Wallerian degeneration of peripheral nerve. Age-dependent loss of nerve lipids

Wallerian degeneration: From mechanism to disease to imaging

Wallerian degeneration (WD) was first discovered by Augustus Waller in 1850 in a transection of the glossopharyngeal and hypoglossal nerves in frogs. Initial studies suggested that the formation mechanism of WD is related to the nutrition of neuronal cell bodies to axons. However, with the wide application of transgenic mice in experiments, the latest studies have found that the mechanism of WD is related to axonal degeneration, myelin clearance and extracellular matrix. This review summarizes the discovery and research progress of WD and discusses the mechanism of WD from the perspective of molecular biology. In addition, this review combines the etiology, symptoms and imaging results of WD patients, and analyzes the clinical and imaging characteristics of WD, to provide the best perspective for future clinical research.

Acute anoxic changes in peripheral nerve: anatomic and physiologic correlations

INTRODUCTION

The response of the peripheral nerve to anoxia is modulated by many factors including glucose and temperature. The purposes of this article are to demonstrate the effects of these factors on the pathological changes induced by anoxia and to compare the electrophysiologic changes and pathological changes in the same nerves.

METHODS

Sciatic nerves were harvested from rats and placed in a perfusion apparatus where neurophysiologic responses could be recorded continuously during a 16 h experiment. After the experiment, light microscopy and electron microscopy were performed.

RESULTS

Light microscopic images showed mild changes from anoxia at normoglycemia. Hypoglycemic anoxia produced massive axonal swelling while hyperglycemic anoxia produced apparent changes in the myelin. Anoxic changes were not uniform in all axons. Electron microscopy showed only minor disruptions of the cytoskeleton with anoxia during normoglycemia. At the extremes of glucose concentration especially with hyperglycemia, there was a more severe disruption of intermediate filaments and loss of axonal structure with anoxia. Hypothermia protected axons from the effect of anoxia and produced peak axonal swelling in the 17-30°C range.

CONCLUSIONS

The combination of hyperglycemia or hypoglycemia and anoxia produces extremely severe axonal disruption. Changes in axonal diameter are complex and are influenced by many factors.

Freeze-fracture analysis of myelin membrane changes in Wallerian degeneration

Transection of mouse sciatic nerves produced microscopic changes in the myelin sheaths distal to the transection. Studied with freeze-fracture, these microscopic changes were correlated with alterations in the macromolecular organization of nerve membranes. In control mice, sciatic nerve myelin contained randomly distributed intramembranous particles. In the early stages of myelin breakdown the lamellae split and large areas of myelin membrane lacked intramembranous particles. The remaining particles clustered with a greater than normal density. Degenerating myelin was found within Schwann cells which still had an outer mesaxon and a normal distribution of intramembranous particles on the cell outer membrane. As the degeneration proceeded, myelin ovoids formed which completely lacked intramembranous particles. The findings suggest that during Wallerian degeneration there is a progression of myelin changes leading to the eventual loss of myelin intramembranous particles. These observations are morphological evidence that Schwann cells remove components from selective portions of their membrane during Wallerian degeneration.

Ultrastructural sequence of myelin breakdown during Wallerian degeneration in the rat optic nerve

Adult albino rats were subjected to unilateral surgical removal of the eyeball. After survival times of 7-140 days, the numerical response of the neuroglial cells, and the progressive disintegration of the myelin sheaths in the optic nerves, were studied qualitatively and quantitatively in electron-microscopic montages. The distribution density of microglia and astroglia in degenerating optic nerve increased to peaks after 35 and 56 days respectively, whereas, the oligodendroglia gradually decreased. During the early stage of degeneration, microglial cells appeared and invaded the sheath at the intraperiod line, peeling off the outer lamellae, which were then engulfed by phagocytosis. Within the microglia, myelin sheath fragments were surrounded by a membrane curled to form a myelin ring. In the intermediate stage of degeneration, the paired electron-dense lines of the ring, made up of myelin basic protein, decomposed and formed a homogeneous or heterogeneous osmiophilic layered structure, the myelin body, which, in the final stages, disintegrated and transformed into globoid lipid droplets and needle shaped cholesterol crystals.

Dendritic growth following labyrinthectomy in the squirrel monkey. Light and electron microscopic studies

In the squirrel monkey (Saimiri sciureus) peripheral vestibular dendrites underwent degeneration after destruction of the vestibular end organs (labyrinthectomy). The dendrites subsequently grew into the remodelled area where the end organs, surrounding tissues and inner ear fluid spaces were previously located, and were progressively occupied by connective tissue, blood vessels and also new bone. This finding indicates that peripheral vestibular dendrites of adult squirrel monkey can grow, that Schwann cells migrate along with these dendrites, and that myelin can be formed in vivo in locations not previously destined for myelination. The importance of these findings in relation to the plastic properties of the squirrel monkey vestibular nerve is discussed.

Myelination of regenerating sciatic nerve of the rat: lipid components and synthesis of myelin lipids

Changes of lipid, free fatty acid, protein, DNA, and RNA content in proximal and distal segments of regenerating sciatic nerve, from 14 to 120 days after crush, were determined. During the early stage of Wallerian degeneration, a marked decrease of phospholipid, cerebroside and sulfatide content and, in contrast, a marked increase of protein, DNA, RNA, and free fatty acid content, in the distal segment of crushed nerve compared to control, was observed. A gradual increase of phospholipid, cerebroside, and sulfatide levels, approaching normal values, and a gradual slope in the increase of protein, DNA, RNA, and free fatty acid levels over the ensuing time periods of regeneration was seen. Total cholesterol content was relatively constant during regeneration, slightly increasing at day 120. The activity of 2', 3'-cyclic nucleotide 3'-phosphodiesterase (CNPase) of myelin fraction purified from distal segment of regenerating sciatic nerve showed a significant increase in the 30-120 day regenerating period. A marked increase of the incorporation of [2-3H]glycerol and of [Me-14C]choline into myelin lipids of distal segment of regenerating nerve, was found. Labeling of myelin lipids with [3H]oleic acid (injected intravenously seven days before crush) support the evidence that a similar pattern of degeneration exists between two different types of trauma, i.e. nerve crush or cut. The findings suggest that, in the distal segment of crushed nerve, the lipid content as well as the myelin lipid synthesis increase as the regeneration period proceeds.

Spinal radiculoneuropathy in aging rats: demyelination secondary to neuronal dwindling?

Temporal development of radicular demyelination was studied in male albino rats examined sequentially throughout the lifespan of the animals. The rats were perfusion-fixed with paraformaldehyde and glutaraldehyde and areas of their nervous system including the lumbar spinal roots, the spinal cord, and the peripheral sciatic nerve, were embedded in epoxy resin and submitted to microscopic examination in semithin and ultrathin sections. In addition, a vital fat stain, teasing of single nerve fibers, and estimates of axon diameter and fiber number were obtained. Degenerative changes occurred earlier in the distal portions of nerve fibers than in the spinal roots. The radicular lesion consisted of swelling of myelin and demyelination possibly secondary to shrinkage of axons, resulting in focal accumulation of lipid debris within the spinal roots of old rats. Although the causation of senile neuronal atrophy affecting rat peripheral neurons is not fully obvious, this condition may be exacerbated by such factors as pressure on the nerves and hypoactivity.

Peripheral nerve phospholipid composition: development in normal nerve and age-dependent changes in Wallerian degenerated nerve

The phospholipid composition of normal peripheral nerve as a function of developmental age as well as that of Wallerian-degenerated nerve as a function of age at nerve transection and duration of Wallerian degeneration have been quantitated in rabbit sciatic nerve. During development, increases in the proportions of ethanolamine plasmalogen, sphingomyelin, and combined phosphatidyl serine plus phosphatidyl inositol and decreases in the proportions of phosphatidyl choline and phosphatidyl ethanolamine correlated well with the concurrent myelin accretion. During Wallerian degeneration, age-dependent changes in phospholipid composition were observed. The large and statistically significant increase in the proportion of phosphatidyl choline and decrease in the proportion of ethanolamine plasmalogen were manifest promptly in nerves transected at 2 weeks of age but in a delayed manner in nerves transected at 8, 12, and 20 weeks of age. The rate of loss of individual phospholipids was greater in nerves transected at younger ages. The findings from normal developing peripheral nerve may well serve as baseline data for subsequent studies of phospholipid composition in pathological peripheral nerve. The findings from Wallerian-degenerated peripheral nerve provide additional evidence for age-dependent chemical changes occurring in Wallerian-degenerated peripheral nerve that may be of significance in explaining the superior functional recovery from peripheral nerve injury observed in younger compared with older subjects.