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Review ArticleReviews and Commentaries

Neurobiology of Peripheral Nerve Injury, Regeneration, and Functional Recovery: From Bench Top Research to Bedside Application

Wale Sulaiman and Tessa Gordon
Ochsner Journal March 2013, 13 (1) 100-108;
Wale Sulaiman
*Department of Neurosurgery, Ochsner Clinic Foundation, and The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA
MD, PhD, FRCS
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Tessa Gordon
†Department of Surgery, Division of Plastic Reconstructive Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Canada
PhD
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    Figure 1.

    Schematic illustration of proximal nerve injuries to the brachial plexus that require prolonged regeneration times for the regenerating axons to reinnervate the muscles in the hand. During this time, injured neurons are chronically axotomized and Schwann cells of the distal stump of injured nerves are chronically denervated. The graphs in the inserts demonstrate the progressive decline in the capacity of injured motoneurons that regenerate axons (MN number) and reinnervate muscles (motor unit [MU] number) as a result of chronic Schwann cell denervation and chronic neuronal axotomy.

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    Figure 2.

    After nerve injury, regeneration-associated genes (RAGs) are upregulated transiently in the neurons while genes associated with normal synaptic transmission are downregulated (A and B). Schwann cells in the denervated nerve stumps undergo proliferation during Wallerian degeneration and express many RAGs while myelin-associated genes are downregulated (A). The gene profiles support the outgrowth of axons, but the expression is very short lived such that over time (while regenerating axons grow at a slow rate of 1 mm/d) the expression of RAGs is downregulated and the capacity of injured neurons to regenerate their axons and Schwann cells to support regeneration is diminished (C). Examples of progressive decline in mRNA levels are plotted for tubulin in neurons and GDNF in Schwann cells in the graphs.

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    Figure 3.

    Regenerative capacity declines with time due to prolonged axotomy and Schwann cell denervation. In rats, we experimentally prolonged either (A) the duration of time during which motoneurons were prevented from regenerating their axons (chronic axotomy; by delaying the suture of the proximal nerve stump to a freshly denervated distal nerve stump) or (B) the denervation of Schwann cells in the distal nerve stumps (chronic denervation; by delaying the suture of a freshly cut proximal nerve stump to a nerve stump that was chronically denervated prior to nerve repair). The capacity of the neurons for regeneration after chronic axotomy of motoneurons or chronic denervation of Schwann cells and target muscles was determined either by (a) calculating the number of reinnervated muscle units (the nerve and the muscle fibers that the one motoneuron supplies) using force measurements in response to stimulation of single axons and the muscle nerve or (b) counting backlabelling motoneurons that had regenerated their axons successfully by application of a retrograde dye to the regenerating axons in the nerve stump distal to the site of nerve repair. The evaluations of regenerative success obtained by the methods of motoneuron counts and counts of motor units were in good agreement demonstrating the progressive decline in regenerative capacity as a function of (C) chronic axotomy of the motoneurons and (D) chronic denervation of the Schwann cells.

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Ochsner Journal
Vol. 13, Issue 1
Mar 2013
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Neurobiology of Peripheral Nerve Injury, Regeneration, and Functional Recovery: From Bench Top Research to Bedside Application
Wale Sulaiman, Tessa Gordon
Ochsner Journal Mar 2013, 13 (1) 100-108;

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Neurobiology of Peripheral Nerve Injury, Regeneration, and Functional Recovery: From Bench Top Research to Bedside Application
Wale Sulaiman, Tessa Gordon
Ochsner Journal Mar 2013, 13 (1) 100-108;
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  • Article
    • ABSTRACT
    • INTRODUCTION
    • REGENERATIVE RESPONSE AFTER NERVE INJURY AND ITS ROLE IN FUNCTIONAL OUTCOME
    • EXPERIMENTAL PARADIGMS AND ASSESSMENT OF AXONAL REGENERATION AFTER NERVE INJURY AND MICROSURGICAL REPAIR
    • CONCLUSIONS
    • Footnotes
    • REFERENCES
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Cited By...

  • Recovery of retinal terminal fields after traumatic brain injury: evidence of collateral sprouting and sexual dimorphism
  • Evaluation of distal facial nerve branches contribution to facial nerve paralysis in rodents
  • Schwann Cells as Orchestrators of Nerve Repair: Implications for Tissue Regeneration and Pathologies
  • Nerve injury converts Schwann cells in a persisting repair state in human neuroma tissue
  • Targeting Vasohibins to Promote Axon Regeneration
  • Human Motor Endplate Survival after Chronic Peripheral Nerve Injury
  • VASH1/2 inhibition accelerates functional recovery of injured nerves
  • Angiogenesis is critical for the regenerative effects of exercise
  • Repetitive Peripheral Magnetic Stimulation (rPMS) in Subjects With Lumbar Radiculopathy: An Electromyography-guided Prospective, Randomized Study
  • Transforming Growth Factor Beta 1 Regulates Fibroblast Growth Factor 7 Expression in Schwann Cells
  • Collagen XIII Is Required for Neuromuscular Synapse Regeneration and Functional Recovery after Peripheral Nerve Injury
  • After Nerve Injury, Lineage Tracing Shows That Myelin and Remak Schwann Cells Elongate Extensively and Branch to Form Repair Schwann Cells, Which Shorten Radically on Remyelination
  • Nerve injuries of the upper extremity and hand
  • STAT3 Controls the Long-Term Survival and Phenotype of Repair Schwann Cells during Nerve Regeneration
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Keywords

  • Axotomy
  • cytokines
  • denervation
  • nerve growth factors
  • nerve regeneration
  • neurobiology
  • peripheral nerve injuries
  • recovery of function
  • Schwann cells

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