Evaluation of Gastrocnemius Motor Evoked Potentials Induced by Trans-Spinal Magnetic Stimulation Following Tibial Nerve Crush in Rats

Simple Summary Peripheral nerve injuries induce long-lasting physiological and severe functional impairment due to motor, sensory, and autonomic denervation. We demonstrated that trans-spinal magnetic stimulation can be used to evaluate the nerve conductance of the tibial nerve in a preclinical model. This noninvasive technique allows us to evaluate the neuromuscular junction property in naive animals, and the nerve conductance can be impacted by the anesthetics used in preclinical studies. In addition, following chronic peripheral nerve injury, trans-spinal magnetic stimulation is useful to evaluate the tibial nerve conductance evolution over time. Thus, we showed that trans-spinal magnetic stimulation is a reliable and non-invasive diagnostic tool to assess peripheral nerve damage, and its subsequent spontaneous or therapeutically induced recovery. Peripheral nerve injuries induce long-lasting physiological and severe functional impairment due to motor, sensory, and autonomic denervation. Preclinical models allow us to study the process of nerve damage, evaluate the capacity of the peripheral nervous system for spontaneous recovery, and test diagnostic tools to assess the damage and subsequent recovery. Methods: In this study on Sprague-Dawley rats, we: (1) compared the use of two different anesthetics (isoflurane and urethane) for the evaluation of motor evoked potentials (MEPs) induced by trans-spinal magnetic stimulation (TSMS) in gastrocnemius and brachioradialis muscles; (2) monitored the evolution of gastrocnemius MEPs by applying paired-pulse stimulation to evaluate the neuromuscular junction activity; and (3) evaluated the MEP amplitude before and after left tibialis nerve crush (up to 7 days post-injury under isoflurane anesthesia). The results showed that muscle MEPs had higher amplitudes under isoflurane anesthesia, as compared with urethane anesthesia in the rats, demonstrating higher motoneuronal excitability under isoflurane anesthesia evaluated by TSMS. Following tibial nerve crush, a significant reduction in gastrocnemius MEP amplitude was observed on the injured side, mainly due to axonal damage from the initial crush. No spontaneous recovery of MEP amplitude in gastrocnemius muscles was observed up to 7 days post-crush; even a nerve section did not induce any variation in residual MEP amplitude, suggesting that the initial crush effectively severed the axonal fibers. These observations were confirmed histologically by a drastic reduction in the remaining myelinated fibers in the crushed tibial nerve. These data demonstrate that TSMS can be reliably used to noninvasively evaluate peripheral nerve function in rats. This method could therefore readily be applied to evaluate nerve conductance in the clinical environment.

Automated summary

Peripheral nerve injuries can cause long-lasting physiological and severe functional impairments. In this study, we demonstrated that trans-spinal magnetic stimulation is a reliable and non-invasive diagnostic tool for assessing peripheral nerve damage and subsequent recovery. This technique can be used to evaluate nerve conductance and neuromuscular junction property in preclinical models and clinical settings.