Hydman Jonas, Remahl Sten, Björck Gunnar, Svensson Mikael, Mattsson Per
Department of Clinical Neuroscience, Section of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
Ann Otol Rhinol Laryngol. 2007 Aug;116(8):623-30. doi: 10.1177/000348940711600811.
Injury of the recurrent laryngeal nerve (RLN) is associated with a high degree of neuronal survival, but leads to various levels of vocal fold motion impairment or laryngeal synkinesis, which has been attributed to misdirected reinnervation of the target muscles in the larynx or aberrant, competing reinnervation from adjacent nerve fibers. The aim of the present study was to evaluate the impact of the regeneration-promoting agent nimodipine on reinnervation and neuromuscular function following RLN crush injury.
Sixty adult rats were randomized into nimodipine-treated or untreated groups and then underwent RLN crush injury. Reinnervation of the posterior cricoarytenoid muscle (PCA) was assessed by electrophysiological examination, retrograde tracing of lower motor neurons before and after injury, and quantification of neuromuscular junctions in the PCA muscle.
At 6 weeks after injury, the nimodipine-treated animals showed significantly enhanced neuromuscular function and also demonstrated a higher number of motor neurons in the brain stem that had reinnervated the PCA, compared to the untreated animals. The somatotopic organization of ambiguus motor neurons innervating the larynx was similar before injury and after reinnervation.
Nimodipine improves regeneration and neuromuscular function following RLN injury in the adult rat, and could be of use in future strategies following RLN injury.
喉返神经(RLN)损伤与高度的神经元存活相关,但会导致不同程度的声带运动障碍或喉联合运动,这归因于喉内靶肌肉的神经再支配错误或来自相邻神经纤维的异常、竞争性再支配。本研究的目的是评估促再生剂尼莫地平对RLN挤压伤后神经再支配和神经肌肉功能的影响。
将60只成年大鼠随机分为尼莫地平治疗组和未治疗组,然后进行RLN挤压伤。通过电生理检查、损伤前后下运动神经元的逆行追踪以及环杓后肌(PCA)中神经肌肉接头的定量分析来评估PCA的神经再支配情况。
损伤后6周,与未治疗的动物相比,尼莫地平治疗的动物神经肌肉功能显著增强,并且在脑干中重新支配PCA的运动神经元数量也更多。支配喉部的疑核运动神经元的躯体定位组织在损伤前和再支配后相似。
尼莫地平可改善成年大鼠RLN损伤后的再生和神经肌肉功能,可能在未来RLN损伤的治疗策略中发挥作用。