Regeneration of Denervated Skeletal Muscles - Brunelli's CNS-PNS Paradigm.
J Med Life
; 12(4): 342-353, 2019.
Article
em En
| MEDLINE
| ID: mdl-32025252
ABSTRACT
The restoration of voluntary muscle activity in posttraumatic paraplegia in both animal experiments and other clinical applications requires reproducibility of a technically-demanding microsurgical procedure, limited by physicians' understanding of Brunelli's spinal cord grafting paradigm. The insufficient clinical investigation of the long-term benefits of the CNS-PNS graft application warrants additional inquiry. The objective of this study is to explore the potential benefits of the first replicated, graft-induced neuroregeneration of denervated skeletal muscle regarding long-term clinical outcomes and to investigate the effect of Cerebrolysin on neuromodulation. A randomized study evaluating 30 rats, approved by the National Animal Ethics Advisory Committee was performed. The medication was administered postoperatively. For 14 days, 12 rats received Cerebrolysin (serum), 11 received NaCl 0.9% (shams), and 7 were controls. For microsurgery, the lateral corticospinal tract T10 was grafted to the denervated internal obliquus abdominal muscle. On day 90, intraoperative proof of reinnervation was observed. On day 100, 15 rats were euthanized for fixation, organ removal, and extensive histology-morphology examination, and the Wei-Lachin statistical procedure was employed. After an open revision of 16 rats, 8 were CMAP positive. After intravenous Vecuronium application, two (Cerebrolysin, NaCl) out of two rats showed an incomplete compound muscle action potential (CMAP) loss due to glutamatergic and cholinergic co-transmission, while two others showed a complete loss of amplitude. Cerebrolysin medication initiated larger restored muscle fiber diameters and less scarring. FB+ neurons were not observed in the brain but were observed in the Rexed laminae. Brunelli's concept was successfully replicated, demonstrating the first graft induced existence of cholinergic and glutamatergic neurotransmission in denervated grafted muscles. Statistics of the histometric count of muscle fibers revealed larger fiber diameters after Cerebrolysin. Brunelli's CNS-PNS experimental concept is suitable to analyze graft-neuroplasticity focused on the voluntary restoration of denervated skeletal muscles in spinal cord injury. Neuroprotection by Cerebrolysin is demonstrated.
Palavras-chave
ACh acetylcholine; AChGL-CN Cholinergic/glutamatergic co-neurotransmission; Brunelli's paradigm; CC Cornel Catoi; CERE Cerebrolysin; CI confidence interval; CMAP compound muscle action potential; CNS PNS graft; CST cortical spinal tract; Cerebrolysin neuromodulation; DM Dafin F. Muresanu; EMG electromyogram; GB Giorgio Brunelli; HPF high-power fields; HRQOL Health-related quality of life; ICU intensive care unit; IOAM internal oblique abdominal muscle; IP intraperitoneal; IV intravenous; KvW Klaus RH von Wild; ML Marlene Löhnhardt; Muscle regeneration; NEZ nerve entrance zone; NG nerve graft; NMJ neuromuscular junction; NR neurorehabilitation; PNG Peripheral Nerve Graft; RCT randomized controlled trial; SC spinal cord; SCI spinal cord injury; SNG sural nerve graft; Traumatic paraplegia; TvW Tobias von Wild
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Sistema Nervoso Central
/
Sistema Nervoso Periférico
/
Músculo Esquelético
/
Regeneração Nervosa
Limite:
Animals
Idioma:
En
Revista:
J Med Life
Assunto da revista:
MEDICINA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Alemanha