Peripheral nerve transfers change target muscle structure and function
Journal article, 2019
Selective nerve transfers surgically rewire motor neurons and are used in extremity reconstruction to restore muscle function or to facilitate intuitive prosthetic control. We investigated the neurophysiological effects of rewiring motor axons originating from spinal motor neuron pools into target muscles with lower innervation ratio in a rat model. Following reinnervation, the target muscle's force regenerated almost completely, with the motor unit population increasing to 116% in functional and 172% in histological assessments with subsequently smaller muscle units. Muscle fiber type populations transformed into the donor nerve's original muscles. We thus demonstrate that axons of alternative spinal origin can hyper-reinnervate target muscles without loss of muscle force regeneration, but with a donor-specific shift in muscle fiber type. These results explain the excellent clinical outcomes following nerve transfers in neuromuscular reconstruction. They indicate that reinnervated muscles can provide an accurate bioscreen to display neural information of lost body parts for high-fidelity prosthetic control.
Author
Konstantin D Bergmeister
Medical University of Vienna
Martin Aman
Medical University of Vienna
Silvia Muceli
University Medical Center Göttingen
Imperial College London
Ivan Vujaklija
Imperial College London
Krisztina Manzano-Szalai
Medical University of Vienna
Ewald Unger
Medical University of Vienna
Ruth A. Byrne
Medical University of Vienna
Clemens Scheinecker
Medical University of Vienna
Otto Riedl
Medical University of Vienna
Stefan Salminger
Medical University of Vienna
Florian Frommlet
Medical University of Vienna
Gregory H. Borschel
Hospital for Sick Children University of Toronto
Dario Farina
Imperial College London
Oskar C. Aszmann
Medical University of Vienna
Science advances
2375-2548 (eISSN)
Vol. 5 1 eaau2956Subject Categories
Basic Medicine
Clinical Medicine
Medical Biotechnology
DOI
10.1126/sciadv.aau2956