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Manual Stimulation of the Suprahyoid-Sublingual Region Diminishes Polynnervation of the Motor Endplates and Improves Recovery of Function After Hypoglossal Nerve Injury in Rats

Faculty of Pre-School and Primary School Education, Sofia University, Bulgaria

Patrick Schweigert

Department of Anatomy I University of Cologne, Germany

Orlando Guntinas-Lichius, MD, PhD

Department of Oto-Rhino-Laryngology, University of Jena, Germany

Stoyan Pavlov, MD

Department of Anatomy, Histology, Embryology, Medical University Varna, Bulgaria

Maria Grosheva, MD

Department of Oto-Rhino-Laryngology, University of Cologne, Germany

Srebrina Angelova, MD

Department of Oto-Rhino-Laryngology, University of Cologne, Germany

Michael Streppel, MD, PhD

Department of Oto-Rhino-Laryngology, University of Cologne, Germany

Andrey Irintchev, MD, PhD

Centre for Molecular Neurobiology, University of Hamburg, Germany

Emmanouil Skouras, MD

Department of Trauma and Reconstructive Surgery, University of Cologne, Germany

Stefanie Kuerten, MD

Department of Anatomy I University of Cologne, Germany

Nektarios Sinis, MD

Department of Hand-, Plastic-, and Reconstructive Surgery with Burn Unit, BG-Trauma Centre, University of Tuebingen, Tuebingen, Germany

Sarah Dunlop, PhD

School of Animal Biology and Western Australian Institute for Medical Research, The University of Western Australia

Victoria Radeva, MD, PhD

Faculty of Pre-School and Primary School Education, Sofia University, Bulgaria

Doychin N. Angelov, MD, PhD

Department of Anatomy I University of Cologne, Germany, angelov.anatomie{at}uni-koeln.de

Background. Using the rat facial nerve axotomy model, the authors recently showed that manual stimulation of denervated whiskerpad muscles reduced the posttransectional polyinnervation at the neuromuscular junctions and promoted full recovery of vibrissal whisking. Objective. Prompted by implications for rehabilitation therapy, the authors examined whether manual stimulation of denervated supra- and infrahyoid muscles would also improve recovery after unilateral lesion on the hypoglossal nerve. Methods. Adult rats underwent transection of the right hypoglossal nerve. Half of the animals received no postoperative treatment, and the other half were subjected to daily manual stimulation of the suprahyoid/sublingual region for 2 months. Recovery was assessed by measuring the angle of tongue-tip deviation from the midline, degree of collateral axonal branching at the lesion site (counts after retrograde labeling with 2 fluorescent dyes), synaptic input to the hypoglossal motoneurons using synaptophysin immunocytochemistry, tongue-muscles motor representation in the cerebral cortex after c-Fos immunocytochemistry, and portion of polyinnervated neuromuscular junctions. Results. In animals receiving manual stimulation, the tongue-tip deviation was 37.0 ± 49.37°, whereas values in control nonstimulated rats were significantly higher (50.1 ± 9.01°; P < .05; mean ± SD). Improved recovery was not associated with reduced collateral axonal branching; there were also no differences in tongue-muscles representation in the motor cortex. However, manual stimulation restored the total synaptic input to levels in intact animals and reduced the proportion of polyinnervated neuromuscular junctions compared with nonstimulated animals. Conclusion. The data show that manual stimulation of denervated muscles improves functional outcome following peripheral nerve injury. This suggests immediate potential for enhancing clinical rehabilitation strategies.

Key Words: Motoneuron • Axotomy • Hypoglossal nerve • Axonal sprouting • Motor cortex • Suprahyoid-sublingual region • Neuromuscular junction • Polyinnervation

This version was published on November 1, 2008

Neurorehabilitation and Neural Repair, Vol. 22, No. 6, 754-768 (2008)
DOI: 10.1177/1545968308316387


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