Departamento de Anatomía y Embriología Humana I, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
J Anat. 2013 Apr;222(4):451-61. doi: 10.1111/joa.12031. Epub 2013 Feb 27.
Motoneurons innervating laryngeal muscles are located in the nucleus ambiguus (Amb), but there is no general agreement on the somatotopic representation and even less is known on how an injury in the recurrent laryngeal nerve (RLN) affects this pattern. This study analyzes the normal somatotopy of those motoneurons and describes its changes over time after a crush injury to the RLN. In the control group (control group 1, n = 9 rats), the posterior cricoarytenoid (PCA) and thyroarytenoid (TA) muscles were injected with cholera toxin-B. In the experimental groups the left RLN of each animal was crushed with a fine tip forceps and, after several survival periods (1, 2, 4, 8, 12 weeks; minimum six rats per time), the PCA and TA muscles were injected as described above. After each surgery, the motility of the vocal folds was evaluated. Additional control experiments were performed; the second control experiment (control group 2, n = 6 rats) was performed labeling the TA and PCA immediately prior to the section of the superior laryngeal nerve (SLN), in order to eliminate the possibility of accidental labeling of the cricothyroid (CT) muscle by spread from the injection site. The third control group (control group 3, n = 5 rats) was included to determine if there is some sprouting from the SLN into the territories of the RLN after a crush of this last nerve. One week after the crush injury of the RLN, the PCA and TA muscles were injected immediately before the section of the SLN. The results show that a single population of neurons represents each muscle with the PCA in the most rostral position followed caudalwards by the TA. One week post-RLN injury, both the somatotopy and the number of labeled motoneurons changed, where the labeled neurons were distributed randomly; in addition, an area of topographical overlap of the two populations was observed and vocal fold mobility was lost. In the rest of the survival periods, the overlapping area is larger, but the movement of the vocal folds tends to recover. After 12 weeks of survival, the disorganization within the Amb is the largest, but the number of motoneurons is similar to control, and all animals recovered the movement of the left vocal fold. Our additional controls indicate that no tracer spread to the CT muscle occurred, and that many of the labeled motoneurons from the PCA after 1 week post-RLN injury correspond to motoneurons whose axons travel in the SLN. Therefore, it seems that after RLN injury there is a collateral sprouting and collateral innervation. Although the somatotopic organization of the Amb is lost after a crush injury of the RLN and does not recover in the times studied here, the movement of the vocal folds as well as the number of neurons that supply the TA and the PCA muscles recovered within 8 weeks, indicating that the central nervous system of the rat has a great capacity of plasticity.
支配喉肌的运动神经元位于疑核(Amb)中,但对于其躯体定位模式尚无普遍共识,对于喉返神经(RLN)损伤如何影响这种模式更是知之甚少。本研究分析了这些运动神经元的正常躯体定位,并描述了 RLN 受压损伤后随时间的变化。在对照组(对照组 1,n=9 只大鼠)中,后环杓肌(PCA)和甲状杓肌(TA)肌肉注射霍乱毒素-B。在实验组中,用细尖端镊子夹伤每只动物的左侧 RLN,然后在几个存活期(1、2、4、8、12 周;每个时间点至少有 6 只大鼠)后,如上所述注射 PCA 和 TA 肌肉。每次手术后,评估声带的运动。进行了额外的对照实验;第二个对照实验(对照组 2,n=6 只大鼠)在切断上喉神经(SLN)之前标记 TA 和 PCA,以排除由于注射部位扩散而意外标记环甲肌(CT)的可能性。第三个对照组(对照组 3,n=5 只大鼠)包括确定在最后一根神经受压后,SLN 是否有一些分支进入 RLN 区域。在 RLN 受压损伤后 1 周,在切断 SLN 之前立即向 PCA 和 TA 肌肉注射。结果表明,单一神经元群体代表每块肌肉,PCA 位于最头端,然后是 TA。RLN 损伤后 1 周,躯体定位和标记运动神经元的数量发生变化,标记神经元随机分布;此外,观察到两个群体的区域重叠,声带活动丧失。在其余的存活期内,重叠区域更大,但声带的运动趋于恢复。12 周存活后,Amb 内的紊乱最大,但运动神经元的数量与对照组相似,所有动物都恢复了左侧声带的运动。我们的额外对照表明,没有示踪剂扩散到 CT 肌肉,并且 RLN 损伤后 1 周 PCA 的许多标记运动神经元对应于其轴突在 SLN 中穿行的运动神经元。因此,似乎在 RLN 损伤后存在侧支发芽和侧支支配。尽管 RLN 损伤后 Amb 的躯体定位组织丢失,并且在本研究中未恢复,但声带的运动以及供应 TA 和 PCA 肌肉的神经元数量在 8 周内恢复,表明大鼠的中枢神经系统具有很大的可塑性。