Department of Hand Surgery, Huashan Hospital, Fudan University; Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, Fudan University.
Department of Hand Surgery, Huashan Hospital, Fudan University.
J Vis Exp. 2021 Oct 19(176). doi: 10.3791/63051.
Crossing nerve transfer surgery has been a powerful approach for repairing injured upper extremities in patients with brachial plexus avulsion injuries. Recently, this surgery was creatively applied in the clinical treatment of brain injury and achieved substantial rehabilitation of the paralyzed arm. This functional recovery after the surgery suggests that peripheral sensorimotor intervention induces profound neuroplasticity to compensate for the loss of function after brain damage; however, the underlying neural mechanism is poorly understood. Therefore, an emergent clinical animal model is required. Here, we simulated clinical surgery to establish a protocol of direct anastomosis of bilateral brachial plexus nerves via the prespinal route in mice. Neuroanatomical, electrophysiological, and behavioral experiments helped identify that the transferred nerves of these mice successfully reinnervated the impaired forelimb and contributed to accelerating motor recovery after brain injury. Therefore, the mouse model revealed the neural mechanisms underlying rehabilitation upon crossing nerve transfer after central and peripheral nervous system injuries.
神经交叉转移手术一直是修复臂丛神经撕脱伤患者上肢损伤的有效方法。最近，该手术被创造性地应用于脑损伤的临床治疗中，使瘫痪的手臂得到了实质性的康复。手术后的这种功能恢复表明，外周感觉运动干预诱导了深刻的神经可塑性，以弥补脑损伤后功能的丧失；然而，其潜在的神经机制尚不清楚。因此，需要建立一种新兴的临床动物模型。在这里，我们模拟了临床手术，通过小鼠的椎管前途径建立了双侧臂丛神经直接吻合的方案。神经解剖学、电生理学和行为学实验表明，这些小鼠的移植神经成功地重新支配了受损的前肢，并有助于促进脑损伤后的运动恢复。因此，该小鼠模型揭示了中枢和外周神经系统损伤后交叉神经转移康复的神经机制。
