Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.
The National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China.
Sci Adv. 2022 Sep 2;8(35):eabn5899. doi: 10.1126/sciadv.abn5899. Epub 2022 Aug 31.
Restoring limb movements after central nervous system injury remains a substantial challenge. Recent studies proved that crossing nerve transfer surgery could rebuild physiological connectivity between the contralesional cortex and the paralyzed arm to compensate for the lost function after brain injury. However, the neural mechanism by which this surgery mediates motor recovery remains still unclear. Here, using a clinical mouse model, we showed that this surgery can restore skilled forelimb function in adult mice with unilateral cortical lesion by inducing cortical remapping and promoting corticospinal tract sprouting. After reestablishing the ipsilateral descending pathway, resecting of the artificially rebuilt peripheral nerve did not affect motor improvements. Furthermore, retaining the sensory afferent, but not the motor efferent, of the transferred nerve was sufficient for inducing brain remapping and facilitating motor restoration. Thus, our results demonstrate that surgically rebuilt sensory input triggers neural plasticity for accelerating motor recovery, which provides an approach for treating central nervous system injuries.
恢复中枢神经系统损伤后的肢体运动仍然是一个巨大的挑战。最近的研究证明，交叉神经转移手术可以重建大脑损伤后对侧皮层和瘫痪手臂之间的生理连接，以补偿丧失的功能。然而，这种手术介导运动恢复的神经机制尚不清楚。在这里，我们使用临床小鼠模型，证明这种手术可以通过诱导皮层重映射和促进皮质脊髓束发芽来恢复单侧皮质损伤成年小鼠的熟练前肢功能。在重建同侧下行通路后，切除人为重建的外周神经不会影响运动改善。此外，保留传入神经的感觉传入，而不是传出神经的运动传出，足以诱导大脑重映射并促进运动恢复。因此，我们的研究结果表明，手术重建的感觉输入触发了神经可塑性，从而加速运动恢复，为治疗中枢神经系统损伤提供了一种方法。
