中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2026, Vol. 21 ›› Issue (8): 3748-3753.doi: 10.4103/NRR.NRR-D-24-00915

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

用于上运动神经元综合征中选择性肌肉再神经支配的新型对侧尺神经转移模型

  

  • 出版日期:2026-08-18 发布日期:2026-04-27

A novel contralateral ulnar nerve transfer model for selective muscle reinnervation in upper motor neuron syndrome

Olga Politikou1, 2, Silvia Muceli3, Leopold Harnoncourt1, Florian Jaklin1, Vlad Tereshenko1, 4, Udo Maierhofer1, Matthias Luft1, 5, Christopher Festin1, Gregor Laengle1, 6, Johanna Klepetko1, Laurenz Pflaum1, Konstantin D. Bergmeister1, 7, Oskar C. Aszmann1, 6, *   

  1. 1Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria; 
    2Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland; 
    3Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden; 
    4Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 
    5Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital of the Brothers of St. John of Gods, Paracelsus Medical University, Salzburg, Austria; 
    6Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria; 
    7Department of Plastic, Aesthetic and Reconstructive Surgery, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, Krems, Austria
  • Online:2026-08-18 Published:2026-04-27
  • Contact: Oskar C. Aszmann, MD, oskar.aszmann@meduniwien.ac.at.
  • Supported by:
    This study was supported by the European Research Council (ERC) under the European Union’s Horizon 2020 Research and Innovation Programme, No. 810346. The ERC Synergy Grant was coordinated by Imperial College London (to OCA).

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摘要：

脑卒中和创伤性脑损伤会导致上运动神经元综合征，其特征是肌肉痉挛或不同程度的瘫痪，具体取决于病变的位置和范围。当前治疗主要为对症治疗，疗效有限且伴有显著副作用。神经转移技术，如动物模型中的对侧L4前根转移及动物和临床研究中的C7根转移，已被证实可减轻痉挛并改善上运动神经元综合征的功能，但缺乏选择性。实验假设使用对侧选择性周围供体神经而非整个神经根进行神经转移，可能代表一种有效的神经转移方法，并为未来在上运动神经元综合征中进行选择性肌肉再神经支配的研究提供坚实基础。实验大鼠进行对侧尺神经至尺神经的神经转移手术。术后12周进行电生理测量，以评估对侧尺侧腕屈肌的成功再神经支配。此外，采集再神经支配的尺侧腕屈肌肌肉活检样本，以分析肌肉纤维类型组成、横截面积和胶原含量，并将其与未处理对照组进行比较。还对再神经支配的神经进行了轴突定量分析。所有大鼠术后恢复顺利，术后仍能正常使用双侧前肢。电生理测试证实了尺侧腕屈肌的成功再神经支配。肌肉纤维类型组成、横截面积和胶原含量未显示出统计学上的显著变化。轴突计数表明神经再生成功且未发生结构破坏。实验成功验证了该新型对侧神经转移模型的可行性、可重复性和安全性，并实现了有效的肌肉再神经支配。该模型为选择性肌肉再神经支配及上运动神经元综合征的治疗研究提供了有价值的工具，可能对改善脑卒中和创伤性脑损伤患者的临床预后具有重要意义。


https://orcid.org/0000-0001-5530-726X (Oskar C. Aszmann)

关键词: 对侧神经, 电生理学, 偏瘫, 肌肉纤维类型, 肌肉再神经支配, 神经转移, 大鼠模型, 痉挛, 脑卒中, 尺神经, 上运动神经元损伤, 神经再生

Abstract:

Stroke and traumatic brain injury lead to upper motor neuron syndrome, which is characterized by muscle spasticity or paresis of varying severity depending on the lesion’s location and extent. Current treatments are mostly symptomatic with limited efficacy and significant side effects. Nerve transfer techniques, such as the contralateral L4 ventral root transfer in animal models and C7 root transfer in both animal and clinical studies, have been shown to reduce spasticity and improve function in upper motor neuron syndrome; however, they lack selectivity. Our hypothesis is that using a selective peripheral donor nerve from the contralateral side, rather than the entire nerve root, may represent an effective nerve transfer and provide a robust basis for future research on selective muscle reinnervation in upper motor neuron syndrome. Ten rats underwent a contralateral ulnar-to-ulnar nerve transfer procedure. Electrophysiological measurements were conducted twelve weeks post-surgery to assess successful reinnervation of the contralateral flexor carpi ulnaris muscle. Additionally, muscle biopsies of the reinnervated flexor carpi ulnaris were harvested to examine the muscle fiber type composition, cross-sectional area, and collagen content as well as compare them to naive counterparts. Axon quantification of the reinnervated nerves was also performed. All rats recovered uneventfully, maintaining the use of both paws post-surgery. Electrophysiological tests confirmed the successful reinnervation of the flexor carpi ulnaris muscle. Muscle fiber type composition, cross-sectional area, and collagen content did not show statistically significant changes. Axon counts indicated successful nerve regeneration without architectural disruption. In conclusion, we were able to demonstrate this novel contralateral nerve transfer model’s feasibility, reproducibility, and safety as well as achieve effective muscle reinnervation. This model provides a valuable tool for further research on selective muscle reinnervation and treatment of upper motor neuron syndrome, with potential implications for improving clinical outcomes in stroke and traumatic brain injury patients.

Key words: electrophysiology, hemiplegia, muscle fiber type, muscle reinnervation, nerve regeneration, nerve transfer, spasticity, stroke, ulnar nerve, upper motor neuron lesion