scholarly journals Nerve recovery from treatment with a vascularized nerve graft compared to an autologous non-vascularized nerve graft in animal models: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0252250
Author(s):  
Berend O. Broeren ◽  
Liron S. Duraku ◽  
Caroline A. Hundepool ◽  
Erik T. Walbeehm ◽  
J. Michiel Zuidam ◽  
...  
Keyword(s):  
Animal Models ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Meta Analysis ◽  
Nerve Graft ◽  
Muscle Weight ◽  
Nerve Grafts ◽  
Significant Difference ◽  
Nerve Recovery

Background Treatment of nerve injuries proves to be a worldwide clinical challenge. Vascularized nerve grafts are suggested to be a promising alternative for bridging a nerve gap to the current gold standard, an autologous non-vascularized nerve graft. However, there is no adequate clinical evidence for the beneficial effect of vascularized nerve grafts and they are still disputed in clinical practice. Objective To systematically review whether vascularized nerve grafts give a superior nerve recovery compared to non-vascularized nerve autografts regarding histological and electrophysiological outcomes in animal models. Material and methods PubMed and Embase were systematically searched. The inclusion criteria were as follows: 1) the study was an original full paper which presented unique data; 2) a clear comparison between a vascularized and a non-vascularized autologous nerve transfer was made; 3) the population study were animals of all genders and ages. A standardized mean difference and 95% confidence intervals for each comparison was calculated to estimate the overall effect. Subgroup analyses were conducted on graft length, species and time frames. Results Fourteen articles were included in this review and all were included in the meta-analyses. A vascularized nerve graft resulted in a significantly larger diameter, higher nerve conduction velocity and axonal count compared to an autologous non-vascularized nerve graft. However, during sensitivity analysis the effect on axonal count disappeared. No significant difference was observed in muscle weight. Conclusion Treating a nerve gap with a vascularized graft results in superior nerve recovery compared to non-vascularized nerve autografts in terms of axon count, diameter and nerve conduction velocity. No difference in muscle weight was seen. However, this conclusion needs to be taken with some caution due to the inherent limitations of this meta-analysis. We recommend future studies to be performed under conditions more closely resembling human circumstances and to use long nerve defects.

scholarly journals Nerve recovery from treatment with a vascularized nerve graft compared to an autologous non-vascularized nerve graft in animal models: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Berend Broeren ◽  
Liron S. Duraku ◽  
Caroline A. Hundepool ◽  
Erik T. Walbeehm ◽  
J. Michiel Zuidam ◽  
...  
Keyword(s):  
Animal Models ◽  
Meta Analysis ◽  
Nerve Transfer ◽  
Nerve Graft ◽  
Muscle Weight ◽  
Promising Alternative ◽  
Nerve Grafts ◽  
Significant Difference ◽  
Nerve Recovery ◽  
Meta Analyses

Background Treatment of nerve injuries proves to be a worldwide clinical challenge. Vascularized nerve grafts are suggested to be a promising alternative for bridging a nerve gap to the current gold standard, an autologous non-vascularized nerve graft. However, there is no adequate clinical evidence for the beneficial effect of vascularized nerve grafts and they are still disputed in clinical practice. Objective To systematically review whether vascularized nerve grafts give a superior nerve recovery compared to non-vascularized nerve autografts regarding histological and electrophysiological outcomes in animal models. Material and methods PubMed and Embase were systematically searched. The inclusion criteria were as follows: 1) the study was an original full paper which presented unique data; 2) a clear comparison between a vascularized and a non-vascularized autologous nerve transfer was made; 3) the population study were animals of all genders and ages. A standardized mean difference and 95% confidence intervals for each comparison was calculated to estimate the overall effect. Subgroup analyses were conducted on graft length, species and time frames. Results Fourteen articles were included in this review and all of them were included in the meta-analyses. A vascularized nerve graft resulted in a significantly larger diameter, higher nerve conduction velocity and axonal count compared to an autologous non-vascularized nerve graft. However, during sensitivity analysis the effect on axonal count disappeared. No significant difference was observed in muscle weight. Conclusion Treating a nerve gap with a vascularized graft results in superior nerve recovery compared to non-vascularized nerve autografts in three out of four outcome measurements. However, this conclusion needs to be taken with some caution due to the inherent limitations of this meta-analysis. We recommend future studies to be performed under conditions more closely resembling human circumstances and to use long nerve defects.

scholarly journals Radix Astragali-Based Chinese Herbal Medicine for Oxaliplatin-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Bo Deng ◽  
Liqun Jia ◽  
Zhiqiang Cheng
Keyword(s):  
Peripheral Neuropathy ◽  
Herbal Medicine ◽  
Conduction Velocity ◽  
Chinese Herbal Medicine ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Keyword Search ◽  
Meta Analysis ◽  
Radix Astragali ◽  
Chinese Herbal

Background. Treatment of chemotherapy-induced peripheral neuropathy (CIPN) remains a big challenge for oncologists. The aim of this study is to evaluate the effects of Radix Astragali- (RA-) based Chinese herbal medicine in the prevention and treatment of oxaliplatin-induced peripheral neuropathy, including the incidence and grading of neurotoxicity, effective percentage, and nerve conduction velocity.Methods. All randomized controlled trials (RCTs) were found using PubMed, Cochrane, Springer, China National Knowledge Infrastructure (CNKI), and Wanfang Database of China Science Periodical Database (CSPD) by keyword search. Meta-analysis was conducted using RevMan 5.0.Results. A total of 1552 participants were included in 24 trials. Meta-analysis showed the incidence of all-grade neurotoxicity was significantly lower in experimental groups and high-grade neurotoxicity was also significantly less. Effective percentage was significantly higher and sensory nerve conduction velocity was improved significantly, but changes in motor nerve conduction velocity were not statistically significant. No adverse events associated with RA-based intervention were reported.Conclusion. RA-based intervention may be beneficial in relieving oxaliplatin-induced peripheral neuropathy. However, more double-blind, multicenter, large-scale RCTs are needed to support this theory.Trial Registration. PROSPERO International prospective register of systematic reviews has registration number  CRD42015019903.

scholarly journals The Effect of Angipars on Diabetic Neuropathy in STZ-Induced Diabetic Male Rats: A Study on Behavioral, Electrophysiological, Sciatic Histological and Ultrastructural Indices

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Nasser Zangiabadi ◽  
Hossein Mohtashami ◽  
Mahboobeh Hojatipour ◽  
Mandana Jafari ◽  
Majid Asadi-Shekaari ◽  
...  
Keyword(s):  
Conduction Velocity ◽  
Nerve Conduction ◽  
Intraperitoneal Injection ◽  
Nerve Conduction Velocity ◽  
Male Rats ◽  
Vehicle Group ◽  
Human Society ◽  
Positive Effects ◽  
Behavioral Indices ◽  
Significant Difference

Diabetes mellitus is the most common metabolic disease with a high prevalence rate in human society that eventually leads to the peripheral nervous system complications in a great number of patients. In the present study, the effects of Angipars on nerve conduction velocity, histological alterations, and behavioral indices were investigated. Diabetes was induced in male rats by intraperitoneal injection of streptozotocin (STZ). Six weeks after STZ injection, animals were divided into five groups control, vehicle, and 3 experimental groups. The vehicle group received 1 mL distilled water daily for two weeks and three experimental groups received, respectively, intraperitoneal injection of 5, 10, and 20 mg/kg Angipars daily for two weeks. Intraperitoneal injection of Angipars, in some extent, could significantly improve behavioral indices of the experimental groups as compared to the vehicle group. Furthermore, mean nerve conduction velocity in the vehicle group showed significant difference with that in the control and the 2nd experimental groups; therefore, Angipars could increase nerve conduction velocity in neuropathic rats. Overall, Angipars exerted positive effects on the treatment and reduction of physiologic symptoms and improvement of sciatic morphological injuries in neuropathic rats.

scholarly journals THERAPY OF ENDOCRINE DISEASE: A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy

2012 ◽  
Vol 167 (4) ◽  
pp. 465-471 ◽  
Author(s):  
Tingting Han ◽  
Jiefei Bai ◽  
Wei Liu ◽  
Yaomin Hu
Keyword(s):  
Peripheral Neuropathy ◽  
Treatment Group ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Methodological Quality ◽  
Nerve Conduction Velocity ◽  
Meta Analysis ◽  
Control Group ◽  
Controlled Trials ◽  
Conduction Velocities

ObjectiveTo evaluate the effects and safety of 300–600 mg α-lipoic acid (ALA) given i.v. for diabetic peripheral neuropathy (DPN).MethodsWe searched the databases of Medline, Embase, and Cochrane central register of Controlled Trials and Chinese biological medicine for clinical trials of ALA in the treatment of DPN. Data were extracted to examine methodological quality and describe characteristics of studies. The primary outcomes were efficacy, median motor nerve conduction velocity (MNCV), median sensory nerve conduction velocity (SNCV), peroneal MNCV, and peroneal SNCV. Secondary outcomes were adverse events.ResultsFifteen randomized controlled trials met the inclusion criteria. The treatment group involved the administration of ALA 300–600 mg i.v. per day. And the control group used the same interventions except for ALA. Compared with the control group, nerve conduction velocities increased significantly in the treatment group. The weighted mean differences in nerve conduction velocities were 4.63 (95% confidence interval 3.58–5.67) for median MNCV, 3.17 (1.75–4.59) for median SNCV, 4.25 (2.78–5.72) for peroneal MNCV, and 3.65 (1.50–5.80) for peroneal SNCV in favor of the treatment group. The odds ratio in terms of efficacy was 4.03 (2.73–5.94) for ALA. Furthermore, no serious adverse events were observed during the treatment period.ConclusionsThe results of this meta-analysis provide evidence that treatment with ALA (300–600 mg/day i.v. for 2–4 weeks) is safe and that the treatment can significantly improve both nerve conduction velocity and positive neuropathic symptoms. However, the evidence may not be strong because most of the studies included in this meta-analysis have poor methodological quality.

scholarly journals Manual Acupuncture or Combination with Vitamin B to Treat Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Hai lun Jiang ◽  
Peng Jia ◽  
Yi hua Fan ◽  
Meng dan Li ◽  
Can can Cao ◽  
...  
Keyword(s):  
Median Nerve ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Peripheral Nerves ◽  
Nerve Conduction Velocity ◽  
Acupuncture Treatment ◽  
Meta Analysis ◽  
Vitamin B ◽  
Manual Acupuncture ◽  
Randomized Controlled

Background and Objective. The efficacy of mecobalamin (vitamin B12) alone in the treatment of diabetic peripheral neuropathy (DPN) is often unsatisfactory, while acupuncture treatment is also controversial. This study compares manual acupuncture to vitamin B in DPN treatment. Methods. Randomized controlled trials on manual acupuncture treatment of DPN were retrieved from the Medline, Web of Science, PubMed, Cochrane Library, EMBASE, CNKI, WanFang, and VIP databases. Extracted research data were summarized in the tables, and methodological assessment was performed using the risk-of-bias assessment tool of Cochrane. Meta-analysis was performed by Revman 5.3, Stata 14.0, and TSA 0.9.5.10 Beta software. Results. A total of 18 randomized clinical trials (RCTs) were recruited: (1) 11 RCTs were acupuncture alone compared with vitamin B; (2) 7 RCTs were acupuncture combined with vitamin B compared with vitamin B, involving 1200 participants. Acupuncture alone improved clinical efficacy ( P < 0.05 ) and nerve conduction velocity of the four peripheral nerves: peroneal nerve, tibial nerve, median nerve, and ulnar nerve ( P < 0.05 ), but there was no significant difference between the group of acupuncture alone and the group of vitamin B ( P = 0.36 > 0.05 ) in improving median nerve SCV (sensory nerve conduction velocity). Acupuncture combined with vitamin B improved clinical efficacy and nerve conduction velocity of the three peripheral nerves, peroneal nerve, tibial nerve, and median nerve ( P < 0.05 ), and decreased the scores of the Toronto clinical scoring system (TCSS) ( P < 0.05 ). Conclusion. Acupuncture alone and vitamin B combined with acupuncture are more effective in treating DPN compared to vitamin B. However, more high-quality RCTs on vitamin B combined with acupuncture are required to confirm our results.

scholarly journals Efficacy and Safety of the Injection of the Traditional Chinese Medicine Puerarin for the Treatment of Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis of 53 Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Baocheng Xie ◽  
Qinghui Wang ◽  
Chenhui Zhou ◽  
Jiahuan Wu ◽  
Daohua Xu
Keyword(s):  
Peripheral Neuropathy ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Diabetic Peripheral Neuropathy ◽  
Nerve Conduction Velocity ◽  
Motor Nerve ◽  
Meta Analysis ◽  
Sensory Nerve ◽  
Control Group ◽  
Efficacy And Safety

Objective. The injection of the traditional Chinese patent medicine puerarin has been widely used in the treatment of various diseases such as angina pectoris or ischemic stroke. We aim to evaluate the efficacy and safety of puerarin injection for the treatment of diabetic peripheral neuropathy (DPN). Methods. A systematic literature search was performed in seven medical databases from their inception until June 2017. 53 studies with RCTs, totaling 3284 patients, were included in this meta-analysis. The included studies were assessed by the Cochrane risk of bias and analyzed by Review Manager 5.3 software. Results. The meta-analysis showed that puerarin injection for the treatment of DPN was significantly better compared with the control group in terms of the total effective rate. The result showed that puerarin injection for the treatment of DPN can significantly increase the probability of sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) of the median and peroneal nerves. Conclusions. This meta-analysis demonstrated that puerarin injection may be more effective and safe for the treatment of DPN. However, further and higher quality RCTs are required to prove its efficacy and provide meaningful evidence for clinical treatment due to the poor methodological quality.

scholarly journals The Method of Activating Blood and Dredging Collaterals for Reducing Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-18
Author(s):  
Zhaoyi Li ◽  
Huimin Jin ◽  
Qingying Yan ◽  
Leitao Sun ◽  
Harpreet S. Wasan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Neuropathy ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Large Scale ◽  
Nerve Conduction Velocity ◽  
Meta Analysis ◽  
Intervention Group ◽  
Sensory Nerve ◽  
Chinese Herbs

Background. Chemotherapy-induced peripheral neuropathy (CIPN) remains as a big unsolved challenge for cancer patients and oncologists. However, there is no effective treatment to prevent and cure it. This systematic review and meta-analysis chiefly aimed to assess the effectiveness and safety on the method of activating blood and dredging collaterals in traditional Chinese medicine (TCM) for reducing CIPN. Methods. Two authors comprehensively searched all the randomized controlled trials (RCTs) via PubMed, Cochrane, China National Knowledge Infrastructure (CNKI), and Wanfang Database of China Science Periodical Database (CSPD). The Review Manager (RevMan) 5.0 was used to conduct the meta-analysis. Results. 20 trials including 1481 participants were analyzed. 15 trials tested the incidence of all-grade CIPN which was significantly lower in intervention arm and 16 trails presented that the result of high-grade CIPN was the same. The total effective rate of the use of Chinese herbs was 77.19% versus 45.79% in the comparator group. Besides, the use of Chinese herbs statistically promoted the sensory nerve conduction velocity (SNCV) and the motor nerve conduction velocity (MNCV). Besides, the quality of life (QoL) in the intervention group was better than the comparator one. Herbs-related adverse events were skin allergy, skin chap, and scald, which could be managed well. Conclusions. The work involving studies of the effectiveness and safety on TCM for reducing CIPN proves to be encouraging. Herbs with the function of activating blood and dredging collaterals were found to potentially promote the curative effects as well as making improvements of SNCV and MNCV. However, in the future, more double-blind, multicenter, large-scale RCTs and more comprehensive researches are still required.

scholarly journals A comparative study of the conduction velocity of motor and sensory fibres of ulnar and median nerves among leprosy patients and normal subjects

2020 ◽  
Vol 8 (6) ◽  
pp. 2088
Author(s):  
Ishita Saha ◽  
Sujoy P. Bhattacharyya ◽  
Debabrata Bandyopadhyay
Keyword(s):  
Action Potential ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Statistical Tests ◽  
Clinical Signs ◽  
Sensory Nerve ◽  
Peripheral Nerve Involvement ◽  
Significant Difference ◽  
Leprosy Patients

Background: Leprosy and the associated scourge have affected humanity for thousands of years. One of the most debilitating consequences of leprosy is peripheral neuropathy. Nerve Conduction Velocity study provides us with a non-invasive modality to assess peripheral nerve involvement in leprosy.Methods: With this in mind, a cross-sectional observational study was conducted including 30 leprosy patients as "Cases" and 30 age-matched healthy subjects, not suffering from any kind of neurological disorders, as "Controls". Using a digital electromyography machine, the Latency, Amplitude and Conduction Velocities of Motor and Sensory fibres of Ulnar and Median nerves were recorded. The results were compared among controls and cases using suitable statistical tests (descriptive statistics and significance testing using unpaired t-test).Results: In this study, with regard to Sensory Nerve conduction Velocity (SNCV), statistically very significant difference was noted in case of right (p 0.0011) and left (p 0.0037) ulnar nerves among controls and cases. The difference in the amplitude of Motor Action potential (MAP) with regard to right median nerve, among cases and controls, was also statistically significant (p 0.0127). Further the amplitude of Sensory Nerve Action Potential (SNAP) values were higher among cases compared to controls.Conclusions: As such, the findings of this study (and which is also corroborated by many previous studies) lead us to the conclusion that NCV studies can detect lepromatous neuropathy much before the emergence of frank clinical signs and this type of neuropathy is predominantly demyelinating in nature with occasional axonal loss.

Repair of Rabbit Facial Nerve with Amniotic Extracellular Matrix Based on Biological Material

2011 ◽  
Vol 322 ◽  
pp. 169-172
Author(s):  
Zhen Gao ◽  
Xiao Ting Luo ◽  
Nian Sheng Li ◽  
Wei Deng ◽  
Shu Mei Li
Keyword(s):  
Extracellular Matrix ◽  
Facial Nerve ◽  
Nerve Conduction ◽  
Peripheral Nerves ◽  
Nerve Conduction Velocity ◽  
Nerve Fibers ◽  
Nerve Graft ◽  
Nerve Conduit ◽  
Nerve Grafts ◽  
Facial Nerves

Objective: To evaluate the effects of amniotic extracellular matrix (AECM) on the repairation of facial nerve in rabbits. Methods: The transected nerve ends of the facial nerves of rabbits were then repaired with the AECM nerve conduit or an autologous nerve graft. After 3 months, the animals’ neural conductive velocity were determined. The myelinated fibers across the specimen were counted with histological examination. Results: The total count of medullated nerve fibers varied significantly, but the nerve conduction velocity had no significance between the AECM grafts and the autologous nerve grafts. Conclusion: AECM could become the biocompatible material for repairing the peripheral nerves.

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