Evgenieva Emilia, Schweigert Patrick, Guntinas-Lichius Orlando, Pavlov Stoyan, Grosheva Maria, Angelova Srebrina, Streppel Michael, Irintchev Andrey, Skouras Emmanouil, Kuerten Stefanie, Sinis Nektarios, Dunlop Sarah, Radeva Victoria, Angelov Doychin N
Faculty of Pre-School and Primary School Education, Sofia University, Bulgaria.
Neurorehabil Neural Repair. 2008 Nov-Dec;22(6):754-68. doi: 10.1177/1545968308316387. Epub 2008 Jul 8.
Using the rat facial nerve axotomy model, the authors recently showed that manual stimulation of denervated whiskerpad muscles reduced the posttransectional polyinnervation at the neuromuscular junctions and promoted full recovery of vibrissal whisking.
Prompted by implications for rehabilitation therapy, the authors examined whether manual stimulation of denervated supra- and infrahyoid muscles would also improve recovery after unilateral lesion on the hypoglossal nerve.
Adult rats underwent transection of the right hypoglossal nerve. Half of the animals received no postoperative treatment, and the other half were subjected to daily manual stimulation of the suprahyoid/sublingual region for 2 months. Recovery was assessed by measuring the angle of tongue-tip deviation from the midline, degree of collateral axonal branching at the lesion site (counts after retrograde labeling with 2 fluorescent dyes), synaptic input to the hypoglossal motoneurons using synaptophysin immunocytochemistry, tongue-muscles motor representation in the cerebral cortex after c-Fos immunocytochemistry, and portion of polyinnervated neuromuscular junctions.
In animals receiving manual stimulation, the tongue-tip deviation was 37.0 +/- 49.37 degrees , whereas values in control nonstimulated rats were significantly higher (50.1 +/- 9.01 degrees ; P < .05; mean +/- SD). Improved recovery was not associated with reduced collateral axonal branching; there were also no differences in tongue-muscles representation in the motor cortex. However, manual stimulation restored the total synaptic input to levels in intact animals and reduced the proportion of polyinnervated neuromuscular junctions compared with nonstimulated animals.
The data show that manual stimulation of denervated muscles improves functional outcome following peripheral nerve injury. This suggests immediate potential for enhancing clinical rehabilitation strategies.
作者最近利用大鼠面神经切断模型表明，手动刺激去神经支配的触须垫肌肉可减少神经肌肉接头处横断后的多神经支配，并促进触须摆动的完全恢复。
受康复治疗意义的启发，作者研究了手动刺激去神经支配的舌骨上和舌骨下肌肉是否也能改善舌下神经单侧损伤后的恢复情况。
成年大鼠接受右侧舌下神经横断术。一半动物术后不接受治疗，另一半动物每天接受舌骨上/舌下区域的手动刺激，持续2个月。通过测量舌尖偏离中线的角度、损伤部位侧支轴突分支的程度（用两种荧光染料逆行标记后的计数）、使用突触素免疫细胞化学法检测舌下运动神经元的突触输入、c-Fos免疫细胞化学法检测大脑皮质中舌肌的运动代表区以及多神经支配的神经肌肉接头的比例来评估恢复情况。
接受手动刺激的动物，舌尖偏斜角度为37.0±49.37度，而未刺激的对照大鼠的值明显更高（50.1±9.01度；P<.05；平均值±标准差）。恢复改善与侧支轴突分支减少无关；运动皮质中舌肌的代表区也没有差异。然而，与未刺激的动物相比，手动刺激使总的突触输入恢复到完整动物的水平，并减少了多神经支配的神经肌肉接头的比例。
数据表明，手动刺激去神经支配的肌肉可改善周围神经损伤后的功能结局。这表明在增强临床康复策略方面具有直接的潜力。
