Fang Xin-Yu, Zhang Wen-Ming, Zhang Chao-Fan, Wong Wai-Man, Li Wen, Wu Wutian, Lin Jian-Hua
The First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
Department of Orthopedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
Neuroscience. 2016 Aug 4;329:213-25. doi: 10.1016/j.neuroscience.2016.05.010. Epub 2016 May 13.
Brachial plexus injury (BPI) often involves the complete or partial avulsion of one or more of the cervical nerve roots, which leads to permanent paralysis of the innervated muscles. Reimplantation surgery has been attempted as a clinical treatment for brachial plexus root avulsion but has failed to achieve complete functional recovery. Lithium is a mood stabilizer drug that is used to treat bipolar disorder; however, its effects on spinal cord or peripheral nerve injuries have also been reported. The purpose of this study was to investigate whether lithium can improve functional motor recovery after ventral root avulsion and reimplantation in a rat model of BPI. The results showed that systemic treatment with a clinical dose of lithium promoted motor neuron outgrowth and increased the efficiency of motor unit regeneration through enhanced remyelination. An analysis of myelin-associated genes showed that the effects of lithium started during the early phase of remyelination and persisted through the late stage of the process. Efficient remyelination of the regenerated axons in the lithium-treated rats led to an earlier functional recovery. Therefore, we demonstrated that lithium might be a potential clinical treatment for BPI in combination with reimplantation surgery.
臂丛神经损伤（BPI）常涉及一根或多根颈神经根的完全或部分撕脱，这会导致受其支配的肌肉永久性麻痹。人们已尝试将再植手术作为臂丛神经根撕脱的临床治疗方法，但未能实现完全的功能恢复。锂是一种用于治疗双相情感障碍的情绪稳定剂药物；然而，也有报道称其对脊髓或周围神经损伤有影响。本研究的目的是调查在BPI大鼠模型中，锂能否改善腹侧神经根撕脱及再植术后的运动功能恢复。结果表明，临床剂量的锂全身治疗可促进运动神经元生长，并通过增强髓鞘再生提高运动单位再生效率。对髓鞘相关基因的分析表明，锂的作用在髓鞘再生早期开始，并持续至该过程的后期。锂治疗大鼠再生轴突的有效髓鞘再生导致功能恢复更早。因此，我们证明锂可能是一种与再植手术联合用于BPI的潜在临床治疗方法。
