Analysis of human muscles of the shoulder and upper extremity a temporal profile of human motor endplate degradation

2019 ◽  
Vol 28 (6) ◽  
pp. e218
Author(s):  
Ranjan Gupta ◽  
Justin Chan ◽  
Jennifer Uong ◽  
Winnie Palispis ◽  
Oswald Steward ◽  
...  
2020 ◽  
pp. 1-8
Author(s):  
Ranjan Gupta ◽  
Justin P. Chan ◽  
Jennifer Uong ◽  
Winnie A. Palispis ◽  
David J. Wright ◽  
...  

OBJECTIVECurrent management of traumatic peripheral nerve injuries is variable with operative decisions based on assumptions that irreversible degeneration of the human motor endplate (MEP) follows prolonged denervation and precludes reinnervation. However, the mechanism and time course of MEP changes after human peripheral nerve injury have not been investigated. Consequently, there are no objective measures by which to determine the probability of spontaneous recovery and the optimal timing of surgical intervention. To improve guidance for such decisions, the aim of this study was to characterize morphological changes at the human MEP following traumatic nerve injury.METHODSA prospective cohort (here analyzed retrospectively) of 18 patients with traumatic brachial plexus and axillary nerve injuries underwent biopsy of denervated muscles from the upper extremity from 3 days to 6 years after injury. Muscle specimens were processed for H & E staining and immunohistochemistry, with visualization via confocal and two-photon excitation microscopy.RESULTSImmunohistochemical analysis demonstrated varying degrees of fragmentation and acetylcholine receptor dispersion in denervated muscles. Comparison of denervated muscles at different times postinjury revealed progressively increasing degeneration. Linear regression analysis of 3D reconstructions revealed significant linear decreases in MEP volume (R = −0.92, R2 = 0.85, p = 0.001) and surface area (R = −0.75, R2 = 0.56, p = 0.032) as deltoid muscle denervation time increased. Surprisingly, innervated and structurally intact MEPs persisted in denervated muscle specimens from multiple patients 6 or more months after nerve injury, including 2 patients who had presented > 3 years after nerve injury.CONCLUSIONSThis study details novel and critically important data about the morphology and temporal sequence of events involved in human MEP degradation after traumatic nerve injuries. Surprisingly, human MEPs not only persisted, but also retained their structures beyond the assumed 6-month window for therapeutic surgical intervention based on previous clinical studies. Preoperative muscle biopsy in patients being considered for nerve transfer may be a useful prognostic tool to determine MEP viability in denervated muscle, with surviving MEPs also being targets for adjuvant therapy.


2015 ◽  
Vol 811 ◽  
pp. 305-310
Author(s):  
Tadeusz Mikolajczyk ◽  
Adrian Olaru ◽  
Pawel Walkowiak

The effectiveness of rehabilitation is closely linked with suitably chosen therapy. The treatment can be performed only by specialized personnel or through the use of automated devices. One of the potential solution of this problem is exoskeleton. It is the kind of suit that allows the user assumed to support or even replace the human motor. The paper presents a proposal of the exoskeleton with 1 degree of freedom providing upper extremity rehabilitation in the elbow with the master-slave program. Control is via stepper motor which ensures high accuracy in the implementation of programmed movements.


2013 ◽  
Vol 61 (2) ◽  
pp. 419-431 ◽  
Author(s):  
D. Jasińska-Choromańska ◽  
K. Szykiedans ◽  
J. Wierciak ◽  
D. Kołodziej ◽  
M. Zaczyk ◽  
...  

Abstract Mechatronics is nowadays a dominating concept in design of various kinds of systems and technical devices. High speeds of data processing by control units of mechatronic systems, as well as high dynamics of their actuators allow the systems to be applied in wider fields. This refers to the medicine as well, especially while making attempts to replace lost human motor abilities by means of robots aiding the man. These devices can be divided into three groups: exoskeletons designed to strengthen the natural force of human muscles, orthotic robots that restore lost or weakened functions of human limbs, and prosthetic robots replacing an amputated limb. The first and the third group are known quite well, whereas the orthotic robots are at an initial phase of their development. The authors have worked on a device for aiding the motion of disabled people suffering from paresis of the lower limbs. The paper presents a concept and a structure of the system that has been created, comparing it with similar devices that have already existed. There are indicated some connections and areas where the subunits merge, as well as the rules of their working with the user.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Juliette Duchesne de Lamotte ◽  
Jérôme Polentes ◽  
Florine Roussange ◽  
Léa Lesueur ◽  
Pauline Feurgard ◽  
...  

Abstract Background The lack of physiologically relevant and predictive cell-based assays is one of the major obstacles for testing and developing botulinum neurotoxins (BoNTs) therapeutics. Human-induced pluripotent stem cells (hiPSCs)-derivatives now offer the opportunity to improve the relevance of cellular models and thus the translational value of preclinical data. Methods We investigated the potential of hiPSC-derived motor neurons (hMNs) optical stimulation combined with calcium imaging in cocultured muscle cells activity to investigate BoNT-sensitivity of an in vitro model of human muscle-nerve system. Results Functional muscle-nerve coculture system was developed using hMNs and human immortalized skeletal muscle cells. Our results demonstrated that hMNs can innervate myotubes and induce contractions and calcium transient in muscle cells, generating an in vitro human motor endplate showing dose-dependent sensitivity to BoNTs intoxication. The implementation of optogenetics combined with live calcium imaging allows to monitor the impact of BoNTs intoxication on synaptic transmission in human motor endplate model. Conclusions Altogether, our findings demonstrate the promise of optogenetically hiPSC-derived controlled muscle-nerve system for pharmaceutical BoNTs testing and development.


2019 ◽  
Vol 61 (3) ◽  
pp. 390-395
Author(s):  
Justin P. Chan ◽  
James Clune ◽  
Sameer B. Shah ◽  
Samuel R. Ward ◽  
Jeffery D. Kocsis ◽  
...  

1998 ◽  
Vol 4 (4) ◽  
pp. 240-249 ◽  
Author(s):  
Brenda Bigland-Ritchie ◽  
Andrew J. Fuglevand ◽  
Christine K. Thomas

A major goal in neuroscience is to understand how the CNS controls posture and movement in humans. This requires an understanding of individual human motor unit properties and how they interact within the muscle to perform different tasks. This article describes differences and similarities between the contractile properties of human motor units and those of the cat prototype medial gastrocnemius (MG) muscle, on which so many studies have been conducted. The article describes the methods available for measuring human motor unit properties and their limitations, and it discusses how far the behavior of whole muscles can be predicted from their histochemistry. It questions the extent to which human motor units conform to the conventional criteria by which S (slow, fatigue resistant), FR (fast but fatigue resistant) and FF (fast, fatigable) unit types are usually classified. An important difference between human and cat MG data is that weak human motor units are not necessarily slow, nor strong ones fast; that is, generally, human unit force is not correlated with contractile speed. Also, unlike cat MG, the few human muscles studied so far contain few if any FF units but a high proportion of units with intermediate fatigue resistance (Flnt). These apparently aberrant human properties, however, are also found in other cat and rat muscles. Thus, cat MG may not be the best model for motor unit behavior generally. Finally, the influence of human motor unit properties on force output by recruitment and/or rate coding is discussed.


2002 ◽  
Vol 7 (2) ◽  
pp. 1-4, 12 ◽  
Author(s):  
Christopher R. Brigham

Abstract To account for the effects of multiple impairments, evaluating physicians must provide a summary value that combines multiple impairments so the whole person impairment is equal to or less than the sum of all the individual impairment values. A common error is to add values that should be combined and typically results in an inflated rating. The Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, includes instructions that guide physicians about combining impairment ratings. For example, impairment values within a region generally are combined and converted to a whole person permanent impairment before combination with the results from other regions (exceptions include certain impairments of the spine and extremities). When they combine three or more values, physicians should select and combine the two lowest values; this value is combined with the third value to yield the total value. Upper extremity impairment ratings are combined based on the principle that a second and each succeeding impairment applies not to the whole unit (eg, whole finger) but only to the part that remains (eg, proximal phalanx). Physicians who combine lower extremity impairments usually use only one evaluation method, but, if more than one method is used, the physician should use the Combined Values Chart.


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