Hundeshagen G, Szameit K, Thieme H, Finkensieper M, Angelov D N, Guntinas-Lichius O, Irintchev A
Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, D-07740 Jena, Germany.
Department of Anatomy I, University of Cologne, Joseph-Stelzmann-Strasse 9, D-50924 Cologne, Germany.
Neuroscience. 2013 Sep 17;248:307-18. doi: 10.1016/j.neuroscience.2013.06.019. Epub 2013 Jun 24.
Crush injuries of peripheral nerves typically lead to axonotmesis, axonal damage without disruption of connective tissue sheaths. Generally, human patients and experimental animals recover well after axonotmesis and the favorable outcome has been attributed to precise axonal reinnervation of the original peripheral targets. Here we assessed functionally and morphologically the long-term consequences of facial nerve axonotmesis in rats. Expectedly, we found that 5 months after crush or cryogenic nerve lesion, the numbers of motoneurons with regenerated axons and their projection pattern into the main branches of the facial nerve were similar to those in control animals suggesting precise target reinnervation. Unexpectedly, however, we found that functional recovery, estimated by vibrissal motion analysis, was incomplete at 2 months after injury and did not improve thereafter. The maximum amplitude of whisking remained substantially, by more than 30% lower than control values even 5 months after axonotmesis. Morphological analyses showed that the facial motoneurons ipsilateral to injury were innervated by lower numbers of glutamatergic terminals (-15%) and cholinergic perisomatic boutons (-26%) compared with the contralateral non-injured motoneurons. The structural deficits were correlated with functional performance of individual animals and associated with microgliosis in the facial nucleus but not with polyinnervation of muscle fibers. These results support the idea that restricted CNS plasticity and insufficient afferent inputs to motoneurons may substantially contribute to functional deficits after facial nerve injuries, possibly including pathologic conditions in humans like axonotmesis in idiopathic facial nerve (Bell's) palsy.
周围神经挤压伤通常会导致轴突断裂,即轴突损伤但结缔组织鞘未被破坏。一般来说,人类患者和实验动物在轴突断裂后恢复良好,良好的预后归因于原始周围靶点的精确轴突再支配。在这里,我们从功能和形态学上评估了大鼠面神经轴突断裂的长期后果。不出所料,我们发现,在挤压或冷冻神经损伤5个月后,有再生轴突的运动神经元数量及其投射到面神经主要分支的模式与对照动物相似,表明靶点得到了精确的再支配。然而,出乎意料的是,我们发现,通过触须运动分析估计的功能恢复在损伤后2个月并不完全,此后也没有改善。即使在轴突断裂5个月后,触须摆动的最大幅度仍大幅低于对照值30%以上。形态学分析表明,与对侧未受伤的运动神经元相比,损伤同侧的面神经运动神经元接受的谷氨酸能终末数量减少了15%,胆碱能胞体周围终扣数量减少了26%。结构缺陷与个体动物的功能表现相关,并与面神经核中的小胶质细胞增生有关,但与肌纤维的多神经支配无关。这些结果支持这样一种观点,即中枢神经系统可塑性受限以及运动神经元的传入输入不足可能是导致面神经损伤后功能缺陷的主要原因,这可能包括人类特发性面神经(贝尔氏)麻痹等病理状况中的轴突断裂。