Survival of Injured Spinal Motoneurons in Adult Rat upon Treatment with Glial Cell Line–Derived Neurotrophic Factor at 2 Weeks but Not at 4 Weeks after Root Avulsion

We conducted a study of whether treatment with glial cell line–derived neurotrophic factor (GDNF) initiated at 2 or 4 weeks after spinal-root avulsion could promote survival and regulate neuronal nitric oxide synthase (nNOS) expression in adult rat spinal motoneurons. By 6 weeks after root avulsion, the treatment given at 2 weeks not only increased motoneuron survival (86.1% vs. 27.9%), but also reversed the atrophy of injured motoneurons and increased their somatic size (101.3% vs. 52.9%) in comparison to the untreated control group of animals. All surviving motoneurons in the GDNF-treated group showed immunoreactivity for choline acetyltransferase. In contrast, GDNF treatment at 4 weeks post-injury failed to promote motoneuron survival (33.1% vs. 27.9%) at 6 weeks compared to the control group. Both the 2- and 4-week post-injury treatments downregulated nNOS expression. This finding suggests that injured adult motoneurons die shortly (a few weeks in the rat) after root avulsion injury, but can be saved from degeneration by treatment within the proper time frame after injury, which in the case of GDNF treatment in rats, appears to be within 2 weeks of the avulsion injury of the spinal root. These findings provide useful information for choosing the best time frame for the potential clinical treatment of brachial plexus avulsion.