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Göksu MR, Gümrükçü Z, Balaban E, Mercantepe T, Gökçe FM. Electrophysiological and histopathological evaluation of the effectiveness of melatonin and glatiramer acetate for traumatic facial nerve injuries. Injury 2024; 55:111719. [PMID: 39003883 DOI: 10.1016/j.injury.2024.111719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/20/2024] [Accepted: 07/04/2024] [Indexed: 07/16/2024]
Abstract
AIM This study aimed to evaluate the effect of systemic/local use of melatonin and glatiramer acetate on regeneration in traumatic nerve injury models. MATERIALS AND METHODS A total of 42 male Wistar albino rats were randomly divided into 6 groups: healthy control (Group 1), injured control (Group 2), local melatonin (Group 3), systemic melatonin (Group 4), local glatiramer acetate (Group 5), and systemic glatiramer acetate (Group 6). In all groups, electromyography recordings of the facial nerve were obtained after surgery and before sacrifice, and the damaged nerve region was histopathologically examined after sacrifice. RESULTS In the electrophysiological evaluation, the control group had the greatest decrease in amplitude and extension in latency time following surgery than the treatment groups. Furthermore, a significant decrease in the degenerative axon count, edematous areas, and fibrotic areas as well as a significant increase in axonal surface areas was observed in all the treatment groups compared with the damage control group. CONCLUSIONS Although both glatiramer acetate and melatonin are beneficial in regeneration in traumatic facial nerve injuries, it can be concluded that systemic use of melatonin can yield more positive results than glatiramer acetate and local use of both two drugs.
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Affiliation(s)
| | - Zeynep Gümrükçü
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Recep Tayyip Erdoğan University, Rize, Turkey.
| | - Emre Balaban
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Recep Tayyip Erdoğan University, Rize, Turkey
| | - Tolga Mercantepe
- Department of Histology Embryology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Fatih Mehmet Gökçe
- Department of Physiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
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Pourshahidi S, Shamshiri AR, Derakhshan S, Mohammadi S, Ghorbani M. The Effect of Acetyl-L-Carnitine (ALCAR) on Peripheral Nerve Regeneration in Animal Models: A Systematic Review. Neurochem Res 2023:10.1007/s11064-023-03911-1. [PMID: 37037995 DOI: 10.1007/s11064-023-03911-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 03/06/2023] [Accepted: 03/11/2023] [Indexed: 04/12/2023]
Abstract
Peripheral neuropathies caused by the peripheral nervous system (PNS) damage can occur due to trauma and other disorders. They present as altered sensation, weakness, autonomic symptoms, and debilitating pain syndrome with a wide range of clinical signs. Acetyl-L-Carnitine (ALCAR) is a biological compound with essential roles in mitochondrial oxidative metabolism and anti-oxidant effects that protects mitochondria from oxidative damage and inhibits apoptosis caused by mitochondrial damage. This study is a systematic review and meta-analysis of the effects of ALCAR on peripheral nerve injuries. This review examines studies on treating traumatic peripheral neuropathies in which ALCAR is administered to rats with sciatic nerve injury with an appropriate control group. The articles were divided based on the mode of ALCAR administration. If one method was used in more than one article, their results were entered in the "Revman5.4" software and were meta-analyzed. Studies were selected from 1994 to 2018 on rats with varying physical injuries to their sciatic nerves. In one study, ALCAR was provided to rats in their drinking water, while in other studies, ALCAR was injected intra-peritoneally. Different mechanisms of ALCAR actions have been suggested in this study, but the underpinnings of the neuroprotective effects of ALCAR are still unclear. Further studies are mandatory to clarify the actual mechanisms of the neuroprotective activity of ALCAR. Based on the results of existing studies, ALCAR effectively increases the tolerance threshold of thermal and mechanical stimuli, reduces latency, and reduces apoptosis; finally, adjusting the dose and duration of administration may increase the dose and duration axon diameter.
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Affiliation(s)
- Sara Pourshahidi
- Oral and Maxillofacial Diseases Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Derakhshan
- Oral and Maxillofacial Pathology Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Preclinical Imaging Group, Preclinical Core Facility, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Mohammadi
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Ghorbani
- Faculty of Veterinary Medicine, Islamic Azad University, Urmia Branch, Urmia, Iran.
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Xu S, Ito A, Wang T, Kawai H, Aoyama T, Kuroki H. Ultrasound Therapy of Injury Site Modulates Gene and Protein Expressions in the Dorsal Root Ganglion in a Sciatic Nerve Crush Injury Rat Model. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:2502-2511. [PMID: 36180311 DOI: 10.1016/j.ultrasmedbio.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to verify the effects of ultrasound on dorsal root ganglion (DRG) neurons at the injury site in a rat model of sciatic nerve crush injury. We evaluated the mRNA expression of neurotrophic and pro-inflammatory factors by quantitative reverse transcription polymerase chain reaction 7 and 14 d post-injury. We also evaluated the protein levels of brain-derived neurotrophic factor (BDNF) 7 and 14 d post-injury. Axon regeneration and motor function analyses were performed 21 days after injury to confirm the facilitative effect of ultrasound on nerve regeneration. In the ultrasound group, BDNF and interleukin-6 mRNA expression of the DRG was significantly reduced 7 d post-injury. Compared with the sham group, the BDNF protein expression of the DRG in the ultrasound group remained at a higher level 14 d post-injury. Motor function, myelinated fiber density and myelin sheath thickness were significantly higher in the ultrasound group than in the sham group 21 d post-injury. These results indicate that ultrasound therapy at the injury site promotes nerve regeneration and modulates gene and protein expression in the DRG of a rat model of a sciatic nerve crush injury.
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Affiliation(s)
- Shixuan Xu
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Ito
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Tianshu Wang
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideki Kawai
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Does hyperbaric oxygen therapy facilitate peripheral nerve recovery in upper extremity injuries? A prospective study of 74 patients. Eur J Trauma Emerg Surg 2022; 48:3997-4003. [DOI: 10.1007/s00068-022-01920-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 02/12/2022] [Indexed: 11/03/2022]
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Middleton SJ, Perez-Sanchez J, Dawes JM. The structure of sensory afferent compartments in health and disease. J Anat 2021; 241:1186-1210. [PMID: 34528255 PMCID: PMC9558153 DOI: 10.1111/joa.13544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/12/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022] Open
Abstract
Primary sensory neurons are a heterogeneous population of cells able to respond to both innocuous and noxious stimuli. Like most neurons they are highly compartmentalised, allowing them to detect, convey and transfer sensory information. These compartments include specialised sensory endings in the skin, the nodes of Ranvier in myelinated axons, the cell soma and their central terminals in the spinal cord. In this review, we will highlight the importance of these compartments to primary afferent function, describe how these structures are compromised following nerve damage and how this relates to neuropathic pain.
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Affiliation(s)
- Steven J Middleton
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - John M Dawes
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Changes of Dorsal Root Ganglion Volume in Dogs with Clinical Signs of Degenerative Myelopathy Detected by Water-Excitation Magnetic Resonance Imaging. Animals (Basel) 2021; 11:ani11061702. [PMID: 34200373 PMCID: PMC8226439 DOI: 10.3390/ani11061702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 01/03/2023] Open
Abstract
Simple Summary Canine degenerative myelopathy (DM) is a chronic, progressive, and fatal neurodegenerative disease. Although degenerative changes in dogs with DM are observed not only in the spinal cord white matter but also the dorsal root ganglion (DRG) neurons, these changes are undetectable on conventional magnetic resonance imaging (MRI). Therefore, we investigated the ability of water-excitation MRI to visualize the DRG in dogs, and whether volumetry of DRG has a premortem diagnostic value for DM. Using water-excitation MRI, DRG could be depicted in all dogs. To normalize the volumes of DRG, body surface area was the most suitable denominator. The normalized DRG volume in dogs with DM was significantly lower than those in control dogs and dogs with intervertebral disc herniation. The results of this study revealed that widespread atrophy of DRG was likely to occur in DM. Moreover, volume reductions of DRG were observed in dogs with DM in both the early disease stage and late disease stage. Our research suggests that the DRG volume obtained by the water-excitation technique could be used as a clinical biomarker for DM. Abstract Canine degenerative myelopathy (DM) is a progressive and fatal neurodegenerative disease. However, a definitive diagnosis of DM can only be achieved by postmortem histopathological examination of the spinal cord. The purpose of this study was to investigate whether the volumetry of DRG using the ability of water-excitation magnetic resonance imaging (MRI) to visualize the DRG in dogs has premortem diagnostic value for DM. Eight dogs with DM, twenty-four dogs with intervertebral disc herniation (IVDH), and eight control dogs were scanned using a 3.0-tesla MRI system, and water-excitation images were obtained to visualize and measure the volume of DRG, normalized by body surface area. The normalized mean DRG volume between each spinal cord segment and mean volume of all DRG between T8 and L2 in the DM group was significantly lower than that in the control and the IVDH groups (P = 0.011, P = 0.002, respectively). There were no correlations within the normalized mean DRG volume between DM stage 1 and stage 4 (rs = 0.312, P = 0.128, respectively). In conclusion, DRG volumetry by the water-excitation MRI provides a non-invasive and quantitative assessment of neurodegeneration in DRG and may have diagnostic potential for DM.
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Atam C, Orhan Z, Toplu G, Serin M, Karaduman ZO, Öztürk A. Comparison of peripheral nerve repair using ethyl-cyanoacrylate and conventional suture technique in a rat sciatic nerve injury model. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2020; 54:330-336. [PMID: 32544069 DOI: 10.5152/j.aott.2020.03.156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to compare the outcomes of primary nerve repair using either ethyl-cyanoacrylate or conventional microsuture technique in a rat peripheral nerve injury model. METHODS In this study, a total of 30 Wistar Albino rats weighing between 220 and 275 g were used. The rats were randomly divided into three groups (10 in each), including one control (group 1) and two experimental groups (group 2, conventional microsuture repair; group 3, cyanoacrylate repair). In each group, the sciatic nerve was identified and transected. No further intervention was performed in group 1. The nerve was repaired using the epineural technique with a 10/0 atraumatic nylon in group 2 and synthetic cyanoacrylate adhesive in group 3. At the fifth postoperative week, needle electromyography (EMG) was performed to measure distal latency, combined muscle action potential (CMAP), and motor nerve conduction velocity (MNCV). Following the EMG recordings, animals were euthanized. Nerve samples were collected to evaluate vacuolar degeneration, fibrosis, and foreign body reaction histopathologically. RESULTS In the EMG analysis, mean distal latency was significantly shorter in group 1 (0.85±0.09 ms) than in groups 2 (1.17±0.25 ms) (p=0.0052) and 3 (1.14±0.14 ms) (p=0.0026) while no significant differences existed between groups 2 and 3 (p>0.9999). The mean CMAP was greater in group 1 (10.5±0.35 mV) than in groups 2 (2.86±1.28 mV) (p=0.011) and 3 (2.16±1.34 mV) (p=0.0002), but there was no significant difference between groups 2 and 3 (p>0.9999). The mean MNCV was 53.5±5.95, 39.62±7.31, and 39.84±4.73 mm/sec in groups 1, 2, and 3, respectively. There was a significant difference between groups 1 and 2 (p=0.0052) and between 1 and 3 (p=0.0026), but not between 2 and 3 (p>0.9999). In the histopathological evaluation, the mean vacuolar degeneration score was 0, 2.12, and 1.88 in groups 1, 2, and 3, respectively. No obvious difference was observed between groups 2 and 3 (p=0.743). The mean fibrosis score was 0, 1.62, and 1.77 in groups 1, 2, and 3, respectively. There was no significant difference between groups 2 and 3 (p=0.888). The mean foreign body reaction score was 0, 2.5, and 2.44 in groups 1, 2, and 3, respectively. No difference was present between groups 2 and 3 (p=0.743). CONCLUSION Primary nerve repair using the cyanoacrylate adhesive may provide similar electrophysiological and histopathological results as compared to the conventional microsuture repair.
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Affiliation(s)
- Camettin Atam
- Clinic of Orthopedics and Traumatology, Kırklareli State Hospital, Kırklareli, Turkey
| | - Zafer Orhan
- Department of Orthopedics and Traumatology, Düzce University, School of Medicine, Düzce, Turkey
| | - Gaye Toplu
- Deparment of Plastic Surgery, Health Sciences University, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Merdan Serin
- Deparment of Plastic Surgery, Health Sciences University, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Z Okan Karaduman
- Department of Orthopedics and Traumatology, Düzce University, School of Medicine, Düzce, Turkey
| | - Ayhan Öztürk
- Deparment of Neurology, Düzce University, School of Medicine, Düzce, Turkey
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Wang ZY, Qin LH, Zhang WG, Zhang PX, Jiang BG. Qian-Zheng-San promotes regeneration after sciatic nerve crush injury in rats. Neural Regen Res 2019; 14:683-691. [PMID: 30632509 PMCID: PMC6352607 DOI: 10.4103/1673-5374.247472] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Qian-Zheng-San, a traditional Chinese prescription consisting of Typhonii Rhizoma, Bombyx Batryticatus, Scorpio, has been found to play an active therapeutic role in central nervous system diseases. However, it is unclear whether Qian-Zheng-San has therapeutic value for peripheral nerve injury. Therefore, we used Sprague-Dawley rats to investigate this. A sciatic nerve crush injury model was induced by clamping the right sciatic nerve. Subsequently, rats in the treatment group were administered 2 mL Qian-Zheng-San (1.75 g/mL) daily as systemic therapy for 1, 2, 4, or 8 weeks. Rats in the control group were not administered Qian-Zheng-San. Rats in sham group did not undergo surgery and systemic therapy. Footprint analysis was used to assess nerve motor function. Electrophysiological experiments were used to detect nerve conduction function. Immunofluorescence staining was used to assess axon counts and morphological analysis. Immunohistochemical staining was used to observe myelin regeneration of the sciatic nerve and the number of motoneurons in the anterior horn of the spinal cord. At 2 and 4 weeks postoperatively, the sciatic nerve function index, nerve conduction velocity, the number of distant regenerated axons and the axon diameter of the sciatic nerve increased in the Qian-Zheng-San treatment group compared with the control group. At 2 weeks postoperatively, nerve fiber diameter, myelin thickness, and the number of motor neurons in the lumbar spinal cord anterior horn increased in the Qian-Zheng-San treatment group compared with the control group. These results indicate that Qian-Zheng-San has a positive effect on peripheral nerve regeneration.
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Affiliation(s)
- Zhi-Yong Wang
- Department of Anatomy and Histo-embryology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Li-Hua Qin
- Department of Anatomy and Histo-embryology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Wei-Guang Zhang
- Department of Anatomy and Histo-embryology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Pei-Xun Zhang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Bao-Guo Jiang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
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Karalija A, Novikova LN, Orädd G, Wiberg M, Novikov LN. Differentiation of Pre- and Postganglionic Nerve Injury Using MRI of the Spinal Cord. PLoS One 2016; 11:e0168807. [PMID: 28036395 PMCID: PMC5201258 DOI: 10.1371/journal.pone.0168807] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 12/06/2016] [Indexed: 01/09/2023] Open
Abstract
Brachial plexus injury (BPI) is a devastating type of nerve injury, potentially causing loss of motor and sensory function. Principally, BPI is either categorized as preganglionic or postganglionic, with the early establishment of injury level being crucial for choosing the correct treatment strategy. Despite diagnostic advances, the need for a reliable, non-invasive method for establishing the injury level remains. We studied the usefulness of in vivo magnetic resonance imaging (MRI) of the spinal cord for determination of injury level. The findings were related to neuronal and glial changes. Rats underwent unilateral L4 & L5 ventral roots avulsion or sciatic nerve axotomy. The injuries served as models for pre- and postganglionic BPI, respectively. MRI of the L4/L5 spinal cord segments 4 weeks after avulsion showed ventral horn (VH) shrinkage on the injured side compared to the uninjured side. Axotomy induced no change in the VH size on MRI. Following avulsion, histological sections of L4/L5 revealed shrinkage in the VH grey matter area occupied by NeuN-positive neurons, loss of microtubular-associated protein-2 positive dendritic branches (MAP2), pan-neurofilament positive axons (PanNF), synaptophysin-positive synapses (SYN) and increase in immunoreactivity for the microglial OX42 and astroglial GFAP markers. Axotomy induced no changes in NeuN-reactivity, modest decrease of MAP2 immunoreactivity, no changes in SYN and PanNF labelling, and a modest increase in OX42 and SYN labeling. Histological and radiological findings were congruent when assessing changes after axotomy, while MRI somewhat underestimated the shrinkage. This study indicates a potential diagnostic value of structural spinal cord MRI following BPI.
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Affiliation(s)
- Amar Karalija
- Department of Integrative Medical Biology, Section of Anatomy, Umeå University, Umeå, Sweden
- Department of Surgical and Perioperative Science, Section of Hand and Plastic Surgery, Umeå University, Umeå, Sweden
- * E-mail:
| | - Liudmila N. Novikova
- Department of Integrative Medical Biology, Section of Anatomy, Umeå University, Umeå, Sweden
| | - Greger Orädd
- Department of Integrative Medical Biology, Section of Physiology, Umeå University, Umeå, Sweden
- Umeå Centre for Comparative Biology, Umeå University, Umeå, Sweden
| | - Mikael Wiberg
- Department of Integrative Medical Biology, Section of Anatomy, Umeå University, Umeå, Sweden
- Department of Surgical and Perioperative Science, Section of Hand and Plastic Surgery, Umeå University, Umeå, Sweden
| | - Lev N. Novikov
- Department of Integrative Medical Biology, Section of Anatomy, Umeå University, Umeå, Sweden
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Henry FP, Wang Y, Rodriguez CLR, Randolph MA, Rust EAZ, Winograd JM, de Boer JF, Park BH. In vivo optical microscopy of peripheral nerve myelination with polarization sensitive-optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:046002. [PMID: 25858593 PMCID: PMC4392067 DOI: 10.1117/1.jbo.20.4.046002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 03/24/2015] [Indexed: 05/19/2023]
Abstract
Assessing nerve integrity and myelination after injury is necessary to provide insight for treatment strategies aimed at restoring neuromuscular function. Currently, this is largely done with electrical analysis, which lacks direct quantitative information. In vivo optical imaging with sufficient imaging depth and resolution could be used to assess the nerve microarchitecture. In this study, we examine the use of polarization sensitive-optical coherence tomography (PS-OCT) to quantitatively assess the sciatic nerve microenvironment through measurements of birefringence after applying a nerve crush injury in a rat model. Initial loss of function and subsequent recovery were demonstrated by calculating the sciatic function index (SFI). We found that the PS-OCT phase retardation slope, which is proportional to birefringence, increased monotonically with the SFI. Additionally, histomorphometric analysis of the myelin thickness and g-ratio shows that the PS-OCT slope is a good indicator of myelin health and recovery after injury. These results demonstrate that PS-OCT is capable of providing nondestructive and quantitative assessment of nerve health after injury and shows promise for continued use both clinically and experimentally in neuroscience.
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Affiliation(s)
- Francis P. Henry
- Massachusetts General Hospital Harvard Medical School, Wellman Center for Photomedicine, Boston, Massachusetts 02114, United States
- Massachusetts General Hospital Harvard Medical School, Plastic Surgery Research Laboratory, No. 15 Parkman Street, WACC 435, Boston, Massachusetts 02114, United States
| | - Yan Wang
- Massachusetts General Hospital Harvard Medical School, Wellman Center for Photomedicine, Boston, Massachusetts 02114, United States
- University of California, Department of Bioengineering, Bourns A247, 900 University Avenue, Riverside, California 92521, United States
| | - Carissa L. R. Rodriguez
- University of California, Department of Bioengineering, Bourns A247, 900 University Avenue, Riverside, California 92521, United States
| | - Mark A. Randolph
- Massachusetts General Hospital Harvard Medical School, Plastic Surgery Research Laboratory, No. 15 Parkman Street, WACC 435, Boston, Massachusetts 02114, United States
| | - Esther A. Z. Rust
- Massachusetts General Hospital Harvard Medical School, Plastic Surgery Research Laboratory, No. 15 Parkman Street, WACC 435, Boston, Massachusetts 02114, United States
| | - Jonathan M. Winograd
- Massachusetts General Hospital Harvard Medical School, Plastic Surgery Research Laboratory, No. 15 Parkman Street, WACC 435, Boston, Massachusetts 02114, United States
| | - Johannes F. de Boer
- Massachusetts General Hospital Harvard Medical School, Wellman Center for Photomedicine, Boston, Massachusetts 02114, United States
- VU University Amsterdam, Department of Physics and Astronomy, De Boelelaan 1081, Amsterdam 1081 HV, The Netherlands
| | - B. Hyle Park
- University of California, Department of Bioengineering, Bourns A247, 900 University Avenue, Riverside, California 92521, United States
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Ooi Y, Inui-Yamamoto C, Suzuki T, Nakadate H, Nagase Y, Seiyama A, Yoshioka Y, Seki J. In vivo magnetic resonance imaging at 11.7 Tesla visualized the effects of neonatal transection of infraorbital nerve upon primary and secondary trigeminal pathways in rats. Brain Res 2014; 1579:84-92. [PMID: 25038563 DOI: 10.1016/j.brainres.2014.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 06/20/2014] [Accepted: 07/08/2014] [Indexed: 01/03/2023]
Abstract
Using 11.7T ultra high-field T2-weighted MRI, the present study aimed to investigate pathological changes of primary and secondary trigeminal pathways following neonatal transection of infraorbital nerve in rats. The trigeminal pathways consist of spinal trigeminal tract, trigeminal sensory nuclear complex, medial lemniscus, ventromedial portion of external medullary lamina and ventral posterior nucleus of thalamus. By selecting optimum parameters of MRI such as repetition time, echo time, and slice orientation, this study visualized the trigeminal pathways in rats without any contrast agents. Pathological changes due to the nerve transection were found at 8 weeks of age as a marked reduction of the areas of the trigeminal pathways connecting from the injured nerve. In addition, T2-weighted MR images of the trigeminal nerve trunk and the spinal trigeminal tract suggest a communication of CSF through the trigeminal nerve between the inside and outside of the brain stem. These results support the utility of ultra high-field MRI system for noninvasive assessment of effects of trigeminal nerve injury upon the trigeminal pathways.
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Affiliation(s)
- Yasuhiro Ooi
- Division of Pathogenesis and Control of Oral Disease, Graduate School of Dentistry, Osaka University, Suita, Osaka 565-0871, Japan; CREST, Japan Science and Technology Agency (JST), Saitama 332-0012, Japan.
| | - Chizuko Inui-Yamamoto
- CREST, Japan Science and Technology Agency (JST), Saitama 332-0012, Japan; High Performance Bioimaging Research Facility, Graduate School of Frontier Biosciences, Osaka University, Suita, Osaka 565-0871, Japan
| | - Takashi Suzuki
- CREST, Japan Science and Technology Agency (JST), Saitama 332-0012, Japan; Department of Biomedical Engineering, National Cerebral & Cardiovascular Center Research Institute, Suita, Osaka 565-8565, Japan
| | - Hiromichi Nakadate
- CREST, Japan Science and Technology Agency (JST), Saitama 332-0012, Japan; Department of Biomedical Engineering, National Cerebral & Cardiovascular Center Research Institute, Suita, Osaka 565-8565, Japan
| | - Yoshitaka Nagase
- Department of Oral Anatomy and Neurobiology, Graduate School of Dentistry, Osaka University, Suita, Osaka 565-0871, Japan
| | - Akitoshi Seiyama
- CREST, Japan Science and Technology Agency (JST), Saitama 332-0012, Japan; Division of Medical Devices for Diagnoses, Faculty of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Yoshichika Yoshioka
- CREST, Japan Science and Technology Agency (JST), Saitama 332-0012, Japan; Biofunctional Imaging Laboratory, Immunology Frontier Research Center, Osaka University, Suita, Osaka 565-0871, Japan
| | - Junji Seki
- CREST, Japan Science and Technology Agency (JST), Saitama 332-0012, Japan; Department of Biomedical Engineering, National Cerebral & Cardiovascular Center Research Institute, Suita, Osaka 565-8565, Japan
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Savastano LE, Laurito SR, Fitt MR, Rasmussen JA, Gonzalez Polo V, Patterson SI. Sciatic nerve injury: A simple and subtle model for investigating many aspects of nervous system damage and recovery. J Neurosci Methods 2014; 227:166-80. [DOI: 10.1016/j.jneumeth.2014.01.020] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 01/16/2014] [Accepted: 01/20/2014] [Indexed: 02/04/2023]
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Ohana M, Moser T, Moussaouï A, Kremer S, Carlier R, Liverneaux P, Dietemann JL. Current and future imaging of the peripheral nervous system. Diagn Interv Imaging 2014; 95:17-26. [DOI: 10.1016/j.diii.2013.05.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hart AM, Terenghi G, Wiberg M. Neuronal death after peripheral nerve injury and experimental strategies for neuroprotection. Neurol Res 2013; 30:999-1011. [DOI: 10.1179/174313208x362479] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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West CA, Ljungberg C, Wiberg M, Hart A. Sensory Neuron Death After Upper Limb Nerve Injury and Protective Effect of Repair. Neurosurgery 2013; 73:632-9; discussion 640. [DOI: 10.1227/neu.0000000000000066] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Abstract
BACKGROUND:
Extensive death of sensory neurons after nerve trauma depletes the number of regenerating neurons, contributing to inadequate cutaneous innervation density and poor sensory recovery. Experimentally proven neuroprotective neoadjuvant drugs require noninvasive in vivo measures of neuron death to permit clinical trials. In animal models of nerve transection, magnetic resonance imaging (MRI) proved a valid tool for quantifying sensory neuron loss within dorsal root ganglia (DRG) by measuring consequent proportional shrinkage of respective ganglia.
OBJECTIVE:
This system is investigated for clinical application after upper limb nerve injury and microsurgical nerve repair.
METHODS:
A 3-T clinical magnet was used to image and measure volume (Cavalieri principle) of C7-T1 DRG in uninjured volunteers (controls, n = 14), hand amputees (unrepaired nerve injury, n = 5), and early nerve repair patients (median and ulnar nerves transected, microsurgical nerve repair within 24 hours, n = 4).
RESULTS:
MRI was well tolerated. Volumetric analysis was feasible in 74% of patients. A mean 14% volume reduction was found in amputees' C7 and C8 DRG (P < .001 vs controls). Volume loss was lower in median and ulnar nerve repair patients (mean 3% volume loss, P < .01 vs amputees), and varied among patients. T1 DRG volume remained unaffected.
CONCLUSION:
MRI provides noninvasive in vivo assessment of DRG volume as a proxy clinical measure of sensory neuron death. The significant decrease found after unrepaired nerve injury provides indirect clinical evidence of axotomy-induced neuronal death. This loss was less after nerve repair, indicating a neuroprotective benefit of early repair. Volumetric MRI has potential diagnostic applications and is a quantitative tool for clinical trials of neuroprotective therapies.
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Affiliation(s)
- Christian Alexander West
- Department of Integrative Medical Biology, Section for Anatomy, Umea University, Umea, Sweden
- Department of Surgical and Perioperative Science, Section for Hand & Plastic Surgery, University Hospital, Umea, Sweden
| | - Christina Ljungberg
- Department of Integrative Medical Biology, Section for Anatomy, Umea University, Umea, Sweden
- Department of Surgical and Perioperative Science, Section for Hand & Plastic Surgery, University Hospital, Umea, Sweden
| | - Mikael Wiberg
- Department of Integrative Medical Biology, Section for Anatomy, Umea University, Umea, Sweden
- Department of Surgical and Perioperative Science, Section for Hand & Plastic Surgery, University Hospital, Umea, Sweden
| | - Andrew Hart
- Department of Surgical and Perioperative Science, Section for Hand & Plastic Surgery, University Hospital, Umea, Sweden
- Plastic Surgery Research, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- Canniesburn Plastic Surgery Unit, Scottish National Brachial Plexus Service, Glasgow Royal Infirmary, Glasgow, United Kingdom
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Maripuu A, Björkman A, Björkman-Burtscher IM, Mannfolk P, Andersson G, Dahlin LB. Reconstruction of sciatic nerve after traumatic injury in humans - factors influencing outcome as related to neurobiological knowledge from animal research. J Brachial Plex Peripher Nerve Inj 2012; 7:7. [PMID: 23050805 PMCID: PMC3540024 DOI: 10.1186/1749-7221-7-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 10/08/2012] [Indexed: 01/09/2023] Open
Abstract
Background The aim was to evaluate what can be learned from rat models when treating patients suffering from a sciatic nerve injury. Methods Two patients with traumatic sciatic nerve injury are presented with examination of motor and sensory function with a five-year follow-up. Reconstruction of the nerve injury was performed on the second and third day, respectively, after injury using sural nerve grafts taken from the injured leg. The patients were examined during follow-up by electromyography (EMG), MRI and functionalMRI (fMRI) to evaluate nerve reinnervation, cell death in dorsal root ganglia (DRG) and cortical activation; factors that were related to clinical history in the patients. Results One patient regained good motor function of the lower leg and foot, confirmed by EMG showing good activation in the leg muscles and some reinnervation in the foot muscles, as well as some sensory function of the sole of the foot. The other patient regained no motor (confirmed by EMG) or sensory function in the leg or foot. Factors most influential on outcome in two cases were type of injury, nerve gap length and particularly type of reconstruction. A difference in follow-up and rehabilitation likely also influence outcome. MRI did not show any differences in DRG size of injured side compared to the uninjured side. fMRI showed normal activation in the primary somatosensory cortex as a response to cutaneous stimulation of the normal foot. However, none of the two patients showed any activation in the primary somatosensory cortex following cutaneous stimulation of the injured foot. Conclusions In decision making of nerve repair and reconstruction data from animal experiments can be translated to clinical practice and to predict outcome in patients, although such data should be interpreted with caution and linked to clinical experience. Rat models may be useful to identify and study factors that influence outcome after peripheral nerve repair and reconstruction; procedures that should be done correctly and with a competent team. However, some factors, such as cognitive capacity and coping, known to influence outcome following nerve repair, are difficult to study in animal models. Future research has to find and develop new paths and techniques to study changes in the central nervous system after nerve injury and develop strategies to utilize brain plasticity during the rehabilitation.
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Affiliation(s)
- Amanda Maripuu
- Departments of Hand Surgery, Lund University, Lund, Sweden.
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Karsidag S, Akcal A, Sahin S, Karsidag S, Kabukcuoglu F, Ugurlu K. Neurophysiological and morphological responses to treatment with acetyl-L-carnitine in a sciatic nerve injury model: preliminary data. J Hand Surg Eur Vol 2012; 37:529-36. [PMID: 22080531 DOI: 10.1177/1753193411426969] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We investigated the effects of acetyl-L-carnitine (ALCAR) on the recovery of sciatic nerve injuries in rats. Sprague Dawley rats were randomized to two groups: ALCAR treated (for 14 days) and control. Each group was divided into three subgroups: distal transection, proximal transection, and grafted. Distal latencies, amplitudes, and motor nerve conduction velocities were measured. In the third month, biopsies were taken and examined under light microscopy. Electrophysiological measurements demonstrated that regeneration occurred earlier and was better in the ALCAR group, particularly in the distal transection subgroup. Better results were obtained in the distal transection subgroup in terms of axonal regeneration compared with the proximal transection and grafted subgroups because the regenerating segment was shorter. ALCAR enhanced the quality of neural recovery at the different levels and in different types of repair, and led to a decline in nerve death.
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Affiliation(s)
- S Karsidag
- Department of Plastic, Reconstructive and Aesthetic Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
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Abstract
Following distal nerve injury significant sensory neuronal cell death occurs in the dorsal root ganglia, while after a more proximal injury, such as brachial plexus injury, a sizeable proportion of spinal motoneurons also undergo cell death. This phenomenon has been undervalued for a long time, but it has a significant role in the lack of functional recuperation, as neuronal cells cannot divide and be replaced, hence the resulting nerve regeneration is usually suboptimal. It is now accepted that this cell death is due to apoptosis, as indicated by analysis of specific genes involved in the apoptotic signalling cascade. Immediate nerve repair, either by direct suturing or nerve grafting, gives a degree of neuroprotection, but this approach does not fully prevent neuronal cell death and importantly it is not always possible. Our work has shown that pharmacological intervention using either acetyl-L-carnitine (ALCAR) or N-acetyl-cysteine (NAC) give complete neuroprotection in different types of peripheral nerve injury. Both compounds are clinically safe and experimental work has defined the best dose, timing after injury and duration of administration. The efficacy of neuroprotection of ALCAR and NAC can be monitored non-invasively using MRI, as demonstrated experimentally and more recently by clinical studies of the volume of dorsal root ganglia. Translation to patients of this pharmacological intervention requires further work, but the available results indicate that this approach will help to secure a better functional outcome following peripheral nerve injury and repair.
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Affiliation(s)
- Giorgio Terenghi
- Blond McIndoe Laboratories, Biomedicine, University of Manchester, Manchester Academic Health Science Centre, UK.
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West CA, McKay Hart A, Terenghi G, Wiberg M. Sensory Neurons of the Human Brachial Plexus. Neurosurgery 2011; 70:1183-94; discussion 1194. [DOI: 10.1227/neu.0b013e318241ace1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Abstract
BACKGROUND:
Extensive neuron death following peripheral nerve trauma is implicated in poor sensory recovery. Translational research for experimentally proven neuroprotective drugs requires knowledge of the numbers and distribution of sensory neurons in the human upper limb and a novel noninvasive clinical measure of neuron loss.
OBJECTIVE:
To compare optical fractionation and volumetric magnetic resonance imaging (MRI) of dorsal root ganglia (DRG) in histological quantification and objective clinical assessment of human brachial plexus sensory neurons.
METHODS:
Bilateral C5-T1 DRG were harvested from 5 human cadavers for stereological volume measurement and sensory neuron counts (optical fractionator). MRI scans were obtained from 14 healthy volunteers for volumetric analysis of C5-T1 DRG.
RESULTS:
The brachial plexus is innervated by 425 409 (standard deviation 15 596) sensory neurons with a significant difference in neuron counts and DRG volume between segmental levels (P < .001), with C7 ganglion containing the most. DRG volume correlated with neuron counts (r = 0.75, P < .001). Vertebral artery pulsation hindered C5 and 6 imaging, yet high-resolution MRI of C7, C8, and T1 DRG permitted unbiased volume measurement. In accord with histological analysis, MRI confirmed a significant difference between C7, C8, and T1 DRG volume (P < .001), interindividual variability (CV = 15.3%), and sex differences (P = .04). Slight right-left sided disparity in neuron counts (2.5%, P = .04) was possibly related to hand dominance, but no significant volume disparity existed.
CONCLUSION:
Neuron counts for the human brachial plexus are presented. These correlate with histological DRG volumes and concur with volumetric MRI results in human volunteers. Volumetric MRI of C7-T1 DRG is a legitimate noninvasive proxy measure of sensory neurons for clinical study.
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Affiliation(s)
- Christian Alexander West
- Department of Integrative Medical Biology, Section for Anatomy, Umea˚ University, Umea˚, Sweden
- Department of Surgical & Perioperative Science, Section for Hand & Plastic Surgery, University Hospital, Umea˚, Sweden
- Blond-McIndoe Research Laboratories, The University of Manchester, Stopford Building, Oxford Road, Manchester, United Kingdom
| | - Andrew McKay Hart
- Department of Integrative Medical Biology, Section for Anatomy, Umea˚ University, Umea˚, Sweden
- College of Medical Veterinary & Life Sciences, The University of Glasgow, Glasgow, United Kingdom
- Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Giorgio Terenghi
- Blond-McIndoe Research Laboratories, The University of Manchester, Stopford Building, Oxford Road, Manchester, United Kingdom
| | - Mikael Wiberg
- Department of Integrative Medical Biology, Section for Anatomy, Umea˚ University, Umea˚, Sweden
- Department of Surgical & Perioperative Science, Section for Hand & Plastic Surgery, University Hospital, Umea˚, Sweden
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Beutler AS. AAV provides an alternative for gene therapy of the peripheral sensory nervous system. Mol Ther 2010; 18:670-3. [PMID: 20357781 DOI: 10.1038/mt.2010.41] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Andreas S Beutler
- Departments of Oncology and Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Gallaher ZR, Larios RM, Ryu V, Sprunger LK, Czaja K. Recovery of viscerosensory innervation from the dorsal root ganglia of the adult rat following capsaicin-induced injury. J Comp Neurol 2010; 518:3529-40. [DOI: 10.1002/cne.22412] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Kretschmer T, Heinen CW, Antoniadis G, Richter HP, König RW. Iatrogenic Nerve Injuries. Neurosurg Clin N Am 2009; 20:73-90, vii. [DOI: 10.1016/j.nec.2008.07.025] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Stephenson DT, Arneric SP. Neuroimaging of Pain: Advances and Future Prospects. THE JOURNAL OF PAIN 2008; 9:567-79. [DOI: 10.1016/j.jpain.2008.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2007] [Revised: 02/07/2008] [Accepted: 02/27/2008] [Indexed: 11/29/2022]
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