Prevention of Denervation atrophy by Nerve Implantation

Prevention of denervation atrophy in skeletal muscle by nerve implantation to a muscle belly was studied in a rat model. In the animals' legs, the tibial nerve branch innervating the lateral head of the gastrocnemius muscle was transected, and subsequently repaired by either simple nerve suture(n = 20) or interpositional nerve grafting (n = 20). The tibial nerve branch innervating the medial head was dissected out. The peroneal nerve was transected and implanted directly to the lateral head of the gastrocnemius muscle on one side and, as a control, the nerve on the other side was cut. After 6 months, isometric tension of the gastrocnemius muscle was greater on the implantation side than on the control side in the nerve-suture group (p < 0.05), but no tension difference between the two sides was observed in the nerve-graft group. The effects of neurotization by an implanted nerve may compete with those by a repaired nerve, when neurotization of the latter is delayed. Only when the time interval between neurotization by an implanted nerve and reinnervation by a repaired original nerve is short, does nerve implantation attenuate denervation atrophy.

KEYWORDS

Denervation atrophy - nerve implantation - direct neurotization

REFERENCES

• 1 Gutmann E, Young J. The re-innervation of muscle after various periods of atrophy.  Anatomy. 1944;  78 15-43
• 2 Dooley D M, Sharkey J. Electrostimulation of the nervous system for patients with demyelinating and degenerative diseases of the nervous system and vascular diseases of the extremities.  Appl Neurophysiol. 1977-78;  40 208-217
• 3 Kanaya F, Tajima T. Effect of electrostimulation on denervated muscle.  Clin Orthop. 1992;  283 296-301
• 4 Kern H, Frey M, Holle J et al.. Functional electrostimulation of paraplegic patients-1 year's practical application. Results in patients and experiences [in German].  Z Orthop. 1985;  123 1-12
• 5 Terzis J. “Babysitters”: an exciting new concept in facial animation. In: Castri D Proceedings of the Sixth International Symposium on the Facial Nerve. Rio de Janeiro; Kugler and Ghedini 1988: 525
• 6 Kamimura S. An experimental study on reinnervation of denervated muscles by direct nerve implantation [in Japanese].  Nippon Seikeigeka Gakkai Zasshi. 1975;  49 463-475
• 7 Mochida K. An experimental study on direct nerve implantation into denervated muscle-the functional recovery and the site of implantation [in Japanese].  Nippon Seikeigeka Gakkai Zasshi. 1992;  66 1059-1072
• 8 Kijima H, Tajima T, Seki T et al.. Experimental study of implantation of the motor nerve in the denervated muscle [in Japanese].  J Jpn Soc Surg Hand. 1989;  6 34-40
• 9 Heineke H. Implantation of the nerve in the muscle [in German].  Archiv Klin Chir. 1914;  105 517-523
• 10 Aitken J. Growth of nerve implants in voluntary muscle.  J Anat. 1950;  84 38-49
• 11 Fex S, Thesleft S. The time required for innervation of denervated muscles by nerve implants.  Life Sci. 1967;  6 635-639
• 12 Guth L, Zalewski A, Brown W. Quantitative changes in cholinesterase activity of denervated sole plates following implantation of nerve into muscle.  Exp Neurol. 1966;  16 136-147
• 13 Sakellarides H, Sorbie C, James L. Reinnervation of denervated muscles by nerve transplantation.  Clin Orthop. 1972;  83 195-201
• 14 Korneliussen H, Sommerschild H. Ultrastructure of the new neuromuscular junctions formed during reinnervation of rat soleus muscle by a “foreign” nerve.  Cell Tissue Res. 1976;  167 439-452
• 15 Sakurai M, Campbell J. Reinnervation of denervated muscle by direct nerve implantation in cats.  Tohoku J Exp Med. 1971;  105 233-246
• 16 Steindler A, Moines D. The method of direct neurotization of paralyzed muscle.  Am J Orthop Surg. 1915;  13 33-45
• 17 Elsberg C. Experiments on motor nerve regeneration and the direct neurotization of paralyzed muscles by their own and foreign nerves.  Science. 1917;  45 318-320
• 18 Erlacher P. Direct and muscular neurotization of paralyzed muscle.  Am J Orthop Surg. 1915;  13 22-32
• 19 Hoffman H. Effects of a fibrosis on the innervation of muscles by nerve implants.  J Comp Neurol. 1954;  100 411-455
• 20 Stocky B. An experimental study of hyperneurotization.  Arch Neurol Psychiat. 1924;  11 113-120
• 21 Brunelli G. Direct neurotization of severely damaged muscles.  J Hand Surg. 1982;  7 572-579
• 22 Mackinnon S, McLean J, Hunter G. Direct muscle neurotization recovers gastrocnemius muscle function.  J Reconstr Microsurgery. 1993;  9 77-80
• 23 Serra J, Samayoa V, Valiente E et al.. Neurotization of the remaining latissimus dorsi muscle following muscle flap transplant.  J Reconstr Microsurg. 1988;  4 415-420
• 24 Frey M, Gruber H, Holle J et al.. An experimental comparison of the different kinds of muscle reinnervation, nerve-suture, nerve implantation and muscular neurotization.  Plast Reconstr Surg. 1982;  69 656-667
• 25 Saito A, Zacks S. Fine structure of neuromuscular junctions after nerve section and implantation of nerve in denervated muscle.  Exp Mol Pathol. 1969;  10 256-273
• 26 Gwyn D, Aitken J. The formation of new motor endplates in mammalian skeletal muscle.  J Anat. 1966;  100 111-126
• 27 Sorbie C. Reinnervation of paralyzed muscles by direct motor nerve implantation: an experimental study in the dog.  J Bone Joint Surg Br. 1969;  51 156-164
• 28 Morioka H. An experimental study of direct nerve implantation in denervated muscle: reinnervation by formation of new motor endplates [in Japanese].  Nippon Seikeigeka Gakkai Zasshi. 1988;  62 43-55
• 29 Frank E, Jansen J, Lomo T et al.. The interaction between foreign and original motor nerves innervating the soleus muscle of rats.  J Physiol. 1975;  247 725-743
• 30 McArdle J. Complex end-plate potentials at the regenerating neuromuscular junction of the rat.  Exp Neurol. 1975;  49 629-638
• 31 Rotshenker S, McMahan V. Altered patterns of innervation in frog muscle after denervation.  J Neurocytol. 1976;  5 719-730
• 32 Mark R, Marotte L, Johnstone J. Reinnervated eye muscles do not respond to impulses in foreign nerves.  Science. 1970;  170 193-194
• 33 Dennis M, Yip J. Formation and elimination of foreign synapses on adult salamander muscle.  J Physiol. 1978;  274 299-310
• 34 Cass D, Sutton T, Mark R. Competition between nerves for functional connexions with axolotl muscles.  Nature. 1973;  243 201-203