Interleukin-10 and regeneration in an end-to-side nerve repair model of the rat. J Peripher Nerv Syst 2011; 16:334-40. [DOI: 10.1111/j.1529-8027.2011.00368.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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18
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Yu Q, Lin ZK, Ding J, Wang T, Chi YL, Gao WY. Functional motor nerve regeneration without motor-sensory specificity following end-to-side neurorrhaphy: an experimental study. J Hand Surg Am 2011; 36:2010-6. [PMID: 22123048 DOI: 10.1016/j.jhsa.2011.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 09/13/2011] [Accepted: 09/13/2011] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the quality of regenerating myelinated axons and motor-sensory specificity in an end-to-side nerve repair model. METHODS We divided 20 rats into 3 groups: (1) end-to-side neurorrhaphy using the ulnar nerve as donor nerve and the musculocutaneous nerve as recipient nerve; (2) normal control; and (3) transected nerve with the stumps buried. At 5 months, we monitored the grooming test, the electrophysiological response, and the histologic changes in nerve and muscle. RESULTS Grooming recovered successfully, and electrophysiological investigations revealed that the target muscles had been reinnervated in the end-to-side group. The mean wet weight of the reinnervated biceps brachii muscle was 72% of the normal muscle, and the mean muscle fiber cross-sectional area of the reinnervated muscle was similar to the normal muscle. The implanted musculocutaneous nerve contained varying but satisfactory numbers of axons (end-to-side group: 596 ± 348 vs normal group: 1,340 ± 241). Acetylcholinesterase staining revealed a similar percentage of myelinated fibers in the musculocutaneous nerve (39%) and the biceps brachii branch of the musculocutaneous nerve (38%) in the end-to-side group. This was similar to the number of myelinated fibers in the donor ulnar nerve (37%). CONCLUSIONS The present study confirms that limited but functional reinnervation can occur on the basis of collateral sprouting of intact axons from the ulnar nerve. The motor-sensory specificity is not important.
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Affiliation(s)
- Qing Yu
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, Zhejiang, China
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19
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Kovacic U, Zele T, Mars T, Sketelj J, Bajrović FF. Aging impairs collateral sprouting of nociceptive axons in the rat. Neurobiol Aging 2010; 31:339-50. [PMID: 18499304 DOI: 10.1016/j.neurobiolaging.2008.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2007] [Revised: 03/25/2008] [Accepted: 03/29/2008] [Indexed: 01/15/2023]
Abstract
Sprouting of uninjured nociceptive axons was examined in young adult, middle aged and aged rats. Axon sprouting from the spared sural nerve, both into adjacent denervated skin and into end-to-side coapted nerve graft, was significantly higher in young rats than in aged rats. Cross-transplantations of the end-to-side coapted nerve grafts between young and aged rats demonstrated that axon sprouting from young recipient nerves into aged donor nerve grafts was significantly deteriorated, whereas the axon sprouting from aged recipient nerves into young donor nerve grafts was not statistically significantly affected. The levels of laminin polypeptides in peripheral nerves were 50-100% higher in young adult than in aged rats. However, the levels of peripherin, NGF isoforms and TrkA in skin, peripheral nerves and DRG, respectively, were not significantly reduced in aged rats. Therefore, impaired sprouting of nociceptive axons in aged rats is due rather to the alterations in peripheral neural pathways, than to the limited sprouting capacity of aged sensory neurons. Decreased levels of extracellular matrix components might be important in this respect.
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Affiliation(s)
- Uros Kovacic
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloska 4, SI-1000 Ljubljana, Slovenia.
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20
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Haastert K, Joswig H, Jäschke KA, Samii M, Grothe C. Nerve Repair by End-to-Side Nerve Coaptation. Neurosurgery 2010; 66:567-76; discussion 576-7. [DOI: 10.1227/01.neu.0000365768.78251.8c] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Kirsten Haastert
- Hannover Medical School, Institute of Neuroanatomy and Center for Systems Neuroscience, Hannover, Germany
| | - Holger Joswig
- Hannover Medical School, Institute of Neuroanatomy, Hannover, Germany
| | | | - Madjid Samii
- Hannover Medical School, Institute of Neuroanatomy and Center for Systems Neuroscience, Hannover, Germany
| | - Claudia Grothe
- Hannover Medical School, Institute of Neuroanatomy and Center for Systems Neuroscience, Hannover, Germany
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21
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Schmidhammer R, Nógrádi A, Szabó A, Redl H, Hausner T, van der Nest D, Millesi H. Synergistic motor nerve fiber transfer between different nerves through the use of end-to-side coaptation. Exp Neurol 2009; 217:388-94. [DOI: 10.1016/j.expneurol.2009.03.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 03/19/2009] [Accepted: 03/19/2009] [Indexed: 11/27/2022]
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22
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Zhu QT, Zhu JK, Chen GY. Location of collateral sprouting of donor nerve following end-to-side neurorrhaphy. Muscle Nerve 2009; 38:1506-1509. [PMID: 18816625 DOI: 10.1002/mus.21116] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Various studies have demonstrated collateral regeneration of the donor nerve following end-to-side neurorrhaphy, but the location of collateral sprouting remains controversial. In a rat end-to-side neurorrhaphy model we isolated nerve fibers from the donor nerve at the neurorrhaphy site utilizing a micro-tease technique. We found that axons sprouted collaterally from a myelinated nerve fiber at the node of Ranvier. Based on this preliminary result we conclude that myelinated nerve fibers could sprout collateral branches at the node of Ranvier at an end-to-side neurorrhaphy site. These findings show that end-to-side neurorrhaphy may be an alternative for peripheral nerve repair.
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Affiliation(s)
- Qing-Tang Zhu
- Division of Microsurgery and Orthopedic Trauma, the First Affiliated Hospital at Sun Yat-Sen University, 58 Zhongsan Er Road, Guangzhou, Guangdong 510080, China.,Orthopedic Surgery Program, California Hospital Medical Center, Los Angeles, California, USA
| | - Jia-Kai Zhu
- Division of Microsurgery and Orthopedic Trauma, the First Affiliated Hospital at Sun Yat-Sen University, 58 Zhongsan Er Road, Guangzhou, Guangdong 510080, China
| | - Gary Y Chen
- Orthopedic Surgery Program, California Hospital Medical Center, Los Angeles, California, USA.,Department of Orthopedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Effect of Aging on Recovery of Cutaneous Nociception After End-to-Side Nerve Repair in the Rat. Ann Plast Surg 2009; 62:439-45. [DOI: 10.1097/sap.0b013e318180c8cb] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Chapter 12 Mechanisms Underlying The End‐to‐Side Nerve Regeneration. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2009; 87:251-68. [DOI: 10.1016/s0074-7742(09)87012-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Geuna S, Raimondo S, Ronchi G, Di Scipio F, Tos P, Czaja K, Fornaro M. Chapter 3: Histology of the peripheral nerve and changes occurring during nerve regeneration. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2009; 87:27-46. [PMID: 19682632 DOI: 10.1016/s0074-7742(09)87003-7] [Citation(s) in RCA: 172] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Peripheral nerves are complex organs that can be found throughout the body reaching almost all tissues and organs to provide motor and/or sensory innervation. A parenchyma (the noble component made by the nerve fibers, i.e., axons and Schwann cells) and a stroma (the scaffold made of various connective elements) can be recognized. Although morphological analysis is the most common approach for studying peripheral nerve regeneration, researchers are not always aware of several histological peculiarities of these organs. Therefore, the aim of this review is to describe, at a structural and ultrastructural level, the main features of the parenchyma and the stroma of the normal undamaged nerve as well as the most important morphological changes that occur after nerve damage and during posttraumatic nerve regeneration. The paper is aimed at providing the reader with the basic framework information on nerve morphology. This would enable the correct interpretation of morphological data obtained by many experimental studies on peripheral nerve repair and regeneration such as those outlined in several other papers included in this special issue of the International Review of Neurobiology.
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Affiliation(s)
- Stefano Geuna
- Department of Clinical and Biological Sciences, San Luigi Gonzaga School of Medicine, University of Turin, Turin 10043, Italy
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Kovacic U, Sketelj J, Bajrović FF. Chapter 26: Age-related differences in the reinnervation after peripheral nerve injury. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2009; 87:465-82. [PMID: 19682655 DOI: 10.1016/s0074-7742(09)87026-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Numerous and extensive functional, structural, and biochemical changes characterize intact aged peripheral nervous system. Functional recovery after peripheral nerve injury depends on survival of injured neurons and functional reinnervation of target tissue by regeneration of injured axons and collateral sprouting of uninjured (intact) adjacent axons. The rate of axonal regeneration becomes slower and its extent (density and number of regenerating axons) decreases in aged animals. Aging also impairs terminal sprouting of regenerated axons and collateral sprouting of intact adjacent axons, thus further limiting target reinnervation and its functional recovery. Decreased survival of aged noninjured and injured neurons, limited intrinsic growth potential of neuron, alteration in its responsiveness to stimulatory or inhibitory environmental factors, and changes in the peripheral neural pathways and target tissues are possible reasons for impaired reinnervation after peripheral nerve injury in old age. The review of present data suggests that this impairment is mostly due to the age-related changes in the peripheral neural pathways and target tissues, and not due to the limited intrinsic growth capacity of neurons or their reduced responsiveness to trophic factors. Age-related alterations in the soluble target derived neurotrophic factors, like nerve growth factor, and nonsoluble extracellular matrix components of neural pathways, like laminin, might be important in this respect.
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Affiliation(s)
- Uros Kovacic
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
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27
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Kovacic U, Sketelj J, Bajrović FF. Sex-related differences in recovery of cutaneous nociception after end-to-side nerve repair in the rat. J Plast Reconstr Aesthet Surg 2008; 62:806-13. [PMID: 18417437 DOI: 10.1016/j.bjps.2007.09.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 07/27/2007] [Accepted: 09/05/2007] [Indexed: 02/06/2023]
Abstract
Sex-related differences in the recovery of cutaneous nociception after end-to-side nerve repair were examined in rats. Recovery of nociception in the dorsal foot was determined by skin pinch test 19 weeks after the proximal end of the distal stump of the transected peroneal nerve was sutured to the side of the adjacent intact sural nerve (end-to-side nerve coaptation). Axon sprouts in the recipient peroneal nerve were counted by light and electron microscopy. Recovery of nociception due to axon sprouting through the end-to-side coaptation was found in 87% of females and in 60% of males. The area of nociception was not significantly different (P=0.59) between females and males (13+/-8% and 11+/-9%, respectively). The number of myelinated axons in the recipient peroneal nerve (but not of unmyelinated axons) was significantly larger (P=0.028) in females (median=512, 25th and 75th percentiles: 467 and 594) than in males (median=322, 25th and 75th percentiles: 239 and 468). The majority of these axons in females and males were thin fibres, and recipient nerves in both groups were responsive to nerve pinch test. In conclusion, collateral sprouting of thin myelinated nociceptive axons into the end-to-side coapted nerve is more abundant in female than in male rats. However, recovery of cutaneous mechano-nociception due to sprouting of these axons was not different between the two sexes. Possible reasons are discussed.
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Affiliation(s)
- Uros Kovacic
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloska 4, 1000 Ljubljana, Slovenia.
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