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Open Access Highly Accessed Research article

Lithium enhances survival and regrowth of spinal motoneurons after ventral root avulsion

Rao Fu1, Ying Tang1, Ze-Min Ling1, Ying-Qin Li1, Xiao Cheng1, Fa-Huan Song1, Li-Hua Zhou1* and Wutian Wu234*

Author Affiliations

1 Department of Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, No. 74, Zhongshan Road 2, Guangzhou, China

2 Department of Anatomy, Li Ka Sheng Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China

3 State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR, China

4 GHM Institute of CNS regeneration, Jinan University, Guangzhou, China

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BMC Neuroscience 2014, 15:84  doi:10.1186/1471-2202-15-84

Published: 2 July 2014

Abstract

Background

During the clinical treatment of the brachial plexus root avulsion (BPRA), reimplantation surgery can not completely repair the motor function of the hand because the axonal growth velocity of the spinal motoneurons (MNs) is too slow to re-innervate the intrinsic hand muscles before muscle atrophy. Here, we investigated whether lithium can enhance the regenerative capacity of the spinal MNs in a rat model of BPRA.

Results

The avulsion and immediate reimplantation of the C7 and C8 ventral roots were performed and followed with daily intraperitoneal administration of a therapeutic concentrationof LiCl. After a 20 week long-term rehabilitation, the motor function recovery of the injured forepaw was studied by a grasping test. The survival and regeneration of MNs were checked by choline acetyltransferase (ChAT) immunofluorescence and by Fluoro-Gold (FG) retrograde labeling through the median and ulnar nerves of the ventral horn MNs. The number and diameter of the nerve fibers in the median nerve were assessed by toluidine blue staining. Our results showed that lithium plus reimplantation therapy resulted in a significantly higher grasping strength of the digits of the injured forepaw. Lithium plus reimplantation allowed 45.1% ± 8.11% of ChAT-positive MNs to survive the injury and increased the number and diameter of nerve fibers in the median nerve. The number of FG-labeled regenerative MNs was significantly elevated in all of the reimplantation animals. Our present data proved that lithium can enhance the regenerative capacity of spinal MNs.

Conclusions

These results suggest that immediate administration of lithium could be used to assist reimplantation surgery in repairing BPRA injuries in clinical treatment.

Keywords:
Lithium; Reimplantation; Motoneuron; Axonal regeneration; Brachial root avulsion