L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage

There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage. Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles, we investigated a potential method of nerve repair using t...

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Autores principales:	Teng-Da Qian, Xi-Feng Zheng, Jing Shi, Tao Ma, Wei-Yan You, Jia-Huan Wu, Bao-Sheng Huang, Yi Tao, Xi Wang, Ze-Wu Song, Li-Xin Li
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2022
Materias:	central hemiplegia; end-to-end anastomosis; functional regeneration; hypertensive intracerebral hemorrhage; l4 nerve root; neural regeneration; neurotization; rat model; reinnervation; skilled restoration Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/af88499a27554a329ee56c7cdb22e4e3
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spelling	oai:doaj.org-article:af88499a27554a329ee56c7cdb22e4e32021-11-19T12:16:44ZL4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage1673-537410.4103/1673-5374.327359https://doaj.org/article/af88499a27554a329ee56c7cdb22e4e32022-01-01T00:00:00Zhttp://www.nrronline.org/article.asp?issn=1673-5374;year=2022;volume=17;issue=6;spage=1278;epage=1285;aulast=Qianhttps://doaj.org/toc/1673-5374There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage. Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles, we investigated a potential method of nerve repair using the L4 nerve roots. Rat models of hindlimb hemiplegia after a hypertensive intracerebral hemorrhage were established by injecting autogenous blood into the posterior limb of internal capsule. The L4 nerve root on the healthy side of model rats was transferred and then anastomosed with the L4 nerve root on the affected side to drive the extensor and flexor muscles of the hindlimbs. We investigated whether this method can restore the flexible movement of the hindlimbs of paralyzed rats after hypertensive intracerebral hemorrhage. In a beam-walking test and ladder rung walking task, model rats exhibited an initial high number of slips, but improved in accuracy on the paretic side over time. At 17 weeks after surgery, rats gained approximately 58.2% accuracy from baseline performance and performed ankle motions on the paretic side. At 9 weeks after surgery, a retrograde tracing test showed a large number of fluoro-gold-labeled motoneurons in the left anterior horn of the spinal cord that supports the L4-to-L4 nerve roots. In addition, histological and ultramicrostructural findings showed axon regeneration of motoneurons in the anterior horn of the spinal cord. Electromyography and paw print analysis showed that denervated hindlimb muscles regained reliable innervation and walking coordination improved. These findings suggest that the L4-to-L4 nerve root transfer method for the treatment of hindlimb hemiplegia after hypertensive intracerebral hemorrhage can improve the locomotion of hindlimb major joints, particularly of the distal ankle. Findings from study support that the L4-to-L4 nerve root transfer method can effectively repair the hindlimb hemiplegia after hypertensive intracerebral hemorrhage. All animal experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (No. IACUC-1906009) in June 2019.Teng-Da QianXi-Feng ZhengJing ShiTao MaWei-Yan YouJia-Huan WuBao-Sheng HuangYi TaoXi WangZe-Wu SongLi-Xin LiWolters Kluwer Medknow Publicationsarticlecentral hemiplegia; end-to-end anastomosis; functional regeneration; hypertensive intracerebral hemorrhage; l4 nerve root; neural regeneration; neurotization; rat model; reinnervation; skilled restorationNeurology. Diseases of the nervous systemRC346-429ENNeural Regeneration Research, Vol 17, Iss 6, Pp 1278-1285 (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	central hemiplegia; end-to-end anastomosis; functional regeneration; hypertensive intracerebral hemorrhage; l4 nerve root; neural regeneration; neurotization; rat model; reinnervation; skilled restoration Neurology. Diseases of the nervous system RC346-429
spellingShingle	central hemiplegia; end-to-end anastomosis; functional regeneration; hypertensive intracerebral hemorrhage; l4 nerve root; neural regeneration; neurotization; rat model; reinnervation; skilled restoration Neurology. Diseases of the nervous system RC346-429 Teng-Da Qian Xi-Feng Zheng Jing Shi Tao Ma Wei-Yan You Jia-Huan Wu Bao-Sheng Huang Yi Tao Xi Wang Ze-Wu Song Li-Xin Li L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage
description	There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage. Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles, we investigated a potential method of nerve repair using the L4 nerve roots. Rat models of hindlimb hemiplegia after a hypertensive intracerebral hemorrhage were established by injecting autogenous blood into the posterior limb of internal capsule. The L4 nerve root on the healthy side of model rats was transferred and then anastomosed with the L4 nerve root on the affected side to drive the extensor and flexor muscles of the hindlimbs. We investigated whether this method can restore the flexible movement of the hindlimbs of paralyzed rats after hypertensive intracerebral hemorrhage. In a beam-walking test and ladder rung walking task, model rats exhibited an initial high number of slips, but improved in accuracy on the paretic side over time. At 17 weeks after surgery, rats gained approximately 58.2% accuracy from baseline performance and performed ankle motions on the paretic side. At 9 weeks after surgery, a retrograde tracing test showed a large number of fluoro-gold-labeled motoneurons in the left anterior horn of the spinal cord that supports the L4-to-L4 nerve roots. In addition, histological and ultramicrostructural findings showed axon regeneration of motoneurons in the anterior horn of the spinal cord. Electromyography and paw print analysis showed that denervated hindlimb muscles regained reliable innervation and walking coordination improved. These findings suggest that the L4-to-L4 nerve root transfer method for the treatment of hindlimb hemiplegia after hypertensive intracerebral hemorrhage can improve the locomotion of hindlimb major joints, particularly of the distal ankle. Findings from study support that the L4-to-L4 nerve root transfer method can effectively repair the hindlimb hemiplegia after hypertensive intracerebral hemorrhage. All animal experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (No. IACUC-1906009) in June 2019.
format	article
author	Teng-Da Qian Xi-Feng Zheng Jing Shi Tao Ma Wei-Yan You Jia-Huan Wu Bao-Sheng Huang Yi Tao Xi Wang Ze-Wu Song Li-Xin Li
author_facet	Teng-Da Qian Xi-Feng Zheng Jing Shi Tao Ma Wei-Yan You Jia-Huan Wu Bao-Sheng Huang Yi Tao Xi Wang Ze-Wu Song Li-Xin Li
author_sort	Teng-Da Qian
title	L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage
title_short	L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage
title_full	L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage
title_fullStr	L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage
title_full_unstemmed	L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage
title_sort	l4-to-l4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage
publisher	Wolters Kluwer Medknow Publications
publishDate	2022
url	https://doaj.org/article/af88499a27554a329ee56c7cdb22e4e3
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L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage

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