Jönsson Krister, Hultgren Tomas, Risling Mårten, Sköld Mattias K
Department of Handsurgery Södersjukhuset, Karolinska Institutet Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.
Department of Neuroscience Karolinska Institutet, Experimental Traumatology Unit, Sweden.
J Brachial Plex Peripher Nerve Inj. 2024 Jan 22;19(1):e6-e12. doi: 10.1055/s-0044-1778691. eCollection 2024 Jan.
Brachial plexus birth injuries cause diminished motor function in the upper extremity. The most common sequel is internal rotation contracture. A number of these patients also suffer from cocontractions, preventing the use of an otherwise good passive range of motion in the shoulder. One theory behind the co-contracture problem is that injured nerve fibers grow into distal support tissue not corresponding to the proximal support tissue, resulting in reinnervation of the wrong muscle groups. To further elucidate this hypothesis, we used rat neonates to investigate a possible model for the study of cocontractions in brachial plexus birth injuries. Five-day-old rats were subjected to a crush injury to the C5-C6 roots. After a healing period of 4 weeks, the infraspinatus muscle was injected with Fluoro-Gold. A week later, the animals were perfused and spinal cords harvested and sectioned. Differences in the uptake of Fluoro-Gold and NeuN positive cells of between sides of the spinal cord were recorded. We found a larger amount of Fluoro-Gold positive cells on the uninjured side, while the injured side had positive cells dispersed over a longer area in the craniocaudal direction. Our findings indicate that the method can be used to trace Fluoro-Gold from muscle through a neuroma. Our results also indicate that a neuroma in continuity somewhat prevents the correct connection from being established between the motor neuron pool in the spinal cord and target muscle and that some neurons succumb to a crushing injury. We also present future research ideas.
臂丛神经产伤会导致上肢运动功能减退。最常见的后遗症是内旋挛缩。许多这类患者还存在共同收缩的问题,这使得肩部原本良好的被动活动范围无法得到利用。共同收缩问题背后的一种理论是,受损的神经纤维长入了与近端支持组织不对应的远端支持组织,导致错误的肌肉群重新获得神经支配。为了进一步阐明这一假设,我们使用新生大鼠来研究臂丛神经产伤中共同收缩的一种可能模型。对5日龄大鼠的C5 - C6神经根进行挤压损伤。在4周的愈合期后,向冈下肌注射荧光金。一周后,对动物进行灌注,取出脊髓并切片。记录脊髓两侧荧光金摄取和NeuN阳性细胞的差异。我们发现未受伤侧有更多的荧光金阳性细胞,而受伤侧的阳性细胞在头尾方向上分布在更长的区域。我们的研究结果表明,该方法可用于通过神经瘤追踪肌肉中的荧光金。我们的结果还表明,连续性神经瘤在一定程度上阻碍了脊髓运动神经元池与靶肌肉之间建立正确的连接,并且一些神经元会死于挤压伤。我们还提出了未来的研究思路。