Neural Regeneration Research ›› 2025, Vol. 20 ›› Issue (5): 1495-1504.doi: 10.4103/NRR.NRR-D-23-00493

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Resting-state brain network remodeling after different nerve reconstruction surgeries: a functional magnetic resonance imaging study in brachial plexus injury rats

Yunttng Xiang1, 2, # , Xiangxin Xing3, # , Xuyun Hua3, 4, # , Yuwen Zhang5 , Xin Xue1 , Jiajia Wu3, 4 , Mouxiong Zheng3, 4, * , He Wang5, 6, 7, * , Jianguang Xu1, 2, 3, *   

  1. 1 School of Rehabilitatton Science, Shanghai University of Tradittonal Chinese Medicine, Shanghai, China;  2 Engineering Research Center of Tradittonal Chinese Medicine Intelligent Rehabilitatton, Ministry of Educatton, Shanghai, China;  3 Department of Rehabilitatton Medicine, Yueyang Hospital of Integrated Tradittonal Chinese and Western Medicine, Shanghai University of Tradittonal Chinese Medicine, Shanghai, China;  4 Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Tradittonal Chinese and Western Medicine, Shanghai University of Tradittonal Chinese Medicine, Shanghai, China;  5 Instttute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China;  6 Key Laboratory of Computattonal Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Educatton, Shanghai, China; 7 Human Phenome Instttute, Fudan University, Shanghai, China
  • Online:2025-05-15 Published:2024-10-31
  • Contact: Jianguang Xu, MD, PhD, xjg@shutcm.edu.cn; He Wang, PhD, hewang@fudan.edu.cn; Mouxiong Zheng, MD, PhD, zhengmouxiong@shutcm.edu.cn.
  • Supported by:
    This work was supported by the Nattonal Natural Science Foundatton of China, Nos. 81871836 (to MZ), 82172554 (to XH), and 81802249 (to XH), 81902301 (to JW); the Nattonal Key R&D Program of China, Nos. 2018YFC2001600 (to JX) and 2018YFC2001604 (to JX); Shanghai Rising Star Program, No. 19QA1409000 (to MZ); Shanghai Municipal Commission of Health and Family Planning, No. 2018YQ02 (to MZ); and Shanghai Youth Top Talent Development Plan and Shanghai “Rising Stars of Medical Talent” Youth Development Program, No. RY411.19.01.10 (to XH).

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Abstract:

Distinct brain remodeling has been found after different nerve reconstruction strategies, including motor representation of the affected limb. However, differences among reconstruction strategies at the brain network level have not been elucidated. This study aimed to explore intra-network changes related to altered peripheral neural pathways after different nerve reconstruction surgeries, including nerve repair, end-to-end nerve transfer, and end-to-side nerve transfer. Sprague–Dawley rats underwent complete left brachial plexus transection and were divided into four equal groups of eight: no nerve repair, grafted nerve repair, phrenic nerve end-to-end transfer, and end-to-side transfer with a graft sutured to the anterior upper trunk. Resting-state brain functional magnetic resonance imaging was obtained 7 months after surgery. The independent component analysis algorithm was utilized to identify group-level network components of interest and extract resting-state functional connectivity values of each voxel within the component. Alterations in intra-network resting-state functional connectivity were compared among the groups. Target muscle reinnervation was assessed by behavioral observation (elbow flexion) and electromyography. The results showed that alterations in the sensorimotor and interoception networks were mostly related to changes in the peripheral neural pathway. Nerve repair was related to enhanced connectivity within the sensorimotor network, while end-to-side nerve transfer might be more beneficial for restoring control over the affected limb by the original motor representation. The thalamic-cortical pathway was enhanced within the interoception network after nerve repair and end-to-end nerve transfer. Brain areas related to cognition and emotion were enhanced after end-to-side nerve transfer. Our study revealed important brain networks related to different nerve reconstructions. These networks may be potential targets for enhancing motor recovery. 

Key words:

brain functional networks, end-to-end nerve transfer, end-to-side nerve transfer, independent component analysis, nerve repair,  , peripheral plexus injury, resting-state functional connectivity