Functional recovery of denervated skeletal muscle with sensory or mixed nerve protection: a pilot study

Functional recovery is usually poor following peripheral nerve injury when reinnervation is delayed. Early innervation by sensory nerve has been indicated to prevent atrophy of the denervated muscle. It is hypothesized that early protection with sensory axons is adequate to improve functional recove...

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Published in:	PloS one 2013-11, Vol.8 (11), p.e79746-e79746
Main Authors:	Li, Qing Tian, Zhang, Pei Xun, Yin, Xiao Feng, Han, Na, Kou, Yu Hui, Deng, Jiu Xu, Jiang, Bao Guo
Format:	Article
Language:	eng
Subjects:	Analysis Animals Atrophy Axons Brain-derived neurotrophic factor Denervation Female Innervation Laboratory animals Muscle Contraction Muscle Denervation - rehabilitation Muscle Strength Muscle, Skeletal - innervation Muscle, Skeletal - metabolism Muscle, Skeletal - pathology Muscle, Skeletal - physiopathology Muscles Muscular Atrophy - etiology Musculoskeletal system Nerve Regeneration Peripheral Nerve Injuries - complications Peroneal nerve Pilot Projects Rats Receptors, Nicotinic - metabolism Recovery Recovery (Medical) Recovery of function Reinnervation Rodents Sensory neurons Skeletal muscle Stem cells Sural nerve Surgery Tibial nerve Tibial Nerve - injuries Trauma
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Summary:	Functional recovery is usually poor following peripheral nerve injury when reinnervation is delayed. Early innervation by sensory nerve has been indicated to prevent atrophy of the denervated muscle. It is hypothesized that early protection with sensory axons is adequate to improve functional recovery of skeletal muscle following prolonged denervation of mixed nerve injury. In this study, four groups of rats received surgical denervation of the tibial nerve. The proximal and distal stumps of the tibial nerve were ligated in all animals except for those in the immediate repair group. The experimental groups underwent denervation with nerve protection of peroneal nerve (mixed protection) or sural nerve (sensory protection). The experimental and unprotected groups had a stage II surgery in which the trimmed proximal and distal tibial nerve stumps were sutured together. After 3 months of recovery, electrophysiological, histological and morphometric parameters were assessed. It was detected that the significant muscle atrophy and a good preserved structure of the muscle were observed in the unprotected and protective experimental groups, respectively. Significantly fewer numbers of regenerated myelinated axons were observed in the sensory-protected group. Enhanced recovery in the mixed protection group was indicated by the results of the muscle contraction force tests, regenerated myelinated fiber, and the results of the histological analysis. Our results suggest that early axons protection by mixed nerve may complement sensory axons which are required for promoting functional recovery of the denervated muscle natively innervated by mixed nerve.
ISSN:	1932-6203 1932-6203