Perifeer zenuwletsel en het effect van vitamines op het herstelproces

Peripheral nerve injury and the effect of vitamins on the recovery process Although peripheral nerve injuries are usually not life-threatening, they can have a significant impact on the patient’s quality of life and daily functioning, with typical symptoms such as complete paralysis or severe neuropathic pain. The peripheral nervous system is capable of some regeneration and recovery, allowing conservative treatment in mild to moderate nerve damage. For severe peripheral nerve injuries surgical reconstruction remains the golden standard. However, despite the extensive knowledge of the pathophysiology of peripheral nerve trauma, a full functional recovery after a severe peripheral nerve injury is rare with the current therapeutic options. Success depends on a variety of factors: location and severity of the injury, age and physical condition of the patient, therapeutical approach, … Therefore, it is important to search for the best possible means to achieve maximal functional recovery. This article first discusses the current knowledge about the pathophysiology of peripheral nerve trauma, highlighting the most important factors that influence the recovery process. Subsequently, it will render a review of the influence of vitamins A/B/C/D/E/K on this recovery process: vit B and D seem to enhance the regeneration process of nerves and the functional recovery of the end organ, while vit C and E show an important antinociceptive effect.

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Permanent central synaptic disconnection of proprioceptors after nerve injury and regeneration. I. Loss of VGLUT1/IA synapses on motoneurons

Journal of Neurophysiology ◽

10.1152/jn.01095.2010 ◽

2011 ◽

Vol 106 (5) ◽

pp. 2450-2470 ◽

Cited By ~ 76

Author(s):

Francisco J. Alvarez ◽

Haley E. Titus-Mitchell ◽

Katie L. Bullinger ◽

Michal Kraszpulski ◽

Paul Nardelli ◽

...

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Cell Body ◽

Peripheral Nerve Injury ◽

Motor Coordination ◽

Electrophysiological Study ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Ia Afferent ◽

Axon Collaterals

Motor and sensory proprioceptive axons reinnervate muscles after peripheral nerve transections followed by microsurgical reattachment; nevertheless, motor coordination remains abnormal and stretch reflexes absent. We analyzed the possibility that permanent losses of central IA afferent synapses, as a consequence of peripheral nerve injury, are responsible for this deficit. VGLUT1 was used as a marker of proprioceptive synapses on rat motoneurons. After nerve injuries synapses are stripped from motoneurons, but while other excitatory and inhibitory inputs eventually recover, VGLUT1 synapses are permanently lost on the cell body (75–95% synaptic losses) and on the proximal 100 μm of dendrite (50% loss). Lost VGLUT1 synapses did not recover, even many months after muscle reinnervation. Interestingly, VGLUT1 density in more distal dendrites did not change. To investigate whether losses are due to VGLUT1 downregulation in injured IA afferents or to complete synaptic disassembly and regression of IA ventral projections, we studied the central trajectories and synaptic varicosities of axon collaterals from control and regenerated afferents with IA-like responses to stretch that were intracellularly filled with neurobiotin. VGLUT1 was present in all synaptic varicosities, identified with the synaptic marker SV2, of control and regenerated afferents. However, regenerated afferents lacked axon collaterals and synapses in lamina IX. In conjunction with the companion electrophysiological study [Bullinger KL, Nardelli P, Pinter MJ, Alvarez FJ, Cope TC. J Neurophysiol (August 10, 2011). doi:10.1152/jn.01097.2010], we conclude that peripheral nerve injuries cause a permanent retraction of IA afferent synaptic varicosities from lamina IX and disconnection with motoneurons that is not recovered after peripheral regeneration and reinnervation of muscle by sensory and motor axons.

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Recovery of Peripheral Nerve with Massive Loss Defect by Tissue Engineered Guiding Regenerative Gel

BioMed Research International ◽

10.1155/2014/327578 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Shimon Rochkind ◽

Zvi Nevo

Keyword(s):

Peripheral Nerve ◽

Nerve Regeneration ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Preclinical Study ◽

Significant Loss ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Reconstructive Procedures ◽

Nerve Conduits

Objective. Guiding Regeneration Gel (GRG) was developed in response to the clinical need of improving treatment for peripheral nerve injuries and helping patients regenerate massive regional losses in peripheral nerves. The efficacy of GRG based on tissue engineering technology for the treatment of complete peripheral nerve injury with significant loss defect was investigated.Background. Many severe peripheral nerve injuries can only be treated through surgical reconstructive procedures. Such procedures are challenging, since functional recovery is slow and can be unsatisfactory. One of the most promising solutions already in clinical practice is synthetic nerve conduits connecting the ends of damaged nerve supporting nerve regeneration. However, this solution still does not enable recovery of massive nerve loss defect.The proposed technologyis a biocompatible and biodegradable gel enhancing axonal growth and nerve regeneration. It is composed of a complex of substances comprising transparent, highly viscous gel resembling the extracellular matrix that is almost impermeable to liquids and gasses, flexible, elastic, malleable, and adaptable to various shapes and formats.Preclinical studyon rat model of peripheral nerve injury showed that GRG enhanced nerve regeneration when placed in nerve conduits, enabling recovery of massive nerve loss, previously unbridgeable, and enabled nerve regeneration at least as good as with autologous nerve graft “gold standard” treatment.

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Relationship of Anti-interleukin-6 Receptor Antibody to Interleukin-6 Level and Inducible Nitrite Oxide Levels in Peripheral Nerve Injury in Chronic Constriction Injury-Induced Rats: A Case-Control Study in Indonesia

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2022.7604 ◽

2022 ◽

Vol 10 (A) ◽

pp. 1-5

Author(s):

Riki Sukiandra ◽

Eti Yerizel ◽

Yuliarni Syafrita ◽

Eryati Darwin

Keyword(s):

Neuropathic Pain ◽

Peripheral Nerve ◽

Nerve Injury ◽

Interleukin 6 ◽

Peripheral Nerve Injury ◽

Sandwich Elisa ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Receptor Antibody ◽

Male Wistar Rats

BACKGROUND: Interleukin-6 (IL-6) and inducible Nitric oxide Synthase (iNOS) have an effect on neuropathic pain in the inflammatory process in peripheral nerve injuries. AIM: This study aims to examine the effect of anti-IL-6 receptor antibody on IL-6 and iNOS levels as a consideration for the treatment of neuropathic pain in a rat model of peripheral nerve injury. METHODS: Twenty-eight young adult male Wistar rats were treated for peripheral nerve injury and then divided into two groups. Fourteen treatment groups (Group P) were given anti-IL-6 receptor antibody by injection at a dose of 100 g/day by injection into the saphenous vein in the rat’s leg for 3 days. In both groups, the serum IL-6 and iNOS levels were assessed on the 3rd day after administration of anti-IL-6 receptor antibody in group P, using the sandwich ELISA method. RESULTS: The results showed that the administration of anti-IL-6 receptor antibody did not have a significant effect on reducing IL-6 and iNOS levels in group P (p > 0.05). Administration of anti-IL-6 receptor antibody had more effect on IL-6 levels on iNOS levels, where a decrease in IL-6 levels caused a decrease in iNOS levels in group P (p = 0.004 and r = 0.693). CONCLUSIONS: We conclude that the present administration of anti-IL-6 receptor antibody cannot be considered as a treatment for neuropathic pain in peripheral nerve injuries, but can be used to influence IL-6 levels on iNOS levels.

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A PERIPHERAL NERVE INJURY MODEL UTILIZING A SIMPLE TISSUE SPARING APPROACH TO THE RABBIT SCIATIC NERVE

Journal of Musculoskeletal Research ◽

10.1142/s0218957718500021 ◽

2018 ◽

Vol 21 (01) ◽

pp. 1850002

Author(s):

Andrew J. Miller ◽

Jacob Tulipan ◽

Mark Wang ◽

Pedro Beredjiklian ◽

Andrzej Fertala ◽

...

Keyword(s):

Sciatic Nerve ◽

Peripheral Nerve ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Rabbit Model ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Muscle Sparing ◽

Tissue Sparing ◽

Injury Models

Background & Aims: Peripheral nerve injury models require a reproducible surgical technique that provides a simple and extensile peripheral nerve exposure. We present a muscle sparing apprach to the sciatic nerve in a rabbit model. A combination of general anestheia, sedative and perioperative analgesics was given to minimize animal discomfort. Methods: A posterior lateral dissection of the rabbit hind leg was performed to expose the proximal sciatic nerve. This facilitated an extensile dissection of both the proximal and distal sciatic nerve. Results: The described dissection is atraumatic, bloodless, and yields minimal postoperative morbidity on the rabbit. All rabbits received standard postoperative care in compliance with all regulatory agencies. A full vetinarian staff was available to manage the animals postoperatively. Conclusion: We found that our technique is a reproducible and easy to perform surgical approach with basic surgical setup. Our animal model provides an opportunity to evaluate and study peripheral nerve injuries peripheral nerve injuries.

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FREQUENCY OF PERIPHERAL NERVE INJURIES IN ATHLETES OF CERTAIN SPORTS CLUBS IN THE CITY OF ZADAR

Acta kinesiologica ◽

10.51371/issn.1840-2976.2021.15.1.15 ◽

2021 ◽

pp. 127-132

Author(s):

Luka Androja ◽

Josip Miočić ◽

Žarko Bilić ◽

Milica Komšo

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Soft Tissues ◽

Original System ◽

Rehabilitation Program ◽

Professional Staff ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Training Process

Peripheral nerves in athletes are susceptible to injury due to an increase in physiological requirements in the training process to neurological structures and to the soft tissues that protect them. The training process is conditioned by the rank and level of competition and its implementation largely depends on the education of professional staff. Common mechanisms of injury are pressure, sprain, strain, ischemia, and sports injury. Seddon's original system of dividing nerve injuries based on neurophysiological changes is most widely used in medicine. The initial stage of nerve injury is neuropraxia, the second stage is axonal degeneration, and the third stage is nerve cutting. Peripheral nerve injuries are more common in the upper extremities than in the lower extremities. They have specifics related to a particular sport, in this case, football and basketball, and often have a biomechanical component in the making. Early detection allows an appropriate rehabilitation program to be initiated and biomechanics changed before the nerve injury becomes permanent. Recognizing nerve injury requires an understanding of peripheral neuroanatomy, knowledge of common nerve injury sites, and awareness of the types of peripheral nerve injuries that are common and specific to a particular sport. Rehabilitation programs in the field of kinesiology can be read through FMS protocols. Electrodiagnostic tests (electromyography), somatosensory evoked potentials, magnetic resonance imaging, and ultrasound are used to diagnose peripheral nerve injuries. Proximal peripheral nerve injuries have a slightly poorer prognosis in terms of neurological recovery in athletes. The survey determined the frequency of injuries in the subjects and that there is a misunderstanding among the athletes themselves, which is a peripheral nerve injury. The survey also found that peripheral nerve injuries occur due to acute injuries, while chronic injuries are excessive, resulting in damage to muscles and joints, and rarely as a result of inappropriate sports equipment. Athletes' knowledge of what constitutes a peripheral nerve injury itself and how this type of injury should be given more importance in further general prevention has also been established.

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Electrical Stimulation to Promote Peripheral Nerve Regeneration

Neurorehabilitation and Neural Repair ◽

10.1177/1545968315604399 ◽

2015 ◽

Vol 30 (5) ◽

pp. 490-496 ◽

Cited By ~ 60

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.

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"MOOD RINGS": A NEW METHOD OF OBJECTIVE CLINICAL ASSESSMENT OF PERIPHERAL NERVE INJURIES

Hand Surgery ◽

10.1142/s0218810410004795 ◽

2010 ◽

Vol 15 (03) ◽

pp. 173-176

Author(s):

F. Ya'ish ◽

J. P. Cooper ◽

M. A. Craigen

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Clinical Assessment ◽

Peripheral Nerve Injury ◽

Objective Assessment ◽

Control Group ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Temperature Changes ◽

Significant Difference

The clinical assessment of patients with peripheral nerve injury is primarily dependent on subjective clinical examination. We aimed to assess whether a thermotropic liquid crystal ring (TLC-ring) could provide the basis for an objective assessment of peripheral nerve injury by detecting temperature changes in the digits innervated by the damaged nerve. A group of patients with known median, ulnar or both digital nerve injuries were compared against a control group. TLC-rings, marketed to the general public as "mood rings", were applied to the affected and unaffected digits and the colour change recorded. Areas with nerve damage showed a statistically significant difference in colour response to those without damage. This study establishes the ability of TLCs to detect cutaneous temperature changes associated with peripheral nerve injuries. Further studies and improvements are needed to refine TLC as an acute assessment tool for peripheral nerve injuries.

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Potential Hollowfiber Polyurethane-Collagen of Chitosan Coatings As a Nerve Graft for the Therapy of Peripheral Nerve Injuries in Limb Paralysis

Journal of Stem Cell Research and Tissue Engineering ◽

10.20473/jscrte.v2i2.11892 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Hendita Maulida

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Sem Analysis ◽

Nerve Graft ◽

The Body ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Nerve Grafts ◽

Collagen Coating

Peripheral nerve injury with a gap of 5–30 mm can cause permanent paralysis because it causes an axon to break up. The distance between axons of more than 1-2 cm requires a graft in the form of a nerve connector to fix it. Synthesis of chitosan coated polyurethane-collagen hollowfiber has been carried out as an accelerator for healing peripheral nerve injury. The results of Fourier Transform Infra Red (FTIR) analysis showed a cross link between chitosan and glutaraldehyde seen in the shift of wave numbers from 1080-1100 cm-1 to 1002 cm-1. The degradation test results showed that the sample experienced a decrease in mass after being immersed in Simulated Body Fluid (SBF) for 7 days. Polyurethane can be degraded in the body after 30 days. This is in accordance with the mechanism of the nerve which regenerates 1 mm per day or 1 inch per month. Scanning Electron Microscope (SEM) analysis showed that the diameter of the hollowfiber was 2.021-2.032 mm which corresponds to the peripheral nerve diameter of 1.5-3 mm and the pore size of the wall is 31.33-39.65 μm. The results of this study are expected to provide the theoretical basis for the use of chitosan polyurethane-collagen coating composites as nerve grafts for the treatment of peripheral nerve injuries that have biocompatible properties, can regenerate and are easily degraded and provide alternative solutions for nerve graft needs that are more economical and easier to manufacture so widely produced in Indonesia.

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Establishment of a Sheep Model for Hind Limb Peripheral Nerve Injury: Common Peroneal Nerve

International Journal of Molecular Sciences ◽

10.3390/ijms22031401 ◽

2021 ◽

Vol 22 (3) ◽

pp. 1401

Author(s):

Rui D. Alvites ◽

Mariana V. Branquinho ◽

Ana C. Sousa ◽

Federica Zen ◽

Monica Maurina ◽

...

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Peroneal Nerve ◽

Common Peroneal Nerve ◽

Small Sample ◽

Therapeutic Options ◽

Nerve Injuries ◽

Sheep Model ◽

The Common

Thousands of people worldwide suffer from peripheral nerve injuries and must deal daily with the resulting physiological and functional deficits. Recent advances in this field are still insufficient to guarantee adequate outcomes, and the development of new and compelling therapeutic options require the use of valid preclinical models that effectively replicate the characteristics and challenges associated with these injuries in humans. In this study, we established a sheep model for common peroneal nerve injuries that can be applied in preclinical research with the advantages associated with the use of large animal models. The anatomy of the common peroneal nerve and topographically related nerves, the functional consequences of its injury and a neurological examination directed at this nerve have been described. Furthermore, the surgical protocol for accessing the common peroneal nerve, the induction of different types of nerve damage and the application of possible therapeutic options were described. Finally, a preliminary morphological and stereological study was carried out to establish control values for the healthy common peroneal nerves regarding this animal model and to identify preliminary differences between therapeutic methods. This study allowed to define the described lateral incision as the best to access the common peroneal nerve, besides establishing 12 and 24 weeks as the minimum periods to study lesions of axonotmesis and neurotmesis, respectively, in this specie. The post-mortem evaluation of the harvested nerves allowed to register stereological values for healthy common peroneal nerves to be used as controls in future studies, and to establish preliminary values associated with the therapeutic performance of the different applied options, although limited by a small sample size, thus requiring further validation studies. Finally, this study demonstrated that the sheep is a valid model of peripheral nerve injury to be used in pre-clinical and translational works and to evaluate the efficacy and safety of nerve injury therapeutic options before its clinical application in humans and veterinary patients.

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