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Tiwari E, Porreca DS, Braverman AS, Holt-Bright L, Frara NA, Brown JM, Johnston BR, Bazarek SF, Hilliard BA, Mazzei M, Pontari MA, Yu D, Ruggieri MR, Barbe MF. Nerve transfer for restoration of lower motor neuron-lesioned bladder, urethral and anal sphincter function. Part 4: Effectiveness of the motor reinnervation. Am J Physiol Regul Integr Comp Physiol 2024; 326:R528-R551. [PMID: 38497126 PMCID: PMC11380993 DOI: 10.1152/ajpregu.00248.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/18/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
In pilot work, we showed that somatic nerve transfers can restore motor function in long-term decentralized dogs. We continue to explore the effectiveness of motor reinnervation in 30 female dogs. After anesthesia, 12 underwent bilateral transection of coccygeal and sacral (S) spinal roots, dorsal roots of lumbar (L)7, and hypogastric nerves. Twelve months postdecentralization, eight underwent transfer of obturator nerve branches to pelvic nerve vesical branches, and sciatic nerve branches to pudendal nerves, followed by 10 mo recovery (ObNT-ScNT Reinn). The remaining four were euthanized 18 mo postdecentralization (Decentralized). Results were compared with 18 Controls. Squat-and-void postures were tracked during awake cystometry. None showed squat-and-void postures during the decentralization phase. Seven of eight ObNT-ScNT Reinn began showing such postures by 6 mo postreinnervation; one showed a return of defecation postures. Retrograde dyes were injected into the bladder and urethra 3 wk before euthanasia, at which point, roots and transferred nerves were electrically stimulated to evaluate motor function. Upon L2-L6 root stimulation, five of eight ObNT-ScNT Reinn showed elevated detrusor pressure and four showed elevated urethral pressure, compared with L7-S3 root stimulation. After stimulation of sciatic-to-pudendal transferred nerves, three of eight ObNT-ScNT Reinn showed elevated urethral pressure; all showed elevated anal sphincter pressure. Retrogradely labeled neurons were observed in L2-L6 ventral horns (in laminae VI, VIII, and IX) of ObNT-ScNT Reinn versus Controls in which labeled neurons were observed in L7-S3 ventral horns (in lamina VII). This data supports the use of nerve transfer techniques for the restoration of bladder function.NEW & NOTEWORTHY This data supports the use of nerve transfer techniques for the restoration of bladder function.
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Affiliation(s)
- Ekta Tiwari
- School of Engineering, Brown University, Providence, Rhode Island, United States
- Center of Translational Research, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
| | - Danielle S Porreca
- Center of Translational Research, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
- Medical Doctor Program, Thomas Jefferson Research, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
| | - Alan S Braverman
- Aging and Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
| | - Lewis Holt-Bright
- Aging and Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
| | - Nagat A Frara
- Aging and Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
| | - Justin M Brown
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Benjamin R Johnston
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | - Stanley F Bazarek
- Department of Neurological Surgery, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | - Brendan A Hilliard
- Aging and Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
| | - Michael Mazzei
- Department of Trauma Surgery and General Surgery, LeHigh Valley Health Network, Allentown, Pennsylvania, United States
| | - Michel A Pontari
- Department of Urology, Lewis Katz School of Medicine, Temple University Health System, Philadelphia, Pennsylvania, United States
| | - Daohai Yu
- Center for Biostatistics and Epidemiology, Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
| | - Michael R Ruggieri
- Center of Translational Research, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Mary F Barbe
- Aging and Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
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Barbe MF, Chen FL, Loomis RH, Harris MY, Kim BM, Xie K, Hilliard BA, McGonagle ER, Bailey TD, Gares RP, Van Der Bas M, Kalicharan BA, Holt-Bright L, Stone LS, Hodges PW, Klyne DM. Characterization of pain-related behaviors in a rat model of acute-to-chronic low back pain: single vs. multi-level disc injury. FRONTIERS IN PAIN RESEARCH 2024; 5:1394017. [PMID: 38770243 PMCID: PMC11102983 DOI: 10.3389/fpain.2024.1394017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction Low back pain is the most common type of chronic pain. We examined pain-related behaviors across 18 weeks in rats that received injury to one or two lumbar intervertebral discs (IVD) to determine if multi-level disc injuries enhance/prolong pain. Methods Twenty-three Sprague-Dawley adult female rats were used: 8 received disc puncture (DP) of one lumbar IVD (L5/6, DP-1); 8 received DP of two lumbar IVDs (L4/5 & L5/6, DP-2); 8 underwent sham surgery. Results DP-2 rats showed local (low back) sensitivity to pressure at 6- and 12-weeks post-injury, and remote sensitivity to pressure (upper thighs) at 12- and 18-weeks and touch (hind paws) at 6, 12 and 18-weeks. DP-1 rats showed local and remote pressure sensitivity at 12-weeks only (and no tactile sensitivity), relative to Sham DP rats. Both DP groups showed reduced distance traveled during gait testing over multiple weeks, compared to pre-injury; only DP-2 rats showed reduced distance relative to Sham DP rats at 12-weeks. DP-2 rats displayed reduced positive interactions with a novel adult female rat at 3-weeks and hesitation and freezing during gait assays from 6-weeks onwards. At study end (18-weeks), radiological and histological analyses revealed reduced disc height and degeneration of punctured IVDs. Serum BDNF and TNFα levels were higher at 18-weeks in DP-2 rats, relative to Sham DP rats, and levels correlated positively with remote sensitivity in hind paws (tactile) and thighs (pressure). Discussion Thus, multi-level disc injuries resulted in earlier, prolonged and greater discomfort locally and remotely, than single-level disc injury. BDNF and TNFα may have contributing roles.
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Affiliation(s)
- Mary F. Barbe
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Frank Liu Chen
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Regina H. Loomis
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Michele Y. Harris
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Brandon M. Kim
- Medical Doctor Program, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Kevin Xie
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Brendan A. Hilliard
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Elizabeth R. McGonagle
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Taylor D. Bailey
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Ryan P. Gares
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Megan Van Der Bas
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Betsy A. Kalicharan
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Lewis Holt-Bright
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Laura S. Stone
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN, United States
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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Frara N, Barbe MF, Giaddui D, Porreca DS, Braverman AS, Tiwari E, Ahmad A, Brown JM, Johnston BR, Bazarek SF, Ruggieri MR. Nerve transfer for restoration of lower motor neuron-lesioned bladder, urethral, and anal sphincter function in a dog model. Part 3. nicotinic receptor characterization. Am J Physiol Regul Integr Comp Physiol 2023; 325:R344-R358. [PMID: 37458380 PMCID: PMC10642361 DOI: 10.1152/ajpregu.00273.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 06/09/2023] [Accepted: 07/05/2023] [Indexed: 09/05/2023]
Abstract
Very little is known about the physiological role of nicotinic receptors in canine bladders, although functional nicotinic receptors have been reported in bladders of many species. Utilizing in vitro methods, we evaluated nicotinic receptors mediating bladder function in dogs: control (9 female and 11 male normal controls, 5 sham operated), Decentralized (9 females, decentralized 6-21 mo), and obturator-to-pelvic nerve transfer reinnervated (ObNT-Reinn; 9 females; decentralized 9-13 mo, then reinnervated with 8-12 mo recovery). Muscle strips were collected, mucosa-denuded, and mounted in muscle baths before incubation with neurotransmitter antagonists, and contractions to the nicotinic receptor agonist epibatidine were determined. Strip response to epibatidine, expressed as percent potassium chloride, was similar (∼35% in controls, 30% in Decentralized, and 24% in ObNT-Reinn). Differentially, epibatidine responses in Decentralized and ObNT-Reinn bladder strips were lower than controls after tetrodotoxin (TTX, a sodium channel blocker that inhibits axonal action potentials). Yet, in all groups, epibatidine-induced strip contractions were similarly inhibited by mecamylamine and hexamethonium (ganglionic nicotinic receptor antagonists), SR 16584 (α3β4 neuronal nicotinic receptor antagonist), atracurium and tubocurarine (neuromuscular nicotinic receptor antagonists), and atropine (muscarinic receptor antagonist), indicating that nicotinic receptors (particularly α3β4 subtypes), neuromuscular and muscarinic receptors play roles in bladder contractility. In control bladder strips, since tetrodotoxin did not inhibit epibatidine contractions, nicotinic receptors are likely located on nerve terminals. The tetrodotoxin inhibition of epibatidine-induced contractions in Decentralized and ObNT-Reinn suggests a relocation of nicotinic receptors from nerve terminals to more distant axonal sites, perhaps as a compensatory mechanism to recover bladder function.
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Affiliation(s)
- Nagat Frara
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Mary F Barbe
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Dania Giaddui
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Danielle S Porreca
- Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
| | - Alan S Braverman
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Ekta Tiwari
- School of Engineering, Brown University, Providence, Rhode Island, United States
| | - Attia Ahmad
- Cooper Medical School of Rowan University, Camden, New Jersey, United States
| | - Justin M Brown
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Benjamin R Johnston
- Department of Neurosurgery, Brigham & Women's Hospital, Boston, Massachusetts, United States
| | - Stanley F Bazarek
- Department of Neurosurgery, Brigham & Women's Hospital, Boston, Massachusetts, United States
| | - Michael R Ruggieri
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, United States
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Johnston BR, Bazarek S, Sten M, McIntyre BS, Fine N, De EJB, McGovern F, Lemos N, Ruggieri MR, Barbe MF, Brown JM. Restoring bladder function using motor and sensory nerve transfers: a cadaveric feasibility study. J Neurosurg Spine 2023; 38:258-264. [PMID: 36208430 PMCID: PMC9898215 DOI: 10.3171/2022.8.spine22291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/04/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Bladder dysfunction after nerve injury has a variable presentation, and extent of injury determines whether the bladder is spastic or atonic. The authors have proposed a series of 3 nerve transfers for functional innervation of the detrusor muscle and external urethral sphincter, along with sensory innervation to the genital dermatome. These transfers are applicable to only cases with low spinal segment injuries (sacral nerve root function is lost) and largely preserved lumbar function. Transfer of the posterior branch of the obturator nerve to the vesical branch of the pelvic nerve provides a feasible mechanism for patients to initiate detrusor contraction by thigh adduction. External urethra innervation (motor and sensory) may be accomplished by transfer of the vastus medialis nerve to the pudendal nerve. The sensory component of the pudendal nerve to the genitalia may be further enhanced by transfer of the saphenous nerve (sensory) to the pudendal nerve. The main limitations of coapting the nerve donors to their intrapelvic targets are the bifurcation or arborization points of the parent nerve. To ensure that the donor nerves had sufficient length and diameter, the authors sought to measure these parameters. METHODS Twenty-six pelvic and anterior thigh regions were dissected in 13 female cadavers. After the graft and donor sites were clearly exposed and the branches identified, the donor nerves were cut at suitable distal sites and then moved into the pelvis for tensionless anastomosis. Diameters were measured with calipers. RESULTS The obturator nerve was bifurcated a mean ± SD (range) of 5.5 ± 1.7 (2.0-9.0) cm proximal to the entrance of the obturator foramen. In every cadaver, the authors were able to bring the posterior division of the obturator nerve to the vesical branch of the pelvic nerve (located internal to the ischial spine) in a tensionless manner with an excess obturator nerve length of 2.0 ± 1.2 (0.0-5.0) cm. The distance between the femoral nerve arborization and the anterior superior iliac spine was 9.3 ± 1.8 (6.5-15.0) cm, and the distance from the femoral arborization to the ischial spine was 12.9 ± 1.4 (10.0-16.0) cm. Diameters were similar between donor and recipient nerves. CONCLUSIONS The chosen donor nerves were long enough and of sufficient caliber for the proposed nerve transfers and tensionless anastomosis.
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Affiliation(s)
| | - Stanley Bazarek
- 1Department of Neurosurgery, Brigham and Women's Hospital, Boston
| | - Margaret Sten
- 2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Brian S McIntyre
- 3Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Noam Fine
- 4Department of Urology, Massachusetts General Hospital, Boston, Massachusetts
| | - Elise J B De
- 4Department of Urology, Massachusetts General Hospital, Boston, Massachusetts
| | - Francis McGovern
- 4Department of Urology, Massachusetts General Hospital, Boston, Massachusetts
| | - Nucelio Lemos
- 5Department of Obstetrics & Gynaecology, University of Toronto, Ontario, Canada; and
| | - Michael R Ruggieri
- 6Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Mary F Barbe
- 6Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Justin M Brown
- 2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
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Giaddui D, Porreca DS, Tiwari E, Frara NA, Hobson LJ, Barbe MF, Braverman AS, Brown JM, Pontari MA, Ruggieri Sr. MR. Lateralization of bladder function in normal female canines. PLoS One 2022; 17:e0264382. [PMID: 35231045 PMCID: PMC8887770 DOI: 10.1371/journal.pone.0264382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 02/10/2022] [Indexed: 11/19/2022] Open
Abstract
This study aimed to identify potential lateralization of bladder function. Electrical stimulation of spinal roots or the pelvic nerve’s anterior vesical branch was performed bilaterally in female dogs. The percent difference between the left and right stimulation-induced increased detrusor pressure was determined. Bladders were considered left or right-sided if differences were greater or less than 25% or 10%. Based on differences of 25%, upon stimulation of spinal roots, bladders were left-sided in 17/44 (38.6%), right-sided in 12/44 (27.2%) and bilateral in 15/44 (34.2%). Using ± 10%, 48% had left side dominance (n = 21/44), 39% had right side dominance (n = 17/44), and 14% were bilateral (n = 6/44). With stimulation of the pelvic nerve’s anterior vesical branch in 19 dogs, bladders were left-sided in 8 (42.1%), right-sided in 6 (31.6%) and bilateral in 5 (26.3%) using 25% differences and left side dominance in 8 (43%), right sided in 7 (37%) and bilateral in 4 (21%) using 10% differences. These data suggest lateralization of innervation of the female dog bladder with left- and right-sided lateralization occurring at similar rates. Lateralization often varied at different spinal cord levels within the same animal.
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Affiliation(s)
- Dania Giaddui
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Danielle S. Porreca
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Ekta Tiwari
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Nagat A. Frara
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Lucas J. Hobson
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Mary F. Barbe
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - Alan S. Braverman
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Justin M. Brown
- Department of Neurosurgery, Neurosurgery Paralysis Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Michel A. Pontari
- Department of Urology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Michael R. Ruggieri Sr.
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
- Shriners Hospitals for Children of Philadelphia, Pennsylvania, Philadelphia, United States of America
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Qian TD, Zheng XF, Shi J, Ma T, You WY, Wu JH, Huang BS, Tao Y, Wang X, Song ZW, Li LX. L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage. Neural Regen Res 2021; 17:1278-1285. [PMID: 34782572 PMCID: PMC8643034 DOI: 10.4103/1673-5374.327359] [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] [Indexed: 11/16/2022] Open
Abstract
There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage. Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles, we investigated a potential method of nerve repair using the L4 nerve roots. Rat models of hindlimb hemiplegia after a hypertensive intracerebral hemorrhage were established by injecting autogenous blood into the posterior limb of internal capsule. The L4 nerve root on the healthy side of model rats was transferred and then anastomosed with the L4 nerve root on the affected side to drive the extensor and flexor muscles of the hindlimbs. We investigated whether this method can restore the flexible movement of the hindlimbs of paralyzed rats after hypertensive intracerebral hemorrhage. In a beam-walking test and ladder rung walking task, model rats exhibited an initial high number of slips, but improved in accuracy on the paretic side over time. At 17 weeks after surgery, rats gained approximately 58.2% accuracy from baseline performance and performed ankle motions on the paretic side. At 9 weeks after surgery, a retrograde tracing test showed a large number of fluoro-gold-labeled motoneurons in the left anterior horn of the spinal cord that supports the L4-to-L4 nerve roots. In addition, histological and ultramicrostructural findings showed axon regeneration of motoneurons in the anterior horn of the spinal cord. Electromyography and paw print analysis showed that denervated hindlimb muscles regained reliable innervation and walking coordination improved. These findings suggest that the L4-to-L4 nerve root transfer method for the treatment of hindlimb hemiplegia after hypertensive intracerebral hemorrhage can improve the locomotion of hindlimb major joints, particularly of the distal ankle. Findings from study support that the L4-to-L4 nerve root transfer method can effectively repair the hindlimb hemiplegia after hypertensive intracerebral hemorrhage. All animal experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (No. IACUC-1906009) in June 2019.
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Affiliation(s)
- Teng-Da Qian
- Department of Neurosurgery, Jintan Hospital, Affiliated Hospital of Jiangsu Vocational College of Medicine, Jintan, Jiangsu Province, China
| | - Xi-Feng Zheng
- Department of Gastroenterology, Jintan Hospital, Affiliated Hospital of Jiangsu Vocational College of Medicine, Jintan, Jiangsu Province, China
| | - Jing Shi
- Department of Neurosurgery, Changzhou First People's Hospital, Suzhou University, Changzhou, Jiangsu Province, China
| | - Tao Ma
- Department of Neurosurgery, Changzhou First People's Hospital, Suzhou University, Changzhou, Jiangsu Province, China
| | - Wei-Yan You
- Deparment of Neurobiology, Basic Medical College, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Jia-Huan Wu
- Deparment of Neurobiology, Basic Medical College, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Bao-Sheng Huang
- Department of Neurosurgery, Sir Run Run Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yi Tao
- Department of Neurosurgery, Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Xi Wang
- Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Ze-Wu Song
- Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Li-Xin Li
- Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
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Miller MQ, Hernández IC, Chacko JV, Minderler S, Jowett N. Two-photon excitation fluorescent spectral and decay properties of retrograde neuronal tracer Fluoro-Gold. Sci Rep 2021; 11:18053. [PMID: 34508127 PMCID: PMC8433443 DOI: 10.1038/s41598-021-97562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/26/2021] [Indexed: 11/14/2022] Open
Abstract
Fluoro-Gold is a fluorescent neuronal tracer suitable for targeted deep imaging of the nervous system. Widefield fluorescence microscopy enables visualization of Fluoro-Gold, but lacks depth discrimination. Though scanning laser confocal microscopy yields volumetric data, imaging depth is limited, and optimal single-photon excitation of Fluoro-Gold requires an unconventional ultraviolet excitation line. Two-photon excitation microscopy employs ultrafast pulsed infrared lasers to image fluorophores at high-resolution at unparalleled depths in opaque tissue. Deep imaging of Fluoro-Gold-labeled neurons carries potential to advance understanding of the central and peripheral nervous systems, yet its two-photon spectral and temporal properties remain uncharacterized. Herein, we report the two-photon excitation spectrum of Fluoro-Gold between 720 and 990 nm, and its fluorescence decay rate in aqueous solution and murine brainstem tissue. We demonstrate unprecedented imaging depth of whole-mounted murine brainstem via two-photon excitation microscopy of Fluoro-Gold labeled facial motor nuclei. Optimal two-photon excitation of Fluoro-Gold within microscope tuning range occurred at 720 nm, while maximum lifetime contrast was observed at 760 nm with mean fluorescence lifetime of 1.4 ns. Whole-mount brainstem explants were readily imaged to depths in excess of 450 µm via immersion in refractive-index matching solution.
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Affiliation(s)
- Matthew Q Miller
- Surgical Photonics and Engineering Laboratory, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.,Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Health Care, Chapel Hill, NC, USA
| | - Iván Coto Hernández
- Surgical Photonics and Engineering Laboratory, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.
| | - Jenu V Chacko
- Laboratory for Optical and Computational Instrumentation, University of Wisconsin, Madison, WI, USA
| | - Steven Minderler
- Surgical Photonics and Engineering Laboratory, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
| | - Nate Jowett
- Surgical Photonics and Engineering Laboratory, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.
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8
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Michel MC, Arioglu-Inan E. Function and morphology of the urinary bladder after denervation. Am J Physiol Regul Integr Comp Physiol 2021; 320:R833-R834. [PMID: 33789439 DOI: 10.1152/ajpregu.00093.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Martin C Michel
- Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany
| | - Ebru Arioglu-Inan
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
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Frara N, Giaddui D, Braverman AS, Porreca DS, Brown JM, Mazzei M, Wagner IJ, Pontari MA, Tiwari E, Testa CL, Yu D, Hobson LJ, Barbe MF, Ruggieri MR. Nerve transfer for restoration of lower motor neuron-lesioned bladder function. Part 1: attenuation of purinergic bladder smooth muscle contractions. Am J Physiol Regul Integr Comp Physiol 2021; 320:R885-R896. [PMID: 33759578 PMCID: PMC8285613 DOI: 10.1152/ajpregu.00299.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This study determined the effect of pelvic organ decentralization and reinnervation 1 yr later on the contribution of muscarinic and purinergic receptors to ex vivo, nerve-evoked, bladder smooth muscle contractions. Nineteen canines underwent decentralization by bilateral transection of all coccygeal and sacral (S) spinal roots, dorsal roots of lumbar (L)7, and hypogastric nerves. After exclusions, 8 were reinnervated 12 mo postdecentralization with obturator-to-pelvic and sciatic-to-pudendal nerve transfers then euthanized 8-12 mo later. Four served as long-term decentralized only animals. Controls included six sham-operated and three unoperated animals. Detrusor muscle was assessed for contractile responses to potassium chloride (KCl) and electric field stimulation (EFS) before and after purinergic receptor desensitization with α, β-methylene adenosine triphosphate (α,β-mATP), muscarinic receptor antagonism with atropine, or sodium channel blockade with tetrodotoxin. Atropine inhibition of EFS-induced contractions increased in decentralized and reinnervated animals compared with controls. Maximal contractile responses to α,β-mATP did not differ between groups. In strips from decentralized and reinnervated animals, the contractile response to EFS was enhanced at lower frequencies compared with normal controls. The observation of increased blockade of nerve-evoked contractions by muscarinic antagonist with no change in responsiveness to purinergic agonist suggests either decreased ATP release or increased ecto-ATPase activity in detrusor muscle as a consequence of the long-term decentralization. The reduction in the frequency required to produce maximum contraction following decentralization may be due to enhanced nerve sensitivity to EFS or a change in the effectiveness of the neurotransmission.
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Affiliation(s)
- Nagat Frara
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Dania Giaddui
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Alan S Braverman
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Danielle S Porreca
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Justin M Brown
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael Mazzei
- Department of Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Ida J Wagner
- Department of Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Michel A Pontari
- Department of Urology, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Ekta Tiwari
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Courtney L Testa
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Daohai Yu
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Lucas J Hobson
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Michael R Ruggieri
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.,Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
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10
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Barbe MF, Testa CL, Cruz GE, Frara NA, Tiwari E, Hobson LJ, McIntyre BS, Porreca DS, Giaddui D, Braverman AS, Day EP, Amin M, Brown JM, Mazzei M, Pontari MA, Wagner IJ, Ruggieri MR. Nerve transfer for restoration of lower motor neuron-lesioned bladder function. Part 2: correlation between histological changes and nerve evoked contractions. Am J Physiol Regul Integr Comp Physiol 2021; 320:R897-R915. [PMID: 33759573 PMCID: PMC8285612 DOI: 10.1152/ajpregu.00300.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We determined the effect of pelvic organ decentralization and reinnervation 1 yr later on urinary bladder histology and function. Nineteen canines underwent decentralization by bilateral transection of all coccygeal and sacral (S) spinal roots, dorsal roots of lumbar (L)7, and hypogastric nerves. After exclusions, eight were reinnervated 12 mo postdecentralization with obturator-to-pelvic and sciatic-to-pudendal nerve transfers, then euthanized 8-12 mo later. Four served as long-term decentralized only animals. Before euthanasia, pelvic or transferred nerves and L1–S3 spinal roots were stimulated and maximum detrusor pressure (MDP) recorded. Bladder specimens were collected for histological and ex vivo smooth muscle contractility studies. Both reinnervated and decentralized animals showed less or denuded urothelium, fewer intramural ganglia, and more inflammation and collagen, than controls, although percent muscle was maintained. In reinnervated animals, pgp9.5+ axon density was higher compared with decentralized animals. Ex vivo smooth muscle contractions in response to KCl correlated positively with submucosal inflammation, detrusor muscle thickness, and pgp9.5+ axon density. In vivo, reinnervated animals showed higher MDP after stimulation of L1–L6 roots compared with their transected L7–S3 roots, and reinnervated and decentralized animals showed lower MDP than controls after stimulation of nerves (due likely to fibrotic nerve encapsulation). MDP correlated negatively with detrusor collagen and inflammation, and positively with pgp9.5+ axon density and intramural ganglia numbers. These results demonstrate that bladder function can be improved by transfer of obturator nerves to pelvic nerves at 1 yr after decentralization, although the fibrosis and inflammation that developed were associated with decreased contractile function.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Courtney L Testa
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Geneva E Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Nagat A Frara
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Ekta Tiwari
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Lucas J Hobson
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Brian S McIntyre
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Danielle S Porreca
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Dania Giaddui
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Alan S Braverman
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Emily P Day
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Mamta Amin
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Justin M Brown
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael Mazzei
- Department of Surgery, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Michel A Pontari
- Department of Urology, Lewis Katz School of Medicine, Temple University Health System, Philadelphia, Pennsylvania
| | - Ida J Wagner
- Department of Surgery, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Michael R Ruggieri
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.,Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
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11
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Granger N, Olby NJ, Nout-Lomas YS. Bladder and Bowel Management in Dogs With Spinal Cord Injury. Front Vet Sci 2020; 7:583342. [PMID: 33263015 PMCID: PMC7686579 DOI: 10.3389/fvets.2020.583342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022] Open
Abstract
Spinal cord injury in companion dogs can lead to urinary and fecal incontinence or retention, depending on the severity, and localization of the lesion along the canine nervous system. The bladder and gastrointestinal dysfunction caused by lesions of the autonomic system can be difficult to recognize, interpret and are easily overlooked. Nevertheless, it is crucial to maintain a high degree of awareness of the impact of micturition and defecation disturbances on the animal's condition, welfare and on the owner. The management of these disabilities is all the more challenging that the autonomic nervous system physiology is a complex topic. In this review, we propose to briefly remind the reader the physiology of micturition and defecation in dogs. We then present the bladder and gastrointestinal clinical signs associated with sacral lesions (i.e., the L7-S3 spinal cord segments and nerves) and supra-sacral lesions (i.e., cranial to the L7 spinal cord segment), largely in the context of intervertebral disc herniation. We summarize what is known about the natural recovery of urinary and fecal continence in dogs after spinal cord injury. In particular we review the incidence of urinary tract infection after injury. We finally explore the past and recent literature describing management of urinary and fecal dysfunction in the acute and chronic phase of spinal cord injury. This comprises medical therapies but importantly a number of surgical options, some known for decades such as sacral nerve stimulation, that might spark some interest in the field of spinal cord injury in companion dogs.
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Affiliation(s)
- Nicolas Granger
- The Royal Veterinary College, University of London, Hertfordshire, United Kingdom.,CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom
| | - Natasha J Olby
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
| | - Yvette S Nout-Lomas
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States
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