School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Neurosurgery. 2023 Jul 1;93(1):233-243. doi: 10.1227/neu.0000000000002370. Epub 2023 Feb 2.
Function recovery is related to cortical plasticity. The brain remodeling patterns induced by alterations in peripheral nerve pathways with different nerve reconstructions are unknown.
To explore brain remodeling patterns related to alterations in peripheral neural pathways after different nerve reconstruction surgeries.
Twenty-four female Sprague-Dawley rats underwent complete left brachial plexus nerve transection, together with the following interventions: no nerve repair (n = 8), grafted nerve repair (n = 8), and phrenic nerve transfer (n = 8). Resting-state functional MR images of brain were acquired at the end of seventh month postsurgery. Amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and functional connectivity (FC) were compared among 3 groups. Behavioral observation and electromyography assessed nerve regeneration.
Compared with brachial plexus injury group, ALFF and ReHo of left entorhinal cortex decreased in nerve repair and nerve transfer groups. The nerve transfer group showed increased ALFF and ReHo than nerve repair group in left caudate putamen, right accumbens nucleus shell (AcbSh), and right somatosensory cortex. The FC between right somatosensory cortex and bilateral piriform cortices and bilateral somatosensory cortices increased in nerve repair group than brachial plexus injury and nerve transfer groups. The nerve transfer group showed increased FC between right somatosensory cortex and areas including left corpus callosum, left retrosplenial cortex, right parietal association cortex, and right dorsolateral thalamus than nerve repair group.
Entorhinal cortex is a key brain area in recovery of limb function after nerve reconstruction. Nerve transfer related brain remodeling mainly involved contralateral sensorimotor areas, facilitating directional "shifting" of motor representation.
功能恢复与皮质可塑性有关。不同神经重建改变外周神经通路后诱导的大脑重塑模式尚不清楚。
探讨不同神经重建术后外周神经通路改变相关的大脑重塑模式。
24 只雌性 Sprague-Dawley 大鼠行左侧全臂丛神经切断术，分别进行以下干预：无神经修复（n=8）、神经移植修复（n=8）和膈神经移位（n=8）。术后第 7 个月末采集脑静息态功能磁共振图像。比较 3 组间脑区局部一致性（ReHo）、低频振幅（ALFF）和功能连接（FC）的差异。行为观察和肌电图评估神经再生。
与臂丛神经损伤组相比，神经修复组和神经移位组左侧内嗅皮质的 ALFF 和 ReHo 降低。与神经修复组相比，神经移位组左侧尾状核壳（AcbSh）和右侧伏隔核（AcbSh）及右侧躯体感觉皮层的 ALFF 和 ReHo 增加。与臂丛神经损伤组和神经移位组相比，神经修复组右侧躯体感觉皮层与双侧梨状皮质和双侧躯体感觉皮层之间的 FC 增加。与神经修复组相比，神经移位组右侧躯体感觉皮层与包括左侧胼胝体、左侧后扣带回皮质、右侧顶叶联合皮质和右侧背外侧丘脑在内的多个脑区之间的 FC 增加。
内嗅皮质是神经重建后肢体功能恢复的关键脑区。神经移位相关的大脑重塑主要涉及对侧感觉运动区，促进运动代表的定向“转移”。
