Barham Mohammed, Andermahr Jonas, Majczyński Henryk, Sławińska Urszula, Vogt Johannes, Neiss Wolfram F
Department II of Anatomy, University of Cologne and University Hospital of Cologne, Cologne, Germany.
Kreiskrankenhaus Mechernich, Mechernich, Germany.
Front Neurol. 2023 Jan 19;13:1050822. doi: 10.3389/fneur.2022.1050822. eCollection 2022.
After peripheral nerve lesions, surgical reconstruction facilitates axonal regeneration and motor reinnervation. However, functional recovery is impaired by aberrant reinnervation.
We tested whether training therapy by treadmill exercise (9 × 250 m/week) before (run-idle), after (idle-run), or both before and after (run-run) sciatic nerve graft improves the accuracy of reinnervation in rats. Female Lewis rats (LEW/SsNHsd) were either trained for 12 weeks (run) or not trained (kept under control conditions, idle). The right sciatic nerves were then excised and reconstructed with 5 mm of a congenic allograft. One week later, training started in the run-run and idle-run groups for another 12 weeks. No further training was conducted in the run-idle and idle-idle groups. Reinnervation was measured using the following parameters: counting of retrogradely labeled motoneurons, walking track analysis, and compound muscle action potential (CMAP) recordings.
In intact rats, the common fibular (peroneal) and the soleus nerve received axons from 549 ± 83 motoneurons. In the run-idle group, 94% of these motoneurons had regenerated 13 weeks after the nerve graft. In the idle-run group, 81% of the normal number of motoneurons had regenerated into the denervated musculature and 87% in both run-run and idle-idle groups. Despite reinnervation, functional outcome was poor: walking tracks indicated no functional improvement of motion in any group. However, in the operated hindlimb of run-idle rats, the CMAP of the soleus muscle reached 11.9 mV (normal 16.3 mV), yet only 6.3-8.1 mV in the other groups.
Treadmill training neither altered the accuracy of reinnervation nor the functional recovery, and pre-operative training (run-idle) led to a higher motor unit activation after regeneration.
周围神经损伤后,手术重建有助于轴突再生和运动神经再支配。然而,异常的神经再支配会损害功能恢复。
我们测试了在坐骨神经移植前(跑-静)、后(静-跑)或前后均进行(跑-跑)跑步机运动训练疗法(每周9×250米)是否能提高大鼠神经再支配的准确性。雌性Lewis大鼠(LEW/SsNHsd)要么接受12周训练(跑),要么不接受训练(保持在对照条件下,静)。然后切除右侧坐骨神经,用5毫米同基因同种异体移植物进行重建。一周后,跑-跑组和静-跑组开始再进行12周训练。跑-静组和静-静组不再进行进一步训练。使用以下参数测量神经再支配情况:逆行标记运动神经元计数、行走轨迹分析和复合肌肉动作电位(CMAP)记录。
在完整大鼠中,腓总(腓骨)神经和比目鱼肌神经接收来自549±83个运动神经元的轴突。在跑-静组中,神经移植1周后,这些运动神经元中有94%发生了再生。在静-跑组中,正常数量运动神经元的81%已再生到失神经肌肉组织中,跑-跑组和静-静组均为87%。尽管实现了神经再支配,但功能结果较差:行走轨迹表明任何组的运动功能均未改善。然而,在跑-静组大鼠的手术侧后肢,比目鱼肌的CMAP达到11.9毫伏(正常为16.3毫伏),而其他组仅为6.3 - 8.1毫伏。
跑步机训练既未改变神经再支配的准确性,也未改善功能恢复,术前训练(跑-静)导致再生后运动单位激活更高。