REVIEW article
Front. Surg.
Sec. Neurosurgery
This article is part of the Research TopicAdvances in Nerve Repair and RegenerationView all 5 articles
The neuromuscular junction: a critical component of functional recovery after peripheral nerve injury
Provisionally accepted
- University of Utah Health, Salt Lake City, United States
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Peripheral nerve injury can result in potentially devastating neurological deficits and often disproportionately impacts young workers. Recovery of motor function after peripheral nerve injury requires the regeneration of the nerve from the site of injury to the neuromuscular junction (NMJ), where signals must be transduced effectively across the synapse, resulting in target muscle contraction. For reasons that are not fully understood, after about 18 months of denervation, functional NMJs fail to recapitulate. This, in combination with the slow velocity of axon regeneration, significantly limits both the window of opportunity for intervention and surgical reconstruction options. Here, we review what is currently known with respect to NMJ physiology, anatomy, development, and changes after injury. We also highlight knowledge gaps and opportunities for study with the goal of developing novel, NMJ-focused avenues of treatment for patients after peripheral nerve injury.
Keywords: Neuromuscular Junction, peripheral nerve injury, Peripheral nerve surgery, Regeneration, translational science
Received: 14 Nov 2025; Accepted: 03 Feb 2026.
Copyright: © 2026 Muhlestein and Mahan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mark A Mahan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.