Distal sensory to distal motor nerve anastomosis can protect lower extremity muscle atrophy in a murine model

Abstract

Background

Delayed reinnervation of denervated motor neuron has irreversible consequences. We introduced distal motor to distal sensory anastomosis (DDSA) as a practical, time-saving method to protect injured motor neurons and its target tissues.

Methods

Two experimental groups of Wistar rats were studied. In DDSA group, the distal end of the tibial sensory nerve of the left leg was anastomosed to the distal common peroneal nerve. The same nerves were dissected without anastomosis in the control group. Four months later, visual functional assessment of sciatic nerves was performed, and histological structures of the nerves and muscles and ultra-structure of nerves were evaluated.

Results

Significant enhancement was seen in intermediate toe spread factor in DDSA group (P < 0.05), but toe spread factor and subsequently sciatic statistic index demonstrated no significant improvement. The surgical procedures resulted in an ipsilateral rehabilitation in DDSA group with statistically significant (P < 0.05) improvement in muscle weight and myelinated axon count. Light and electron microscopy evaluations of the histological specimen showed obvious prevention of nerve and muscle tissues degeneration following anastomosis.

Conclusions

Overall, DDSA showed a peripheral nerve could repair, survive, and protect target tissues from degeneration without connection to their cell bodies and central nervous system. Some possible explanations for these positive results could be the restorative role of electrochemical signaling directly from the skin sensory nerve receptors and stimulation of Schwann cell to convert to its regenerative phenotype.

Level of Evidence: Not ratable.

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