title: Lithium accelerates functional motor recovery by improving remyelination of regenerating axons following ventral root avulsion and reimplantation.
abstract: Brachial plexus injury (BPI) often involves the complete or partial avulsion of one or more of the cervical nerve roots, which leads to permanent paralysis of the innervated muscles. Reimplantation surgery has been attempted as a clinical treatment for brachial plexus root avulsion but has failed to achieve complete functional recovery. Lithium is a mood stabilizer drug that is used to treat bipolar disorder; however, its effects on spinal cord or peripheral nerve injuries have also been reported. The purpose of this study was to investigate whether lithium can improve functional motor recovery after ventral root avulsion and reimplantation in a rat model of BPI. The results showed that systemic treatment with a clinical dose of lithium promoted motor neuron outgrowth and increased the efficiency of motor unit regeneration through enhanced remyelination. An analysis of myelin-associated genes showed that the effects of lithium started during the early phase of remyelination and persisted through the late stage of the process. Efficient remyelination of the regenerated axons in the lithium-treated rats led to an earlier functional recovery. Therefore, we demonstrated that lithium might be a potential clinical treatment for BPI in combination with reimplantation surgery.
authors.affiliation: The First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Xin-Yu
authors.initials: XY
authors.lastname: Fang
authors.affiliation: Department of Orthopedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Zhang
authors.affiliation: Department of Orthopedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; Department of Orthopedics & Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Chao-Fan
authors.initials: CF
authors.lastname: Zhang
authors.affiliation: School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Wai-Man
authors.initials: WM
authors.lastname: Wong
authors.affiliation: School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
authors.forename: Wen
authors.initials: W
authors.lastname: Li
authors.affiliation: School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region; Joint Laboratory for CNS Regeneration, Jinan University and The University of Hong Kong, GHM Institute of CNS Regeneration, Jinan University, Guangzhou, China. Electronic address: wtwu@hku.hk.
authors.forename: Wutian
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Orthopedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China. Electronic address: jianhual0591@163.com.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Lin
mesh_terms: D000818:Animals; D001369:Axons / Q000187:drug effects* / Q000473:pathology / Q000502:physiology; D001917:Brachial Plexus / Q000187:drug effects / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D005260:Female; D018020:Lithium Compounds / Q000494:pharmacology*; D009046:Motor Neurons / Q000187:drug effects / Q000473:pathology / Q000502:physiology; D009186:Myelin Sheath / Q000187:drug effects* / Q000473:pathology / Q000502:physiology; D009416:Nerve Regeneration / Q000187:drug effects* / Q000502:physiology; D018696:Neuroprotective Agents / Q000494:pharmacology*; D011897:Random Allocation; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology; D012092:Replantation; D013126:Spinal Nerve Roots / Q000187:drug effects* / Q000293:injuries / Q000503:physiopathology / Q000601:surgery
chemical_list: D018020:Lithium Compounds; D018696:Neuroprotective Agents
keywords: avulsion; lithium; motor function; reimplantation; remyelination; ventral root