Conservative Management of Peripheral Nerve Injuries Utilizing Selective Electrical Stimulation of Denervated Muscle With Exponentially Progressive Current Forms

1985 ◽  
Vol 7 (1) ◽  
pp. 11-15 ◽  
Author(s):  
John P. Cummings
Keyword(s):  
Electrical Stimulation ◽  
Peripheral Nerve ◽  
Conservative Management ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Denervated Muscle ◽  
Stimulation Of

scholarly journals Exercise, Neurotrophins, and Axon Regeneration in the PNS

Physiology ◽  
2014 ◽  
Vol 29 (6) ◽  
pp. 437-445 ◽  
Author(s):  
Arthur W. English ◽  
Jennifer C. Wilhelm ◽  
Patricia J. Ward
Keyword(s):  
Electrical Stimulation ◽  
Androgen Receptor ◽  
Peripheral Nerve ◽  
Neuronal Activity ◽  
Axon Regeneration ◽  
Sex Steroid ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Cellular Mechanisms ◽  
Androgen Receptor Signaling

Electrical stimulation and exercise are treatments to enhance recovery from peripheral nerve injuries. Brain-derived neurotrophic factor and androgen receptor signaling are requirements for the effectiveness of these treatments. Increased neuronal activity is adequate to promote regeneration in injured nerves, but the dosing of activity and its relationship to neurotrophins and sex steroid hormones is less clear. Translation of these therapies will require principles associated with their cellular mechanisms.

scholarly journals Electrical Stimulation to Promote Peripheral Nerve Regeneration

2015 ◽  
Vol 30 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Michael P. Willand ◽  
May-Anh Nguyen ◽  
Gregory H. Borschel ◽  
Tessa Gordon
Keyword(s):  
Electrical Stimulation ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Functional Recovery ◽  
Axonal Regeneration ◽  
Surgical Repair ◽  
Primary Repair ◽  
Low Frequency ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

Peripheral nerve injury afflicts individuals from all walks of life. Despite the peripheral nervous system’s intrinsic ability to regenerate, many patients experience incomplete functional recovery. Surgical repair aims to expedite this recovery process in the most thorough manner possible. However, full recovery is still rarely seen especially when nerve injury is compounded with polytrauma where surgical repair is delayed. Pharmaceutical strategies supplementary to nerve microsurgery have been investigated but surgery remains the only viable option. Brief low-frequency electrical stimulation of the proximal nerve stump after primary repair has been widely investigated. This article aims to review the currently known biological basis for the regenerative effects of acute brief low-frequency electrical stimulation on axonal regeneration and outline the recent clinical applications of the electrical stimulation protocol to demonstrate the significant translational potential of this modality for repairing peripheral nerve injuries. The review concludes with a discussion of emerging new advancements in this exciting area of research. The current literature indicates the imminent clinical applicability of acute brief low-frequency electrical stimulation after surgical repair to effectively promote axonal regeneration as the stimulation has yielded promising evidence to maximize functional recovery in diverse types of peripheral nerve injuries.

Peripheral Nerve Injuries of the Shoulder in the Athlete

1990 ◽  
Vol 9 (2) ◽  
pp. 331-342 ◽  
Author(s):  
Francis X. Mendoza ◽  
Kenneth Main
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

Human motor endplate remodeling after traumatic nerve injury

2020 ◽  
pp. 1-8
Author(s):  
Ranjan Gupta ◽  
Justin P. Chan ◽  
Jennifer Uong ◽  
Winnie A. Palispis ◽  
David J. Wright ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Surgical Intervention ◽  
Linear Regression Analysis ◽  
Motor Endplate ◽  
Nerve Injuries ◽  
Denervated Muscle ◽  
Sequence Of Events ◽  
Human Motor ◽  
Denervated Muscles

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.

Examination of peripheral nerve injuries

2007 ◽  
Vol 163 (5) ◽  
pp. 619
Author(s):  
A. Echaniz-Laguna
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

Therapeutic Electrical Stimulation of Injured Peripheral Nerve Tissue Utilizing Implantable Thin-Film Wireless Nerve Stimulators

2015 ◽  
Vol 84 (2) ◽  
pp. 601-602 ◽  
Author(s):  
Matthew MacEwan ◽  
Paul Gamble ◽  
Manu Stephen ◽  
Wilson Z. Ray
Keyword(s):  
Thin Film ◽  
Electrical Stimulation ◽  
Peripheral Nerve ◽  
Nerve Tissue ◽  
Stimulation Of
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