Human dorsal root ganglia are either preserved or completely lost after deafferentation by brachial plexus injury
Authors' conclusion
Patients with plexus injury separate into two groups with either neuronal preservation or neuronal loss.
Study context
- Population
- Patients with brachial plexus injury (clinically and MRI-characterised) undergoing reconstructive nerve surgery
- Participants
- 13 plexus injury patients
- Comparison
- Avulsed dorsal root ganglia (DRG) from plexus injury vs DRG from forensic autopsy
- Plexus injuryn = 13
- Outcome
- Cellular composition of DRG (multicolour immunohistochemistry, deep-learning bioimage analysis) and bulk RNA sequencing
Methodological detailshistopathological and transcriptomic phenotyping, forensic autopsy controls
- Histopathological and transcriptomic phenotyping
- Forensic autopsy controls
Main finding
As reported in the abstract
DRG cellular composition
- Loss of typical DRG units (neurones and satellite glial cells), replaced by mesodermal/connective tissue, in about half of patients
- Cellular units well preserved in the remaining patients
- Preoperative plexus MRI neurography could not distinguish the two types
Further findings
Pain and arm function
- Less maximum pain with 'neuronal preservation' than with 'neuronal loss'
- Arm function improved after nerve reconstruction, but severe pain persisted
Transcriptome of preserved DRGs
- Expression of subtype-specific sensory neurone marker genes but downregulation of neuronal attributes
- Signs of ongoing inflammation and connective tissue remodelling
Original publication
Human dorsal root ganglia are either preserved or completely lost after deafferentation by brachial plexus injury. Br J Anaesth. Published 11 October 2024. doi:10.
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