Studies in monkeys have shown substantial neuronal reorganization and behavioral recovery during the months following a cervical dorsal root lesion (DRL; Darian-Smith [2004] J. Comp. Neurol. 470:134-150; Darian-Smith and Ciferri [2005] J. Comp. Neurol. 491:27-45, [2006] J. Comp. Neurol. 498:552-565). The goal of the present study was to identify ultrastructural synaptic changes post-DRL within the dorsal horn (DH). Two monkeys received a unilateral DRL, as described previously (Darian-Smith and Brown [2000] Nat. Neurosci. 3:476-481), which removed cutaneous and proprioceptive input from the thumb, index finger, and middle finger. Six weeks before terminating the experiment at 4 post-DRL months, hand representation was mapped electrophysiologically within the somatosensory cortex, and anterograde tracers were injected into reactivated cortex to label corticospinal terminals. Sections were collected through the spinal lesion zone. Corticospinal terminals and inhibitory profiles were visualized by using preembedding immunohistochemistry and postembedding gamma-aminobutyric acid (GABA) immunostaining, respectively. Synaptic elements were systematically counted through the superficial DH and included synaptic profiles with round vesicles (R), pleomorphic flattened vesicles (F; presumed inhibitory synapses), similar synapses immunolabeled for GABA (F-GABA), primary afferent synapses (C-type), synapses with dense-cored vesicles (D, mostly primary afferents), and presynaptic dendrites of interneurons (PSD). Synapse types were compared bilaterally via ANOVAs. As expected, we found a significant drop in C-type profiles on the lesioned side ( approximately 16% of contralateral), and R profiles did not differ bilaterally. More surprising was a significant increase in the number of F profiles ( approximately 170% of contralateral) and F-GABA profiles ( approximately 315% of contralateral) on the side of the lesion. Our results demonstrate a striking increase in the inhibitory circuitry within the deafferented DH.

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