Conditioning Electrical Stimulation Is Superior to Postoperative Electrical Stimulation in Enhanced Regeneration and Functional Recovery Following Nerve Graft Repair

2020 ◽  
Vol 34 (4) ◽  
pp. 299-308 ◽  
Author(s):  
Jenna-Lynn B. Senger ◽  
Ashley W. M. Chan ◽  
K. Ming Chan ◽  
Terence Kwan-Wong ◽  
Leah Acton ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Nerve Regeneration ◽  
Primary Repair ◽  
Clinical Intervention ◽  
Nerve Graft ◽  
Sprague Dawley ◽  
Axon Extension ◽  
Sensory Recovery ◽  
Nerve Autograft ◽  
Sensorimotor Recovery

Background. Autologous nerve graft is the most common clinical intervention for repairing a nerve gap. However, its regenerative capacity is decreased in part because, unlike a primary repair, the regenerating axons must traverse 2 repair sites. Means to promote nerve regeneration across a graft are needed. Postoperative electrical stimulation (PES) improves nerve growth by reducing staggered regeneration at the coaptation site whereas conditioning electrical stimulation (CES) accelerates axon extension. In this study, we directly compared these electrical stimulation paradigms in a model of nerve autograft repair. Methods. To lay the foundation for clinical translation, regeneration and reinnervation outcomes of CES and PES in a 5-mm nerve autograft model were compared. Sprague-Dawley rats were divided into: ( a) CES, ( b) PES, and ( c) no stimulation cohorts. CES was delivered 1 week prior to nerve cut/coaptation, and PES was delivered immediately following coaptation. Length of nerve regeneration (n = 6/cohort), and behavioral testing (n = 16/cohort) were performed at 14 days and 6 to 14 weeks post-coaptation, respectively. Results. CES treated axons extended 5.9 ± 0.2 mm, significantly longer than PES (3.8 ± 0.2 mm), or no stimulation (2.5 ± 0.2 mm) ( P < .01). Compared with PES animals, the CES animals had significantly improved sensory recovery (von Frey filament testing, intraepidermal nerve fiber reinnervation) ( P < .001) and motor reinnervation (horizontal ladder, gait analysis, nerve conduction studies, neuromuscular junction analysis) ( P < .01). Conclusion. CES resulted in faster regeneration through the nerve graft and improved sensorimotor recovery compared to all other cohorts. It is a promising treatment to improve outcomes in patients undergoing nerve autograft repair.

Biocompatibility and Efficacy of Five-Channel and Eight-Channel Crosslinked Urethane-Doped Polyester Elastomers (CUPEs) as Nerve Guidance Conduit for Reconstruction of Segmental Peripheral Nerve Defect Using Rat Model

2014 ◽  
Vol 21 ◽  
pp. 57-70
Author(s):  
Angela W.H. Ho ◽  
W.Y. Ip
Keyword(s):  
Peripheral Nerve ◽  
Nerve Regeneration ◽  
Rat Model ◽  
Donor Site ◽  
Nerve Graft ◽  
Nerve Tissue ◽  
Histomorphometric Analysis ◽  
Sprague Dawley ◽  
Fiber Density ◽  
Nerve Guidance Conduit

Introduction: Peripheral nerve injury is common in clinical practice. Nerve defect is a challenging scenario. The current gold standard of managing a nerve defect is autologous nerve graft. However, due to the selection of nerve graft and donor site morbidity, artificial nerve conduits are gaining popularity. However, there are drawbacks of single hollow conduit such as lack of internal support to prevent conduit collapse and inability so as to recreate the proper native spatial arrangement of cells and extracellular matrix within the conduit. In this study, the biocompatibility and efficacy of five-channel and eight-channel Crosslinked Urethane-doped Polyester Elastomers (CUPEs) as nerve guidance conduit will be evaluated through a rat model with reconstruction of segmental peripheral nerve defect. Material and Method: Eighteen adult Sprague-Dawley rats were used. They were randomly allocated to three groups: autograft group, five-channel conduit group and eight-channel conduit group with each consisted of six rats. A 10mm nerve defects were created at the right sciatic nerve. They were bridged with reverse autograft, 5-channel conduit and 8-channel conduit. After eight weeks the rats were euthanized and the reconstructed nerves were harvested for histomorphometric analysis. Result: All conduits showed regenerated nerve tissue inside. There was no collapse of the conduits. There were no severe tissue reaction or scarring near the reconstructed nerve. No neuroma was formed. Histomorphometric analysis showed nerve regeneration was enhanced with increasing number of channels inside conduit. There was overall drop in fiber density between proximal and distal segment among all groups. Conclusion: CUPE nerve guidance conduit is biocompatible and shows good nerve regeneration in reconstructing nerve defect.

Brief electrical stimulation improves nerve regeneration after delayed repair in Sprague Dawley rats

2015 ◽  
Vol 269 ◽  
pp. 142-153 ◽  
Author(s):  
Kate Elzinga ◽  
Neil Tyreman ◽  
Adil Ladak ◽  
Bohdan Savaryn ◽  
Jaret Olson ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Nerve Regeneration ◽  
Sprague Dawley ◽  
Delayed Repair ◽  
Sprague Dawley Rats

scholarly journals Remote Corticospinal Tract Degeneration After Cortical Stroke in Rats May Not Preclude Spontaneous Sensorimotor Recovery

2021 ◽  
pp. 154596832110413
Author(s):  
Michel R. T. Sinke ◽  
Geralda A. F. van Tilborg ◽  
Anu E. Meerwaldt ◽  
Caroline L. van Heijningen ◽  
Annette van der Toorn ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Corticospinal Tract ◽  
Sprague Dawley ◽  
Post Stroke ◽  
Neuronal Communication ◽  
Cortical Stroke ◽  
Magnetic Resonance Imaging Mri ◽  
And Behavior ◽  
Sensorimotor Recovery

Background. Recovery of motor function after stroke appears to be related to the integrity of axonal connections in the corticospinal tract (CST) and corpus callosum, which may both be affected after cortical stroke. Objective. In the present study, we aimed to elucidate the relationship of changes in measures of the CST and transcallosal tract integrity, with the interhemispheric functional connectivity and sensorimotor performance after experimental cortical stroke. Methods. We conducted in vivo diffusion magnetic resonance imaging (MRI), resting-state functional MRI, and behavior testing in twenty-five male Sprague Dawley rats recovering from unilateral photothrombotic stroke in the sensorimotor cortex. Twenty-three healthy rats served as controls. Results. A reduction in the number of reconstructed fibers, a lower fractional anisotropy, and higher radial diffusivity in the ipsilesional but intact CST, reflected remote white matter degeneration. In contrast, transcallosal tract integrity remained preserved. Functional connectivity between the ipsi- and contralesional forelimb regions of the primary somatosensory cortex significantly reduced at week 8 post-stroke. Comparably, usage of the stroke-affected forelimb was normal at week 28, following significant initial impairment between day 1 and week 8 post-stroke. Conclusions. Our study shows that post-stroke motor recovery is possible despite degeneration in the CST and may be supported by intact neuronal communication between hemispheres.

Nerve grafts and transfers

2021 ◽  
pp. 275-282
Author(s):  
Robert Bains ◽  
Simon Kay
Keyword(s):  
Recovery Of Function ◽  
Primary Repair ◽  
Nerve Repair ◽  
Nerve Grafting ◽  
Nerve Reconstruction ◽  
Nerve Grafts ◽  
Axonal Regrowth ◽  
Bone Shortening ◽  
Eighteenth And Nineteenth Centuries ◽  
Nerve Autograft

Following Cruickshank’s (1795) ingenious (and at first disbelieved) demonstration of the regenerative capacity of mammalian nerves, the eighteenth and nineteenth centuries saw a pan-European enthusiasm to redress the nihilism surrounding nerve injury. The first recorded experimental nerve grafts were performed by Philipeaux and Vulpian who attempted both nerve autografting as well as allografting in dogs. At that time, and for many years, allografts were thought to behave similarly to autografts, a belief that persisted well into the twentieth century in some clinics and laboratories. These early attempts at nerve grafting yielded poor results and most surgeons aimed for primary nerve repair despite nerve gaps. Other techniques to allow direct repair involved alteration of position, transposition of the nerve, and even sometimes bone shortening. Although primary repair was frequently possible, after these measures the repair was under tension and mechanical failure was common. Spurling (1945), Whitcomb (1946), and Woodall (1956) showed failure rates of 4%, 7.5%, and 22.4% respectively. Some recovery of function following nerve grafting was documented by Sanders (1942), Seddon (1954), and Brooks (1955). Millesi subsequently published his results for nerve grafting for injuries to the upper limb in 1984. These papers demonstrated more significant recovery of function and highlighted the detriment of delay in treatment to final outcome. Microsurgical advances were central to Millesi’s results, and he emphasized atraumatic dissection and the deleterious effect of tension at the repair site resulting in fibrosis preventing axonal regrowth. Nerve autograft is now the standard for orthotopic nerve reconstruction when primary repair cannot be achieved.

scholarly journals Dexmedetomidine to Help Nerve Regeneration in a Rat Sciatic Nerve Injury Model

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wook Jeong ◽  
Hsichiang Kung ◽  
Chia Chi Cheng ◽  
Changwoo Lim ◽  
Min Jung Jung ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Regeneration ◽  
Nerve Injury ◽  
Peripheral Nerve Regeneration ◽  
Sciatic Nerve Injury ◽  
Sprague Dawley ◽  
Neuroprotective Effects ◽  
Adrenoceptor Agonist ◽  
Group 3 ◽  
Group 2

Background. Several studies have shown that dexmedetomidine (DXM), a selective α2-adrenoceptor agonist, also has neuroprotective effects. However, its effect on impaired peripheral nerve regeneration has not been studied. Materials and Methods. Forty-five Sprague-Dawley rats were randomly assigned to three groups: group 1 (control SHAM), group 2 (sciatic nerve injury + normal saline), and group 3 (sciatic nerve injury + DXM). The rats of group 3 were subdivided into the following three groups: DXM 0.5, 6, and 20 μg·kg−1 (groups 3A, 3B, and 3C, resp.). The sciatic nerve injury was assessed for nerve regeneration at 2 and 6 weeks. Results. There were no differences between groups 2 and 3 in their sciatic functional index (SFI) values or histological findings at 2 weeks postinjury. However, SFI differences were statistically significant at 6 weeks postinjury in group 3. The gross findings with H&E staining showed that the number of axons was higher in group 3 than in group 2. There was no histological difference according to the DXM concentration. Conclusion. The coincidental functional and histological assessment results of this study suggest that DXM for 6 weeks positively affects damaged peripheral nerves.

A New Fibrin Seal: Functional Evaluation of Sensory Regeneration Following Primary Repair of Peripheral Nerves

1994 ◽  
Vol 19 (2) ◽  
pp. 250-254 ◽  
Author(s):  
B. POVLSEN
Keyword(s):  
Peripheral Nerves ◽  
Primary Repair ◽  
Functional Results ◽  
Relevant Information ◽  
Functional Evaluation ◽  
Sprague Dawley ◽  
Morphological Examination ◽  
Sprague Dawley Rats ◽  
Low Threshold ◽  
Fibrin Seal

A new fibrin seal has recently been evaluated in terms of axonal regeneration; however morphological examination of the fibre composition of regenerated nerves may not necessarily provide functionally relevant information. This study therefore aims to evaluate the functional regenerated sensation, following peripheral nerve transection treated with fibrin seal (Tisseel-Duo, Immuno; Austria). The sural nerve-innervated skin of the rat hindfoot served as the target organ. Previously published results from animals following transection and suture served as controls. Ten 3-month-old female Sprague-Dawley rats were used. The sciatic nerve was divided and rejoined with fibrin seal. The rats were allowed unrestricted movement directly after surgery and allowed to survive for 3 months. Our observations show that the functional results of regenerated polymodal nociceptors and low-threshold mecanoreceptors show no statistical difference when compared with microsuture. This strengthens the early positive morphological impression of this new product. Further prospective studies in man are anticipated.

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