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Examination of the human motor endplate after brachial plexus injury with two‐photon microscopy
Author(s) -
Chan Justin P.,
Clune James,
Shah Sameer B.,
Ward Samuel R.,
Kocsis Jeffery D.,
Mozaffar Tahseen,
Steward Oswald,
Gupta Ranjan
Publication year - 2020
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26778
Subject(s) - wallerian degeneration , medicine , deltoid curve , brachial plexus , neuromuscular junction , pathology , anatomy , neuroscience , biology
After traumatic nerve injury, neuromuscular junction remodeling plays a key role in determining functional outcomes. Immunohistochemical analyses of denervated muscle biopsies may provide valuable prognostic data regarding clinical outcomes to supplement electrodiagnostic studies. Methods We performed biopsies on nonfunctioning deltoid muscles in two patients after gunshot wounds and visualized the neuromuscular junctions using two‐photon microscopy with immunohistochemistry. Results Although the nerves in both patients showed evidence of acute Wallerian degeneration, some of the motor endplates were intact but exhibited significantly decreased surface area and volume. Both patients exhibited substantial recovery of motor function over several weeks postinjury. Discussion Two‐photon microscopic assessment of neuromuscular junction integrity and motor endplate morphometry in muscle biopsies provided evidence of partial sparing of muscle innervation. This finding supported the clinical judgment that eventual recovery would occur. With further study, this technique may help to guide operative decisionmaking after traumatic nerve injuries.