Reinnervation of skeletal muscle in the tongue by preganglionic parasympathetic vagal neurons.

Reinnervation of the skeletal muscle in the tongue following vago-hypoglossal anastomosis was studied by means of retrograde labelling with horseradish peroxidase and anterograde labelling with the autoradiographic tracing method combined with acetylcholinesterase staining for motor endplates. The proximal stump of the transected vagus nerve was anastomosed to the distal stump of the transected hypoglossal nerve in the neck, or in the thorax below the emergence of the recurrent laryngeal fibres. After 2-3 months, reinnervation of the tongue by vagal fibres was studied. Control cases in which the hypoglossal nerve was transected, but anastomosis was not performed, revealed that innervation of the lingual muscle is derived entirely from the hypoglossal nerves. Following unilateral vago-hypoglossal anastomosis a reduced number of fine nerve fibres terminated in relation to the acetylcholinesterase-stained endplates on the side of the anastomosis. At no time were fibres on either side observed to form sprouts which crossed the midline. Horseradish peroxidase (HRP) was injected into the tongue to determine the origin of the fibres that reinnervated the lingual muscle following anastomosis. On the side of the anastomosis, HRP-labelled neurons were present within the dorsal motor nucleus of the vagus and were absent from the hypoglossal nucleus. When the anastomosis was performed in the neck, neurons within the nucleus ambiguous were also labelled with HRP, but this was not observed following anastomosis in the thorax below the recurrent laryngeal nerve. When tritiated amino acids were injected into the dorsal motor nucleus of the vagus, the motor endplates on the anastomosed side of the tongue were labelled autoradiographically. This labelling could not be abolished by transecting both hypoglossal nerves, confirming that the labelling was due to reinnervation by vagal fibres. It is concluded that anastomosis of the proximal end of the transected vagus nerve to the distal end of the transected hypoglossal nerve is followed by regeneration of the vagal fibres which cross the anastomosis and reinnervate the denervated motor endplates in the tongue. The cell bodies of origin are located within the dorsal motor nucleus of the vagus and are preganglionic parasympathetic neurons.