Department of Prosthetic Dentistry, School of Dental and Oral Medicine, University of Cologne, Cologne, Germany.
Department of Neurosurgery, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany.
Anat Rec (Hoboken). 2019 Aug;302(8):1287-1303. doi: 10.1002/ar.24123. Epub 2019 Apr 17.
Insufficient recovery after injury of a peripheral motor nerve is due to (1) inappropriate pathfinding as a result of axonal regrowth to inappropriate targets, (2) excessive collateral axonal branching at the lesion site, and (3) polyinnervation of the neuromuscular junctions (NMJs). The rat facial nerve model is often used because of its simple and reliable readout to measure recovery of function (vibrissal whisking). Over the last decades scientists have concentrated their efforts to combat mostly NMJ polyinnervation, because it turned out to be very difficult to reduce collateral axonal branching and impossible to navigate thousands of axons toward the original fascicles. In the past, several groups of scientists concentrated their efforts to reduce the activity-dependent polyinnervation of NMJs by electrical stimulation of the muscles (square 0.1 msec pulses at 5 Hz). The results showed no recovery of functions and a severe reduction in the number of innervated NMJs to approximately one fifth of those observed in intact animals. More recent experiments, however, have shown that motor recovery improved significantly following mechanical stimulation of the denervated facial muscles (vibrissal and orbicularis oculi) and that restored functions could invariably be linked to reduced polyinnervation at the NMJ while the number of innervated NMJ remained the same. These results suggest that clinically feasible and effective therapies could be developed and tested in the near future. Anat Rec, 302:1287-1303, 2019. © 2019 Wiley Periodicals, Inc.
(1)轴突再生到不合适的靶标导致不当的寻路,(2)损伤部位的轴突分支过多,以及(3)神经肌肉接头(NMJ)的多神经支配。由于其简单可靠的读数可用于测量功能恢复(触须刷动),因此大鼠面神经模型经常被使用。在过去的几十年中,科学家们集中精力主要对抗 NMJ 的多神经支配,因为减少分支轴突和引导数千个轴突回到原来的束很困难。过去,几组科学家集中精力通过肌肉电刺激来减少 NMJ 的活动依赖性多神经支配(以 5 Hz 的频率施加 0.1 msec 方波脉冲)。结果表明,功能没有恢复,并且受神经支配的 NMJ 数量严重减少,大约为完整动物中观察到的 NMJ 数量的五分之一。然而,最近的实验表明,面神经去神经支配的面部肌肉(触须和眼轮匝肌)的机械刺激后,运动功能明显恢复,并且恢复的功能总是与 NMJ 的多神经支配减少有关,而受神经支配的 NMJ 数量保持不变。这些结果表明,在不久的将来可以开发和测试临床上可行且有效的治疗方法。解剖学记录,302:1287-1303, 2019. © 2019 Wiley Periodicals, Inc.