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Gouveia D, Cardoso A, Carvalho C, Rijo I, Almeida A, Gamboa Ó, Lopes B, Sousa P, Coelho A, Balça MM, Salgado AJ, Alvites R, Varejão ASP, Maurício AC, Ferreira A, Martins Â. The Role of Early Rehabilitation and Functional Electrical Stimulation in Rehabilitation for Cats with Partial Traumatic Brachial Plexus Injury: A Pilot Study on Domestic Cats in Portugal. Animals (Basel) 2024; 14:323. [PMID: 38275783 PMCID: PMC10812540 DOI: 10.3390/ani14020323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
This prospective observational cohort pilot study included 22 cats diagnosed with partial traumatic brachial plexus injury (PTBPI), aiming to explore responses to an early intensive neurorehabilitation protocol in a clinical setting. This protocol included functional electrical stimulation (FES), locomotor treadmill training and kinesiotherapy exercises, starting at the time with highest probability of nerve repair. The synergetic benefits of this multimodal approach were based on the potential structural and protective role of proteins and the release of neurotrophic factors. Furthermore, FES was parametrized according to the presence or absence of deep pain. Following treatment, 72.6% of the cats achieved ambulation: 9 cats within 15 days, 2 cats within 30 days and 5 cats within 60 days. During the four-year follow-up, there was evidence of improvement in both muscle mass and muscle weakness, in addition to the disappearance of neuropathic pain. Notably, after the 60 days of neurorehabilitation, 3 cats showed improved ambulation after arthrodesis of the carpus. Thus, early rehabilitation, with FES applied in the first weeks after injury and accurate parametrization according to the presence or absence of deep pain, may help in functional recovery and ambulation, reducing the probability of amputation.
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Affiliation(s)
- Débora Gouveia
- Arrábida Veterinary Hospital—Arrábida Animal Rehabilitation Center, 2925-538 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (I.R.); (Â.M.)
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Campo Grande, 1950-396 Lisboa, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Campo Grande, 1749-024 Lisboa, Portugal
| | - Ana Cardoso
- Arrábida Veterinary Hospital—Arrábida Animal Rehabilitation Center, 2925-538 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (I.R.); (Â.M.)
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Campo Grande, 1950-396 Lisboa, Portugal
| | - Carla Carvalho
- Arrábida Veterinary Hospital—Arrábida Animal Rehabilitation Center, 2925-538 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (I.R.); (Â.M.)
| | - Inês Rijo
- Arrábida Veterinary Hospital—Arrábida Animal Rehabilitation Center, 2925-538 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (I.R.); (Â.M.)
| | - António Almeida
- Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal; (A.A.); (Ó.G.); (A.F.)
| | - Óscar Gamboa
- Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal; (A.A.); (Ó.G.); (A.F.)
| | - Bruna Lopes
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, n° 228, 4050-313 Porto, Portugal; (B.L.); (P.S.); (A.C.); (M.M.B.); (R.A.)
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto (ICETA), Rua D. Manuel II, 4051-401 Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 1300-477 Lisboa, Portugal;
| | - Patrícia Sousa
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, n° 228, 4050-313 Porto, Portugal; (B.L.); (P.S.); (A.C.); (M.M.B.); (R.A.)
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto (ICETA), Rua D. Manuel II, 4051-401 Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 1300-477 Lisboa, Portugal;
| | - André Coelho
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, n° 228, 4050-313 Porto, Portugal; (B.L.); (P.S.); (A.C.); (M.M.B.); (R.A.)
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto (ICETA), Rua D. Manuel II, 4051-401 Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 1300-477 Lisboa, Portugal;
| | - Maria Manuel Balça
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, n° 228, 4050-313 Porto, Portugal; (B.L.); (P.S.); (A.C.); (M.M.B.); (R.A.)
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto (ICETA), Rua D. Manuel II, 4051-401 Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 1300-477 Lisboa, Portugal;
| | - António J. Salgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal;
- ICVS/3B’s—PT Government Associate Laboratory, 4710-057 Braga, Portugal
| | - Rui Alvites
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, n° 228, 4050-313 Porto, Portugal; (B.L.); (P.S.); (A.C.); (M.M.B.); (R.A.)
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto (ICETA), Rua D. Manuel II, 4051-401 Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 1300-477 Lisboa, Portugal;
- Instituto Universitário de Ciências da Saúde (CESPU), Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal
| | - Artur Severo P. Varejão
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 1300-477 Lisboa, Portugal;
- Department of Veterinary Sciences, Universidade de Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal
- Centro de Ciência Animal e Veterinária (CECAV), Universidade de Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Ana Colette Maurício
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, n° 228, 4050-313 Porto, Portugal; (B.L.); (P.S.); (A.C.); (M.M.B.); (R.A.)
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto (ICETA), Rua D. Manuel II, 4051-401 Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 1300-477 Lisboa, Portugal;
| | - António Ferreira
- Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal; (A.A.); (Ó.G.); (A.F.)
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 1300-477 Lisboa, Portugal;
- CIISA—Centro Interdisciplinar-Investigação em Saúde Animal, Faculdade de Medicina Veterinária, Av. Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal
| | - Ângela Martins
- Arrábida Veterinary Hospital—Arrábida Animal Rehabilitation Center, 2925-538 Setúbal, Portugal; (D.G.); (A.C.); (C.C.); (I.R.); (Â.M.)
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Campo Grande, 1950-396 Lisboa, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Campo Grande, 1749-024 Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 1300-477 Lisboa, Portugal;
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Tavares Oliveira M, Maciel Santos M, Lucas Mayara da Cruz Reis K, Resende Oliveira L, DeSantana JM. Transcutaneous Electric Nerve Stimulation in Animal Model Studies: From Neural Mechanisms to Biological Effects for Analgesia. Neuromodulation 2024; 27:13-21. [PMID: 37115123 DOI: 10.1016/j.neurom.2023.02.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/11/2023] [Accepted: 02/01/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE This systematic and meta-analysis review evaluated the transcutaneous electrical nerve stimulation (TENS)-induced action mechanisms for animal analgesia. MATERIALS AND METHODS Two independent investigators identified relevant articles published until February 2021 through a literature review, and a random-effects meta-analysis was performed to synthesize the results. RESULTS Of the 6984 studies found in the data base search, 53 full-text articles were selected and used in the systematic review. Most studies used Sprague Dawley rats (66.03%). High-frequency TENS was applied to at least one group in 47 studies, and most applications were performed for 20 minutes (64.15%). Mechanical hyperalgesia was analyzed as the primary outcome in 52.83% of the studies and thermal hyperalgesia in 23.07% of studies using a heated surface. More than 50% of the studies showed a low risk of bias on allocation concealment, random housing, selective outcome reporting, and acclimatization before the behavioral tests. Blinding was not performed in only one study and random outcome assessment in another study; acclimatization before the behavioral tests was not performed in just one study. Many studies had an uncertain risk of bias. Meta-analyses indicated no difference between low-frequency and high-frequency TENS with variations among the pain models. CONCLUSIONS This systematic review and meta-analysis suggests that TENS has presented a substantial scientific foundation for its hypoalgesic effect in preclinical studies for analgesia.
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Affiliation(s)
| | - Mateus Maciel Santos
- Department of Physical Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Larissa Resende Oliveira
- Graduate Program in Physiological Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Josimari Melo DeSantana
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil; Department of Physical Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil; Graduate Program in Physiological Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
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Al-Zamil M, Minenko IA, Kulikova NG, Mansur N, Nuvakhova MB, Khripunova OV, Shurygina IP, Topolyanskaya SV, Trefilova VV, Petrova MM, Narodova EA, Soloveva IA, Nasyrova RF, Shnayder NA. Efficiency of Direct Transcutaneous Electroneurostimulation of the Median Nerve in the Regression of Residual Neurological Symptoms after Carpal Tunnel Decompression Surgery. Biomedicines 2023; 11:2396. [PMID: 37760837 PMCID: PMC10525175 DOI: 10.3390/biomedicines11092396] [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: 06/16/2023] [Revised: 07/28/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. CTS therapy includes wrist immobilization, kinesiotherapy, non-steroidal anti-inflammatory drugs, carpal tunnel steroid injection, acupuncture, and physical therapy. Carpal tunnel decompression surgery (CTDS) is recommended after failure of conservative therapy. In many cases, neurological disorders continue despite CTDS. The aim of this study was to investigate the efficiency of direct transcutaneous electroneurostimulation (TENS) of the median nerve in the regression of residual neurological symptoms after CTDS. Material and Methods: 60 patients aged 28-62 years with persisting sensory and motor disorders after CTDS were studied; 15 patients received sham stimulation with a duration 30 min.; 15 patients received high-frequency low-amplitude TENS (HF TENS) with a duration 30 min; 15 patients received low-frequency high-amplitude TENS (LF TENS) with a duration 30 min; and 15 patients received a co-administration of HF TENS (with a duration of15 min) and LF TENS (with a duration of 15 min). Results: Our research showed that TENS significantly decreased the pain syndrome, sensory disorders, and motor deficits in the patients after CTDS. Predominantly, negative and positive sensory symptoms and the pain syndrome improved after the HF TENS course. Motor deficits, reduction of fine motor skill performance, electromyography changes, and affective responses to chronic pain syndrome regressed significantly after the LF TENS course. Co-administration of HF TENS and LF TENS was significantly more effective than use of sham stimulation, HF TENS, or LF TENS in patients with residual neurological symptoms after CTDS.
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Affiliation(s)
- Mustafa Al-Zamil
- Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples’ Friendship University of Russia, 117198 Moscow, Russia; (N.G.K.); (N.M.)
- Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia;
| | - Inessa A. Minenko
- Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia;
- Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia;
| | - Natalia G. Kulikova
- Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples’ Friendship University of Russia, 117198 Moscow, Russia; (N.G.K.); (N.M.)
- National Medical Research Center for Rehabilitation and Balneology, 121099 Moscow, Russia;
| | - Numman Mansur
- Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples’ Friendship University of Russia, 117198 Moscow, Russia; (N.G.K.); (N.M.)
- Department of Restorative Medicine and Neurorehabilitation, Medical Dental Institute, 127253 Moscow, Russia;
- City Clinical Hospital Named after V. V. Vinogradov, 117292 Moscow, Russia
| | - Margarita B. Nuvakhova
- National Medical Research Center for Rehabilitation and Balneology, 121099 Moscow, Russia;
| | - Olga V. Khripunova
- Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia;
| | - Irina P. Shurygina
- Department of Ophthalmology, Rostov State Medical University, 344022 Rostov, Russia;
| | - Svetlana V. Topolyanskaya
- Department of Hospital Therapy No. 2, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia;
| | - Vera V. Trefilova
- Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia; (V.V.T.); (R.F.N.)
| | - Marina M. Petrova
- Shared Core Facilities “Molecular and Cell Technologies”, Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (E.A.N.); (I.A.S.)
| | - Ekaterina A. Narodova
- Shared Core Facilities “Molecular and Cell Technologies”, Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (E.A.N.); (I.A.S.)
| | - Irina A. Soloveva
- Shared Core Facilities “Molecular and Cell Technologies”, Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (E.A.N.); (I.A.S.)
| | - Regina F. Nasyrova
- Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia; (V.V.T.); (R.F.N.)
| | - Natalia A. Shnayder
- Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia; (V.V.T.); (R.F.N.)
- Shared Core Facilities “Molecular and Cell Technologies”, Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (E.A.N.); (I.A.S.)
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Pion AM, Roy AA, Ma X, Beaumont E, Lin JC. Transcutaneous and Direct Electrical Stimulation of Mouse Sciatic Nerve Accelerates Functional Recovery After Nerve Transection and Immediate Repair. Ann Plast Surg 2023; 90:237-241. [PMID: 36796045 DOI: 10.1097/sap.0000000000003463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Electrical stimulation can accelerate peripheral nerve regeneration after injury and repair. Clinically, direct electrical stimulation (DES) may involve longer operating times, increasing risks of perioperative complications. Transcutaneous electrical stimulation (TCES) is a noninvasive alternative. In this study, we investigate how transcutaneous and DES compare for accelerating functional nerve recovery in a mouse sciatic nerve model. METHODS Twenty-eight mice were divided into sham (n = 4), axotomy (n = 8), DES (n = 8), and TCES (n = 8) groups. After sciatic nerve transection and repair, the proximal nerve was subjected to DES or TCES at 20 Hz for 1 hour. Sciatic functional index was measured before the injury, and at weeks 1, 2, 4, 6, 8, 10, and 12 by walking-track analysis. Electrophysiological measures were taken at week 12. RESULTS Kinematic studies showed significant improvement from the 8th week to the 12th week for both electrical stimulation groups compared with the axotomy group (P < 0.05), with no difference between the electrical stimulation groups. At the 12th week, both DES and TCES groups had significantly faster average conduction velocity than the axotomy group. CONCLUSIONS Functional recovery was significantly better from 8 weeks onward in mice receiving either DES or TCES stimulation when compared with axotomy and repair alone. Transcutaneous electrical stimulation is a minimally invasive alternative treatment for accelerating functional recovery after peripheral nerve injury.
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Affiliation(s)
- Anne-Marie Pion
- From the Plastic Surgery, Faculty of Medicine, University of Montréal, Montreal, Quebec, Canada
| | - Andrée-Anne Roy
- From the Plastic Surgery, Faculty of Medicine, University of Montréal, Montreal, Quebec, Canada
| | - Xiya Ma
- From the Plastic Surgery, Faculty of Medicine, University of Montréal, Montreal, Quebec, Canada
| | - Eric Beaumont
- Faculty of Medicine, East Tennessee State University, Johnson City, TN
| | - Jenny C Lin
- From the Plastic Surgery, Faculty of Medicine, University of Montréal, Montreal, Quebec, Canada
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Cho YS, Ryu O, Cho K, Kim D, Lim J, Hong SH, Cho YS. The effect of charge-balanced transcutaneous electrical nerve stimulation on rodent facial nerve regeneration. Sci Rep 2022; 12:1388. [PMID: 35082405 PMCID: PMC8791984 DOI: 10.1038/s41598-022-05542-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 12/30/2021] [Indexed: 01/23/2023] Open
Abstract
This study aimed to investigate the effect of charge-balanced transcutaneous electrical nerve stimulation (cb-TENS) in accelerating recovery of the facial function and nerve regeneration after facial nerve (FN) section in a rat model. The main trunk of the left FN was divided and immediately sutured just distal to the stylomastoid foramen in 66 Sprague-Dawley rats. The control group had no electrical stimulus. The other two groups received cb-TENS at 20 Hz (20 Hz group) or 40 Hz (40 Hz group). Cb-TENS was administered daily for seven days and then twice a week for three weeks thereafter. To assess the recovery of facial function, whisker movement was monitored for four weeks. Histopathological evaluation of nerve regeneration was performed using transmission electron microscopy (TEM) and confocal microscopy with immunofluorescence (IF) staining. In addition, the levels of various molecular biological markers that affect nerve regeneration were analyzed. Whisker movement in the cb-TENS groups showed faster and better recovery than the control group. The 40 Hz group showed significantly better movement at the first week after injury (p < 0.0125). In histopathological analyses using TEM, nerve axons and Schwann cells, which were destroyed immediately after the injury, recovered in all groups over time. However, the regeneration of the myelin sheath was remarkably rapid and thicker in the 20 Hz and 40 Hz groups than in the control group. Image analysis using IF staining showed that the expression levels of S100B and NF200 increased over time in all groups. Specifically, the expression of NF200 in the 20 Hz and 40 Hz groups increased markedly compared to the control group. The real-time polymerase chain reaction was performed on ten representative neurotrophic factors, and the levels of IL-1β and IL-6 were significantly higher in the 20 and 40 Hz groups than in the control group (p < 0.015). Cb-TENS facilitated and accelerated FN recovery in the rat model, as it significantly reduced the recovery time for the whisker movement. The histopathological study and analysis of neurotrophic factors supported the role of cb-TENS in the enhanced regeneration of the FN.
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Affiliation(s)
- Young Sang Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | | | | | - Jihyun Lim
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Sung Hwa Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Yang-Sun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Alarcón JB, Chuhuaicura PB, Sluka KA, Vance CG, Fazan VPS, Godoy KA, Fuentes RE, Dias FJ. Transcutaneous Electrical Nerve Stimulation in Nerve Regeneration: A Systematic Review of In Vivo Animal Model Studies. Neuromodulation 2022; 25:1248-1258. [DOI: 10.1016/j.neurom.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/18/2021] [Accepted: 12/08/2021] [Indexed: 01/25/2023]
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Mattos E, Guedes A, Lessa PIF, Baptista AF. Influence of surface peripheral electrical stimulation on nerve regeneration after digital nerve neurorrhaphy: study protocol for a randomized clinical trial. F1000Res 2021; 10:219. [PMID: 34909180 PMCID: PMC8596177 DOI: 10.12688/f1000research.42120.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 11/28/2022] Open
Abstract
We will study the influence of low intensity and frequency surface peripheral electrical stimulation (PES) on nerve regeneration of digital nerve injuries of the hand after its surgical repair in humans. Participants will be patients with acute traumatic peripheral nerve injury referred to the Hand Surgery Service of the General Hospital of the State of Bahia, a reference service in the state. These patients will undergo surgery followed by PES in the immediate postoperative period. After hospital discharge, they will be followed up on an outpatient basis by researchers, who will remotely supervise a physiotherapy program. Our hypothesis is that PES will positively influence the recovery of sensory function in patients undergoing neurorrhaphy of digital nerves of the hand. ReBEC registration: U1111-1259-1998 (12/18/2020)
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Affiliation(s)
- Enilton Mattos
- Pos Graduate Program in Medicine and Human Health, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.,Professor Edgard Santos University Hospital Complex, Salvador, Bahia, Brazil
| | - Alex Guedes
- Professor Edgard Santos University Hospital Complex, Salvador, Bahia, Brazil.,Bahia Medical School, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Abrahão Fontes Baptista
- Pos Graduate Program in Medicine and Human Health, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.,Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, São Paulo, Brazil.,Laboratory of Medical Investigations 54 (LIM-54), São Paulo University, São Paulo, São Paulo, Brazil
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Allen MD, Dalton BH, Gilmore KJ, McNeil CJ, Doherty TJ, Rice CL, Power GA. Neuroprotective effects of exercise on the aging human neuromuscular system. Exp Gerontol 2021; 152:111465. [PMID: 34224847 DOI: 10.1016/j.exger.2021.111465] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 05/31/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022]
Abstract
Human biological aging from maturity to senescence is associated with a gradual loss of muscle mass and neuromuscular function. It is not until very old age (>80 years) however, that these changes often manifest into functional impairments. A driving factor underlying the age-related loss of muscle mass and function is the reduction in the number and quality of motor units (MUs). A MU consists of a single motoneuron, located either in the spinal cord or the brain stem, and all of the muscle fibres it innervates via its peripheral axon. Throughout the adult lifespan, MUs are slowly, but progressively lost. The compensatory process of collateral reinnervation attempts to recapture orphaned muscle fibres following the death of a motoneuron. Whereas this process helps mitigate loss of muscle mass during the latter decades of adult aging, the neuromuscular system has fewer and larger MUs, which have lower quality connections between the axon terminal and innervated muscle fibres. Whether this process of MU death and degradation can be attenuated with habitual physical activity has been a challenging question of great interest. This review focuses on age-related alterations of the human neuromuscular system, with an emphasis on the MU, and presents findings on the potential protective effects of lifelong physical activity. Although there is some discrepancy across studies of masters athletes, if one considers all experimental limitations as well as the available literature in animals, there is compelling evidence of a protective effect of chronic physical training on human MUs. Our tenet is that high-levels of physical activity can mitigate the natural trajectory of loss of quantity and quality of MUs in old age.
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Affiliation(s)
- Matti D Allen
- Department of Physical Medicine and Rehabilitation, School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON K7L 4X3, Canada; School of Kinesiology and Health Studies, Faculty of Arts and Sciences, Queen's University, Kingston, ON K7L 4X3, Canada
| | - Brian H Dalton
- School of Health and Exercise Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Kevin J Gilmore
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E1, Canada
| | - Chris J McNeil
- School of Health and Exercise Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Timothy J Doherty
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Charles L Rice
- School of Kinesiology, The University of Western Ontario, London, ON, Canada; Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
| | - Geoffrey A Power
- Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
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Beeve AT, Shen I, Zhang X, Magee K, Yan Y, MacEwan MR, Scheller EL. Neuroskeletal Effects of Chronic Bioelectric Nerve Stimulation in Health and Diabetes. Front Neurosci 2021; 15:632768. [PMID: 33935630 PMCID: PMC8080454 DOI: 10.3389/fnins.2021.632768] [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: 11/24/2020] [Accepted: 03/16/2021] [Indexed: 12/02/2022] Open
Abstract
Background/Aims Bioelectric nerve stimulation (eStim) is an emerging clinical paradigm that can promote nerve regeneration after trauma, including within the context of diabetes. However, its ability to prevent the onset of diabetic peripheral neuropathy (DPN) has not yet been evaluated. Beyond the nerve itself, DPN has emerged as a potential contributor to sarcopenia and bone disease; thus, we hypothesized that eStim could serve as a strategy to simultaneously promote neural and musculoskeletal health in diabetes. Methods To address this question, an eStim paradigm pre-optimized to promote nerve regeneration was applied to the sciatic nerve, which directly innervates the tibia and lower limb, for 8 weeks in control and streptozotocin-induced type 1 diabetic (T1D) rats. Metabolic, gait, nerve and bone assessments were used to evaluate the progression of diabetes and the effect of sciatic nerve eStim on neuropathy and musculoskeletal disease, while also considering the effects of cuff placement and chronic eStim in otherwise healthy animals. Results Rats with T1D exhibited increased mechanical allodynia in the hindpaw, reduced muscle mass, decreased cortical and cancellous bone volume fraction (BVF), reduced cortical bone tissue mineral density (TMD), and decreased bone marrow adiposity. Type 1 diabetes also had an independent effect on gait. Placement of the cuff electrode alone resulted in altered gait patterns and unilateral reductions in tibia length, cortical BVF, and bone marrow adiposity. Alterations in gait patterns were restored by eStim and tibial lengthening was favored unilaterally; however, eStim did not prevent T1D-induced changes in muscle, bone, marrow adiposity or mechanical sensitivity. Beyond this, chronic eStim resulted in an independent, bilateral reduction in cortical TMD. Conclusion Overall, these results provide new insight into the pathogenesis of diabetic neuroskeletal disease and its regulation by eStim. Though eStim did not prevent neural or musculoskeletal complications in T1D, our results demonstrate that clinical applications of peripheral neuromodulation ought to consider the impact of device placement and eStim on long-term skeletal health in both healthy individuals and those with metabolic disease. This includes monitoring for compounded bone loss to prevent unintended consequences including decreased bone mineral density and increased fracture risk.
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Affiliation(s)
- Alec T Beeve
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States.,Department of Internal Medicine, Division of Bone and Mineral Diseases, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Ivana Shen
- Department of Internal Medicine, Division of Bone and Mineral Diseases, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Xiao Zhang
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States.,Department of Internal Medicine, Division of Bone and Mineral Diseases, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Kristann Magee
- Department of Internal Medicine, Division of Bone and Mineral Diseases, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Ying Yan
- Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Matthew R MacEwan
- Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Erica L Scheller
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States.,Department of Internal Medicine, Division of Bone and Mineral Diseases, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
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10
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Xing HY, Liu N, Zhou MW. Satellite cell proliferation and myofiber cross-section area increase after electrical stimulation following sciatic nerve crush injury in rats. Chin Med J (Engl) 2020; 133:1952-1960. [PMID: 32826459 PMCID: PMC7462209 DOI: 10.1097/cm9.0000000000000822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Electrical stimulation has been recommended as an effective therapy to prevent muscle atrophy after nerve injury. However, the effect of electrical stimulation on the proliferation of satellite cells in denervated muscles has not yet been fully elucidated. This study was aimed to evaluate the changes in satellite cell proliferation after electrical stimulation in nerve injury and to determine whether these changes are related to the restoration of myofiber cross-section area (CSA). METHODS Sciatic nerve crush injury was performed in 48 male Sprague-Dawley rats. In half (24/48) of the rats, the gastrocnemius was electrically stimulated transcutaneously on a daily basis after injury, while the other half were not stimulated. Another group of 24 male Sprague-Dawley rats were used as sham operation controls without injury or stimulation. The rats were euthanized 2, 4, and 6 weeks later. After 5-bromo-2'-deoxyuridine (BrdU) labeling, the gastrocnemia were harvested for the detection of paired box protein 7 (Pax7), BrdU, myofiber CSA, and myonuclei number per fiber. All data were analyzed using two-way analysis of variance and Bonferroni post-hoc test. RESULTS The percentages of Pax7-positive nuclei (10.81 ± 0.56%) and BrdU-positive nuclei (34.29 ± 3.87%) in stimulated muscles were significantly higher compared to those in non-stimulated muscles (2.58 ± 0.33% and 1.30 ± 0.09%, respectively, Bonferroni t = 15.91 and 18.14, P < 0.05). The numbers of myonuclei per fiber (2.19 ± 0.24) and myofiber CSA (1906.86 ± 116.51 μm) were also increased in the stimulated muscles (Bonferroni t = 3.57 and 2.73, P < 0.05), and both were positively correlated with the Pax7-positive satellite cell content (R = 0.52 and 0.60, P < 0.01). There was no significant difference in the ratio of myofiber CSA/myonuclei number per fiber among the three groups. CONCLUSIONS Our results indicate that satellite cell proliferation is promoted by electrical stimulation after nerve injury, which may be correlated with an increase in myonuclei number and myofiber CSA.
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Affiliation(s)
- Hua-Yi Xing
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing 100191, China
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11
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Liao CF, Hsu ST, Chen CC, Yao CH, Lin JH, Chen YH, Chen YS. Effects of Electrical Stimulation on Peripheral Nerve Regeneration in a Silicone Rubber Conduit in Taxol-Treated Rats. MATERIALS 2020; 13:ma13051063. [PMID: 32120862 PMCID: PMC7084817 DOI: 10.3390/ma13051063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 02/06/2023]
Abstract
Taxol, a type of antimitotic agent, could modulate local inflammatory conditions in peripheral nerves, which may impair their regeneration and recovery when injured. This study provided in vivo trials of silicone rubber chambers to bridge a long 10 mm sciatic nerve defect in taxol-treated rats. It was aimed to determine the effects of electrical stimulation at various frequencies on regeneration of the sciatic nerves in the bridging conduits. Taxol-treated rats were divided into four groups (n = 10/group): sham control (no current delivered from the stimulator); and electrical stimulation (3 times/week for 3 weeks at 2, 20, and 200 Hz with 1 mA current intensity). Neuronal electrophysiology, animal behavior, neuronal connectivity, macrophage infiltration, calcitonin gene-related peptide (CGRP) expression levels, and morphological observations were evaluated. At the end of 4 weeks, animals in the low- (2 Hz) and medium-frequency (20 Hz) groups had dramatic higher rates of successful regeneration (90% and 80%) across the wide gap as compared to the groups of sham and high-frequency (200 Hz) (60% and 50%). In addition, the 2 Hz group had significantly larger amplitudes and evoked muscle action potentials compared to the sham and the 200 Hz group, respectively (P < 0.05). Heat, cold plate licking latencies, motor coordination, and neuronal connectivity were unaffected by the electrical stimulation. Macrophage density, CGRP expression level, and axon number were all significantly increased in the 20 Hz group compared to the sham group (P < 0.05). This study suggested that low- (2 Hz) to medium-frequency (20 Hz) electrical stimulation could ameliorate local inflammatory conditions to augment recovery of regenerating nerves by accelerating their regrowth and improving electrophysiological function in taxol-treated peripheral nerve injury repaired with the silicone rubber conduit.
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Affiliation(s)
- Chien-Fu Liao
- Department of Biological Science and Technology, School of Medicine, China Medical University, Taichung 40402, Taiwan; (C.-F.L.); (C.-H.Y.)
| | - Shih-Tien Hsu
- Lab of Biomaterials, Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan;
- Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Chung-Chia Chen
- Linsen Chinese Medicine and Kunming Branch, Taipei City Hospital, Taipei 10341, Taiwan;
| | - Chun-Hsu Yao
- Department of Biological Science and Technology, School of Medicine, China Medical University, Taichung 40402, Taiwan; (C.-F.L.); (C.-H.Y.)
- Lab of Biomaterials, Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan;
- Department of Bioinformatics and Medical Engineering, Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Biomaterials Translational Research Center, China Medical University Hospital, Taichung 40447, Taiwan
| | - Jia-Horng Lin
- Department of Fiber and Composite Materials, Feng Chia University, Taichung 40724, Taiwan;
| | - Yung-Hsiang Chen
- Department of Bioinformatics and Medical Engineering, Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 40402, Taiwan
- Correspondence: (Y.-H.C.); (Y.-S.C.)
| | - Yueh-Sheng Chen
- Department of Biological Science and Technology, School of Medicine, China Medical University, Taichung 40402, Taiwan; (C.-F.L.); (C.-H.Y.)
- Lab of Biomaterials, Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan;
- Department of Bioinformatics and Medical Engineering, Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Biomaterials Translational Research Center, China Medical University Hospital, Taichung 40447, Taiwan
- Correspondence: (Y.-H.C.); (Y.-S.C.)
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12
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Oliveira MA, Heimfarth L, Passos FRS, Miguel-Dos-Santos R, Mingori MR, Moreira JCF, Lauton SS, Barreto RSS, Araújo AAS, Oliveira AP, Oliveira JT, Baptista AF, Martinez AMB, Quintans-Júnior LJ, Quintans JSS. Naringenin complexed with hydroxypropyl-β-cyclodextrin improves the sciatic nerve regeneration through inhibition of p75 NTR and JNK pathway. Life Sci 2020; 241:117102. [PMID: 31790691 DOI: 10.1016/j.lfs.2019.117102] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/19/2019] [Accepted: 11/22/2019] [Indexed: 11/17/2022]
Abstract
Peripheral nerve injuries are common conditions that often lead to dysfunctions. Although much knowledge exists on the several factors that mediate the complex biological process involved in peripheral nerve regeneration, there is a lack of effective treatments that ensure full functional recovery. Naringenin (NA) is the most abundant flavanone found in citrus fruits and it has promising neuroprotective, anti-inflammatory and antioxidant effects. This study aimed to enhance peripheral nerve regeneration using an inclusion complex containing NA and hydroxypropyl-β-cyclodextrin (HPβCD), named NA/HPβCD. A mouse sciatic nerve crush model was used to evaluate the effects of NA/HPβCD on nerve regeneration. Sensory and motor parameters, hyperalgesic behavior and the sciatic functional index (SFI), respectively, improved with NA treatment. Western blot analysis revealed that the levels of p75NTR ICD and p75NTR full length as well phospho-JNK/total JNK ratios were preserved by NA treatment. In addition, NA treatment was able to decrease levels of caspase 3. The concentrations of TNF-α and IL-1β were decreased in the lumbar spine, on the other hand there was an increase in IL-10. NA/HPβCD presented a better overall morphological profile but it was not able to increase the number of myelinated fibers. Thus, NA was able to enhance nerve regeneration, and NA/HPβCD decreased effective drug doses while maintaining the effect of the pure drug, demonstrating the advantage of using the complex over the pure compound.
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Affiliation(s)
- Marlange A Oliveira
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Luana Heimfarth
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Fabiolla Rocha Santos Passos
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Rodrigo Miguel-Dos-Santos
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Moara R Mingori
- Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - José Cláudio F Moreira
- Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Sandra S Lauton
- Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Rosana S S Barreto
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil
| | - Adriano A S Araújo
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Aldeidia P Oliveira
- Medicinal Plants Research Center, Federal University of Piauí, Teresina, PI 64.049-550, Brazil
| | - Júlia T Oliveira
- Department of Pathology, Medical School - HUCFF - Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Ana Maria B Martinez
- Department of Pathology, Medical School - HUCFF - Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucindo J Quintans-Júnior
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil.
| | - Jullyana S S Quintans
- Multiuser Health Center Facility (CMulti-Saúde), Federal University of Sergipe; Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, 49100-000 lBrazil.
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13
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Senger JLB, Chan KM, Webber CA. Conditioning electrical stimulation is superior to postoperative electrical stimulation, resulting in enhanced nerve regeneration and functional recovery. Exp Neurol 2019; 325:113147. [PMID: 31837321 DOI: 10.1016/j.expneurol.2019.113147] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/25/2019] [Accepted: 12/10/2019] [Indexed: 01/11/2023]
Abstract
Postoperative electrical stimulation (PES) improves nerve regeneration by decreasing staggered regeneration at the coaptation site. By contrast, conditioning (preoperative) electrical stimulation (CES) accelerates axon extension. Given that both techniques can be delivered at the bedside, a direct comparison of outcomes is of significant clinical importance. In this study, we compared regeneration and reinnervation outcomes of CES, PES, a combination of CES and PES, and a no stimulation control. Sprague Dawley rats were randomly divided into i) CES, ii) PES, iii) CES + PES, and iv) no stimulation. CES was delivered one week prior to nerve cut/coaptation, and PES was delivered immediately following nerve repair. Length of nerve regeneration was assessed at 7 days post-coaptation (n = 6/cohort), and behavioral testing was performed between 6 and 8 weeks post-coaptation (n = 8/cohort). Animals treated with CES had significantly longer axon extension and improved sensorimotor recovery compared to all other cohorts. CES treated axons extended 8.5 ± 0.6 mm, significantly longer than PES (5.5 ± 0.5 mm), CES + PES (3.6 ± 0.7 mm), or no stimulation (2.7 ± 0.5 mm) (p < .001). Sensory recovery (von Frey filament testing, intraepidermal nerve fiber reinnervation) (p < .001) and motor reinnervation (horizontal ladder, gait analysis, nerve conduction studies, neuromuscular junction analysis) (p < .05 - p < .001) were significantly improved in CES animals. CES significantly improves regeneration and reinnervation beyond the current clinical paradigm of PES. The combination of CES and PES does not have a synergistic effect. CES alone therefore may be a more promising treatment to improve outcomes in patients undergoing nerve repair surgeries.
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Affiliation(s)
| | - K Ming Chan
- Division of Physical Medicine and Rehabilitation, University of Alberta, Alberta, Canada
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14
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Qian Y, Cheng Y, Cai J, Zhao X, Ouyang Y, Yuan WE, Fan C. Advances in electrical and magnetic stimulation on nerve regeneration. Regen Med 2019; 14:969-979. [PMID: 31583954 DOI: 10.2217/rme-2018-0079] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Central and peripheral nerve injuries pose a great threat to people. Complications such as inflammation, muscle atrophy, traumatic neuromas and delayed reinnervation can bring huge challenges to clinical practices and barriers to complete nerve regrowth. Physical interventions such as electrical and magnetic stimulation show satisfactory results with varying parameters for acute and chronic nerve damages. The biological basis of electrical and magnetic stimulation mainly relies on protein synthesis, ion channel regulation and growth factor secretion. This review focuses on the various paradigms used in different models of electrical and magnetic stimulation and their regenerative potentials and underlying mechanisms in nerve injuries. The combination of physical stimulation and conductive biomaterial scaffolds displays an infinite potentiality in translational application in nerve regeneration.
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Affiliation(s)
- Yun Qian
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China
| | - Yuan Cheng
- Engineering Research Center of Cell & Therapeutic Antibody, Ministry of Education, & School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Jiangyu Cai
- Department of Sports Medicine & Arthroscopic Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, PR China
| | - Xiaotian Zhao
- Engineering Research Center of Cell & Therapeutic Antibody, Ministry of Education, & School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Yuanming Ouyang
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China
- Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201306, PR China
| | - Wei-En Yuan
- Engineering Research Center of Cell & Therapeutic Antibody, Ministry of Education, & School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Cunyi Fan
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China
- Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201306, PR China
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15
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Imani M, Kazemi S, Saviz M, Farahmand L, Sadeghi B, Faraji-Dana R. Morphological Changes Induced By Extremely Low-Frequency Electric Fields. Bioelectromagnetics 2019; 40:375-390. [PMID: 31157927 DOI: 10.1002/bem.22195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 04/16/2019] [Indexed: 01/27/2023]
Abstract
In this paper, morphological effects of electric fields on avian erythrocytes (nucleated red blood cells) have been studied in detail. Morphological changes include rounding and cytoplasm transparency. It has been shown that the effect is non-thermal. Careful imaging and image analyses have been carried out to show that the degree of this effect is frequency-dependent, and has a higher conversion rate at higher temperatures. Furthermore, to better understand the mechanisms behind the morphological changes, we investigated the dedifferentiation hypothesis and performed a series of tests on avian erythrocytes including fluorescence spectroscopy for hemoglobin, and tests on human umbilical cord blood, mesenchymal stem cells, and bone marrow mesenchymal stem cells including flow-cytometry analysis for expression of certain markers and calcium staining. Bioelectromagnetics. 2019;40:375-390. © 2019 Bioelectromagnetics Society.
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Affiliation(s)
- Mahdi Imani
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Sepide Kazemi
- Department of Immunotherapy and Regenerative Medicine, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Mehrdad Saviz
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Leila Farahmand
- Department of Recombinant Proteins, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Behnam Sadeghi
- Department of Immunotherapy and Regenerative Medicine, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Reza Faraji-Dana
- INSF Chair of Computational Electromagnetics and Bio-electromagnetics, School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
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16
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Rice FL, Castel D, Ruggiero E, Dockum M, Houk G, Sabbag I, Albrecht PJ, Meilin S. Human-like cutaneous neuropathologies associated with a porcine model of peripheral neuritis: A translational platform for neuropathic pain. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2019; 5:100021. [PMID: 31194066 PMCID: PMC6550106 DOI: 10.1016/j.ynpai.2018.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/19/2018] [Accepted: 07/19/2018] [Indexed: 01/10/2023]
Abstract
Despite enormous investment in research and development of novel treatments, there remains a lack of predictable, effective, and safe therapeutics for human chronic neuropathic pain (NP) afflictions. NP continues to increase among the population and treatments remain a major unmet public health care need. In recent years, numerous costly (time and money) failures have occurred attempting to translate successful animal pain model results, typically using rodents, to human clinical trials. These continued failures point to the essential need for better animal models of human pain conditions. To address this challenge, we have previously developed a peripheral neuritis trauma (PNT) model of chronic pain induced by a proximal sciatic nerve irritation in pigs, which have a body size, metabolism, skin structure, and cutaneous innervation more similar to humans. Here, we set out to determine the extent that the PNT model presents with cutaneous neuropathologies consistent with those associated with human chronic NP afflictions. Exactly as is performed in human skin biopsies, extensive quantitative multi-molecular immunofluorescence analyses of porcine skin biopsies were performed to assess cutaneous innervation and skin structure. ChemoMorphometric Analysis (CMA) results demonstrated a significant reduction in small caliber intraepidermal nerve fiber (IENF) innervation, altered dermal vascular innervation, and aberrant analgesic/algesic neurochemical properties among epidermal keratinocytes, which are implicated in modulating sensory innervation. These comprehensive pathologic changes very closely resemble those observed from CMA of human skin biopsies collected from NP afflictions. The results indicate that the porcine PNT model is more appropriate for translational NP research compared with commonly utilized rodent models. Because the PNT model creates cutaneous innervation and keratinocyte immunolabeling alterations consistent with human NP conditions, use of this animal model for NP testing and treatment response characteristics will likely provide more realistic results to direct successful translation to humans.
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Affiliation(s)
- Frank L. Rice
- Neuroscience & Pain Research Group, Integrated Tissue Dynamics, LLC, Rensselaer, NY 12144, United States
- Division of Health Sciences, University at Albany, Rensselaer, NY 12144, United States
| | - David Castel
- The Neufeld Cardiac Research Institute, Sheba Medical Centre, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Elizabeth Ruggiero
- Neuroscience & Pain Research Group, Integrated Tissue Dynamics, LLC, Rensselaer, NY 12144, United States
| | - Marilyn Dockum
- Neuroscience & Pain Research Group, Integrated Tissue Dynamics, LLC, Rensselaer, NY 12144, United States
| | - George Houk
- Neuroscience & Pain Research Group, Integrated Tissue Dynamics, LLC, Rensselaer, NY 12144, United States
| | - Itai Sabbag
- Lahav Research Institute, Kibutz Lahav, Negev 85335, Israel
| | - Phillip J. Albrecht
- Neuroscience & Pain Research Group, Integrated Tissue Dynamics, LLC, Rensselaer, NY 12144, United States
- Division of Health Sciences, University at Albany, Rensselaer, NY 12144, United States
| | - Sigal Meilin
- MD Biosciences, Neurology R&D Division, Nes-Ziona 74140, Israel
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17
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Langer HT, Senden JMG, Gijsen AP, Kempa S, van Loon LJC, Spuler S. Muscle Atrophy Due to Nerve Damage Is Accompanied by Elevated Myofibrillar Protein Synthesis Rates. Front Physiol 2018; 9:1220. [PMID: 30233398 PMCID: PMC6127268 DOI: 10.3389/fphys.2018.01220] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/13/2018] [Indexed: 12/15/2022] Open
Abstract
Muscle loss is a severe complication of many medical conditions such as cancer, cardiac failure, muscular dystrophies, and nerve damage. The contribution of myofibrillar protein synthesis (MPS) to the loss of muscle mass after nerve damage is not clear. Using deuterium oxide (D2O) labeling, we demonstrate that MPS is significantly increased in rat m.tibialis anterior (TA) compared to control (3.23 ± 0.72 [damaged] to 2.09 ± 0.26%∗day−1 [control]) after 4 weeks of nerve constriction injury. This is the case despite substantial loss of mass of the TA (350 ± 96 mg [damaged] to 946 ± 361 mg [control]). We also show that expression of regulatory proteins involved with MPS (p70s6k1: 2.4 ± 0.3 AU [damaged] to 1.8 ± 0.2 AU [control]) and muscle protein breakdown (MPB) (MAFbx: 5.3 ± 1.2 AU [damaged] to 1.4 ± 0.4 AU [control]) are increased in nerve damaged muscle. Furthermore, the expression of p70s6k1 correlates with MPS rates (r2 = 0.57). In conclusion, this study shows that severe muscle wasting following nerve damage is accompanied by increased as opposed to decreased MPS.
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Affiliation(s)
- Henning T Langer
- Experimental and Clinical Research Center, a Joint Cooperation of Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Joan M G Senden
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Annemie P Gijsen
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Stefan Kempa
- Berlin Institute of Health, Berlin, Germany.,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Luc J C van Loon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Simone Spuler
- Experimental and Clinical Research Center, a Joint Cooperation of Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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18
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Alvites R, Rita Caseiro A, Santos Pedrosa S, Vieira Branquinho M, Ronchi G, Geuna S, Varejão AS, Colette Maurício A. Peripheral nerve injury and axonotmesis: State of the art and recent advances. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1466404] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Rui Alvites
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
| | - Ana Rita Caseiro
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
- Departamento de Engenharia Metalúrgica e Materiais, Faculdade de Engenharia, Universidade do Porto (REQUIMTE/LAQV), R. Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Sílvia Santos Pedrosa
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
| | - Mariana Vieira Branquinho
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
| | - Giulia Ronchi
- Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Stefano Geuna
- Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Artur S.P. Varejão
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
- Department of Clinical and Biological Sciences, and Cavalieri Ottolenghi Neuroscience Institute, University of Turin, Ospedale San Luigi, 10043 Orbassano, Turin, Italy
| | - Ana Colette Maurício
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
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de Oliveira RF, Goldman RS, Mendes FM, de Freitas PM. Influence of Electroacupuncture and Laser-Acupuncture on Treating Paresthesia in Patients Submitted to Combined Orthognathic Surgery and Genioplasty. Med Acupunct 2017; 29:290-299. [PMID: 29067139 DOI: 10.1089/acu.2017.1228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective: The goal of this research was to observe the influence of electroacupuncture (EA) and laser-acupuncture on the return of tactile/pain sensitivity in patients who underwent orthognathic surgery. Materials and Methods: Thirty volunteers subjected to orthognathic surgery were evaluated and randomly divided into 2 groups, in which 3 treatments were evaluated: control (n = 30) (G0, medication + placebo laser treatment) and 2 experimental treatments (n = 15) (G1, medication + EA) or G2 (medication + laser-acupuncture). The control group had n = 30 because for each experimental treatment conducted on a volunteer's hemi-face, there was a control treatment on the other hemi-face. In G1, medication was given with EA, with needles placed at predetermined points (ST 4 [Dicang], M-HN-18 [Jiachengjiang], CV 24 [Chengjiang], ST 5 [Daying], ST 6 [Jiache], and point A1 [YNSA]). For electrostimulation, the device used delivered transcutaneous electrical nerve stimulation of a burst type, with intensity and frequency variations of T = 220 ms and F = 4 Hz (30 minutes, 2 × /week). In G2, in addition to the medication, laser irradiation (at 780 nm) was applied on acupuncture points (at 0.04 cm2, 70 mW, 6 s/point, 0.42 J/point, 10 J/cm2, 2 × /week). All volunteers were evaluated before and during the 4 months following the surgery. Tactile sensitivity was assessed by mechanical brushing (brush #s 2 and 12) and by a 2-point discrimination test, using a bow compass. A pain test was performed with a pulp electrical test that stimulates intact nerves of the dentin-pulp complex. A Kaplan-Meier test was performed, and survival curves were plotted for comparison between groups. Cox regression analysis was also conducted (α = 0.05). Results: There were no statistically significant differences among the groups for the 2-point discrimination test (brushes #2 and #12) on the buccal mucosa region and for the pulp test on all evaluated regions. However, the tactile test using brush #12 revealed significant differences between G1 and the other groups when considering the lower lip (P = 0.024) and chin (P = 0.028) areas. Conclusions: Only EA was able to influence-using the brushing test (brush #12)-the return of tactile sensitivity on the chin and lower lip positively after combined orthognathic surgery and genioplasty.
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Affiliation(s)
- Renata F de Oliveira
- Special Laboratory of Lasers in Dentistry, Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Ricardo S Goldman
- Clínica de Cirurgia e Traumatologia Buco-Maxilo-Faciais, São Paulo, SP, Brazil
| | - Fausto Medeiros Mendes
- Department of Orthodontics and Pediatrics Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Patricia Moreira de Freitas
- Special Laboratory of Lasers in Dentistry, Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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Ribeiro T, Oliveira JT, Almeida FM, Tomaz MA, Melo PA, Marques SA, de Andrade GM, Martinez AMB. Blockade of ATP P2X7 receptor enhances ischiatic nerve regeneration in mice following a crush injury. Brain Res 2017; 1669:69-78. [PMID: 28554806 DOI: 10.1016/j.brainres.2017.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 05/15/2017] [Accepted: 05/22/2017] [Indexed: 12/31/2022]
Abstract
Preventing damage caused by nerve degeneration is a great challenge. There is a growing body of evidence implicating extracellular nucleotides and their P2 receptors in many pathophysiological mechanisms. In this work we aimed to investigate the effects of the administration of Brilliant Blue G (BBG) and Pyridoxalphosphate-6-azophenyl-2', 4'- disulphonic acid (PPADS), P2X7 and P2 non-selective receptor antagonists, respectively, on sciatic nerve regeneration. Four groups of mice that underwent nerve crush lesion were used: two control groups treated with vehicle (saline), a group treated with BBG and a group treated with PPADS during 28days. Gastrocnemius muscle weight was evaluated. For functional evaluation we used the Sciatic Functional Index (SFI) and the horizontal ladder walking test. Nerves, dorsal root ganglia and spinal cords were processed for light and electron microscopy. Antinoceptive effects of BBG and PPADS were evaluated through von Frey E, and the levels of IL-1β and TNF-α were analyzed by ELISA. BBG promoted an increase in the number of myelinated fibers and on axon, fiber and myelin areas. BBG and PPADS led to an increase of TNF-α and IL-1β in the nerve on day 1 and PPADS caused a decrease of IL-1β on day 7. Mechanical allodynia was reversed on day 7 in the groups treated with BBG and PPADS. We concluded that BBG promoted a better morphological regeneration after ischiatic crush injury, but this was not followed by anticipation of functional improvement. In addition, both PPADS and BBG presented anti-inflammatory as well as antinociceptive effects.
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Affiliation(s)
- Tatianne Ribeiro
- Laboratório de Neurodegeneração e Reparo, Departamento de Patologia, Faculdade de Medicina, HUCFF, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Júlia Teixeira Oliveira
- Laboratório de Neurodegeneração e Reparo, Departamento de Patologia, Faculdade de Medicina, HUCFF, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Fernanda Martins Almeida
- Laboratório de Neurodegeneração e Reparo, Departamento de Patologia, Faculdade de Medicina, HUCFF, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Marcelo Amorim Tomaz
- Laboratório de Farmacologia das Toxinas, Programa de Pós-Graduação em Farmacologia e Química Medicinal, ICB, CCS, UFRJ, Brazil
| | - Paulo A Melo
- Laboratório de Farmacologia das Toxinas, Programa de Pós-Graduação em Farmacologia e Química Medicinal, ICB, CCS, UFRJ, Brazil
| | - Suelen Adriani Marques
- Laboratório de Regeneração Neural e Função, Departamento de Neurobiologia, Instituto de Biologia, UFF, Rio de Janeiro, Brazil
| | - Geanne Matos de Andrade
- Laboratório de Neurociências e Comportamento, Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, UFC, Ceará, Brazil.
| | - Ana Maria Blanco Martinez
- Laboratório de Neurodegeneração e Reparo, Departamento de Patologia, Faculdade de Medicina, HUCFF, UFRJ, Rio de Janeiro, RJ, Brazil.
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Mendonça ACR, Rett MT, Garcez PDA, Aquino MJDV, Lima LV, DeSantana JM. TENS effects on dysesthesia and quality of life after breast cancer surgery with axilectomy: randomized controlled trial. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.s01.ao28] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract Introduction: After breast cancer surgery, many women may present quality of life (QOL) impairment due to the presence of discomfort as dysesthesia in the anterolateral region of the chest, armpit and/or medial part of the arm caused by intercostobrachial nerve injury (ICBN). Objective: To investigate the effects of Transcutaneous Electrical Nerve Stimulation (TENS) on dysesthesia intensity at the intercostobrachial nerve (ICBN) dermatome and QOL in women after breast cancer surgery. Methods: A randomized, double-blinded, placebo controlled clinical trial was conducted. Women undergoing axillary lymphadenectomy (AL), with dysesthesia on ICBN dermatome were included. Patients were divided into active and placebo TENS groups. TENS was applied with a frequency of 100 Hz, pulse duration of 100 µs and amplitude at the highest sensory intensity tolerable for 20 minutes during 20 sessions, three times a week, on alternating days. In the placebo TENS group, electrical current was delivered only during the first 45 seconds of application. Skin sensitivity was assessed by esthesiometry. Dysesthesia intensity was assessed with a visual analogue scale (VAS) and QOL with the EORTC QLQ-C30 and the specific EORTC QLQ-BR23 which is the Breast Cancer Module. Results: VAS decreased significantly over the 20 sessions in the active TENS group (p<0.006) and no difference was found between groups. There weren’t significant differences in EORTC QLQ-C30 and EORTC QLQ-BR23 after 20 sessions or between groups. Conclusion: TENS decreased dysesthesia intensity in the ICBN dermatome after breast cancer surgery, but did not improve quality of life.
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Badri O, Shahabi P, Abdolalizadeh J, Alipour MR, Veladi H, Farhoudi M, Zak MS. Combination therapy using evening primrose oil and electrical stimulation to improve nerve function following a crush injury of sciatic nerve in male rats. Neural Regen Res 2017; 12:458-463. [PMID: 28469662 PMCID: PMC5399725 DOI: 10.4103/1673-5374.202927] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Peripheral nerve injuries with a poor prognosis are common. Evening primrose oil (EPO) has beneficial biological effects and immunomodulatory properties. Since electrical activity plays a major role in neural regeneration, the present study investigated the effects of electrical stimulation (ES), combined with evening primrose oil (EPO), on sciatic nerve function after a crush injury in rats. In anesthetized rats, the sciatic nerve was crushed using small haemostatic forceps followed by ES and/or EPO treatment for 4 weeks. Functional recovery of the sciatic nerve was assessed using the sciatic functional index. Histopathological changes of gastrocnemius muscle atrophy were investigated by light microscopy. Electrophysiological changes were assessed by the nerve conduction velocity of sciatic nerves. Immunohistochemistry was used to determine the remyelination of the sciatic nerve following the interventions. EPO + ES, EPO, and ES obviously improved sciatic nerve function assessed by the sciatic functional index and nerve conduction velocity of the sciatic nerve at 28 days after operation. Expression of the peripheral nerve remyelination marker, protein zero (P0), was increased in the treatment groups at 28 days after operation. Muscle atrophy severity was decreased significantly while the nerve conduction velocity was increased significantly in rats with sciatic nerve injury in the injury + EPO + ES group than in the EPO or ES group. Totally speaking, the combined use of EPO and ES may produce an improving effect on the function of sciatic nerves injured by a crush. The increased expression of P0 may have contributed to improving the functional effects of combination therapy with EPO and ES as well as the electrophysiological and histopathological features of the injured peripheral nerve.
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Affiliation(s)
- Omid Badri
- Tabriz University of Medical Sciences, International Branch Aras, Tabriz, Iran
| | - Parviz Shahabi
- Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jalal Abdolalizadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Hadi Veladi
- Microsystem Fabrication Laboratory, Tabriz University, Tabriz, Iran
| | - Mehdi Farhoudi
- Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohsen Sharif Zak
- Department of Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Castel D, Sabbag I, Brenner O, Meilin S. Peripheral Neuritis Trauma in Pigs: A Neuropathic Pain Model. THE JOURNAL OF PAIN 2016; 17:36-49. [DOI: 10.1016/j.jpain.2015.09.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 09/21/2015] [Accepted: 09/26/2015] [Indexed: 12/29/2022]
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Histological study on the role of bone marrow-derived mesenchymal stem cells on the sciatic nerve and the gastrocnemius muscle in a model of sciatic nerve crush injury in albino rats. ACTA ACUST UNITED AC 2015. [DOI: 10.1097/01.ehx.0000470653.67231.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Bonetti LV, Ilha J, Schneider APK, Barbosa S, Faccioni-Heuser MC. Balance and coordination training, but not endurance training, enhances synaptophysin and neurotrophin-3 immunoreactivity in the lumbar spinal cord after sciatic nerve crush. Muscle Nerve 2015; 53:617-25. [PMID: 26316168 DOI: 10.1002/mus.24889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 08/19/2015] [Accepted: 08/25/2015] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Numerous rehabilitation treatments have been shown to be useful for peripheral and central restoration after (PNI). METHODS After sciatic nerve crush, we investigated 4 weeks of endurance training (ET) and balance and coordination training (BCT) with sciatic function index, hind-paw stride length, and spinal cord dorsal horn synaptophysin and neurotrophin-3 immunoreactivity. RESULTS Our results demonstrated no significant differences between the non-trained (NT), ET, and BCT groups in sciatic functional index, and in stride-length analysis, but the ET showed higher values compared with the NT group. Synaptophysin immunoreactivity was higher in the BCT group compared with the NT group, and neurotrophin-3 immunoreactivity in the BCT group was greater compared with the other groups. CONCLUSION BCT can positively affect spinal cord plasticity after a (PNI), and these modifications are important in the rehabilitation process.
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Affiliation(s)
- Leandro Viçosa Bonetti
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Laboratório de Histofisiologia Comparada, Departamento de Ciências Morfológicas, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Sarmento Leite 500, CEP 90050-170, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jocemar Ilha
- Laboratório de Pesquisa Experimental, Departamento de Fisioterapia, Universidade do Estado de Santa Catarina, Santa Catarina, Brazil
| | - Ana Paula Krauthein Schneider
- Laboratório de Histofisiologia Comparada, Departamento de Ciências Morfológicas, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Sarmento Leite 500, CEP 90050-170, Porto Alegre, Rio Grande do Sul, Brazil
| | - Silvia Barbosa
- Laboratório de Histofisiologia Comparada, Departamento de Ciências Morfológicas, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Sarmento Leite 500, CEP 90050-170, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Cristina Faccioni-Heuser
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Laboratório de Histofisiologia Comparada, Departamento de Ciências Morfológicas, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Sarmento Leite 500, CEP 90050-170, Porto Alegre, Rio Grande do Sul, Brazil
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Geuna S. The sciatic nerve injury model in pre-clinical research. J Neurosci Methods 2015; 243:39-46. [PMID: 25629799 DOI: 10.1016/j.jneumeth.2015.01.021] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 01/15/2015] [Accepted: 01/16/2015] [Indexed: 12/15/2022]
Abstract
In the pre-clinical view, the study of peripheral nerve repair and regeneration still needs to be carried out in animal models due to the structural complexity of this organ which can be only partly simulated in vitro. The far most used experimental model is based on the injury of the sciatic nerve, the largest nerve trunk in mammals. In this paper, the potential application of the sciatic nerve injury model in pre-clinical research is critically reviewed. This paper is aimed at helping researchers in properly employing this in vivo model for the study of nerve repair and regeneration as well as interpreting the results in a clinical translation perspective.
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Affiliation(s)
- Stefano Geuna
- Neuroscience Institute of the Cavalieri Ottolenghi Foundation & Department of Clinical and Biological Sciences, University of Turin, Italy.
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Xing H, Zhou M, Assinck P, Liu N. Electrical stimulation influences satellite cell differentiation after sciatic nerve crush injury in rats. Muscle Nerve 2015; 51:400-11. [PMID: 24947716 DOI: 10.1002/mus.24322] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2014] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Electrical stimulation is often used to prevent muscle atrophy and preserve contractile function, but its effects on the satellite cell population after nerve injury are not well understood. In this study we aimed to determine whether satellite cell differentiation is affected by electrical stimulation after nerve crush. METHODS The sciatic nerves of Sprague-Dawley (SD) rats were crushed. Half of the injured rats received daily electrical stimulation of the gastrocnemius muscle, and the others did not. Tests for detecting paired box protein 7 (Pax7), myogenic differentiation antigen (MyoD), embryonic myosin heavy chain (eMyHC), and force production were performed 2, 4, and 6 weeks after injury. RESULTS More Pax7+/MyoD+ nuclei in stimulated muscles were observed than in non-stimulated muscles. eMyHC expression was elevated in stimulated muscles and correlated positively with enhanced force production. CONCLUSIONS Increased satellite cell differentiation is correlated with preserved muscle function in response to electrical stimulation after nerve injury.
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Affiliation(s)
- Huayi Xing
- Department of Rehabilitation Medicine, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, PR China
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The parameters of transcutaneous electrical nerve stimulation are critical to its regenerative effects when applied just after a sciatic crush lesion in mice. BIOMED RESEARCH INTERNATIONAL 2014; 2014:572949. [PMID: 25147807 PMCID: PMC4131508 DOI: 10.1155/2014/572949] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 06/05/2014] [Accepted: 06/16/2014] [Indexed: 12/19/2022]
Abstract
We investigated the effect of two frequencies of transcutaneous electrical nerve stimulation (TENS) applied immediately after lesion on peripheral nerve regeneration after a mouse sciatic crush injury. The animals were anesthetized and subjected to crushing of the right sciatic nerve and then separated into three groups: nontreated, Low-TENS (4 Hz), and High-TENS (100 Hz). The animals of Low- and High-TENS groups were stimulated for 2 h immediately after the surgical procedure, while the nontreated group was only positioned for the same period. After five weeks the animals were euthanized, and the nerves dissected bilaterally for histological and histomorphometric analysis. Histological assessment by light and electron microscopy showed that High-TENS and nontreated nerves had a similar profile, with extensive signs of degeneration. Conversely, Low-TENS led to increased regeneration, displaying histological aspects similar to control nerves. High-TENS also led to decreased density of fibers in the range of 6-12 μm diameter and decreased fiber diameter and myelin area in the range of 0-2 μm diameter. These findings suggest that High-TENS applied just after a peripheral nerve crush may be deleterious for regeneration, whereas Low-TENS may increase nerve regeneration capacity.
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Kao CH, Chen JJJ, Hsu YM, Bau DT, Yao CH, Chen YS. High-frequency electrical stimulation can be a complementary therapy to promote nerve regeneration in diabetic rats. PLoS One 2013; 8:e79078. [PMID: 24265744 PMCID: PMC3827114 DOI: 10.1371/journal.pone.0079078] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 09/26/2013] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to evaluate whether 1 mA of percutaneous electrical stimulation (ES) at 0, 2, 20, or 200 Hz augments regeneration between the proximal and distal nerve stumps in streptozotocin diabetic rats. A10-mm gap was made in the diabetic rat sciatic nerve by suturing the stumps into silicone rubber tubes. Normal animals were used as the controls. Starting 1 week after transection, ES was applied between the cathode placed at the distal stump and the anode at the proximal stump every other day for 3 weeks. At 4 weeks after surgery, the normal controls and the groups receiving ES at 20, and 200 Hz had a higher success percentage of regeneration compared to the ES groups at 0 and 2 Hz. In addition, quantitative histology of the successfully regenerated nerves revealed that the groups receiving ES at a higher frequency, especially at 200 Hz, had a more mature structure with more myelinated fibers compared to those in the lower-frequency ES groups. Similarly, electrophysiology in the ES group at 200 Hz showed significantly shorter latency, larger amplitude, larger area of evoked muscle action potentials and faster conduction velocity compared to other groups. Immunohistochemical staining showed that ES at a higher frequency could significantly promote calcitonin gene-related peptide expression in lamina I-II regions in the dorsal horn and recruit a higher number of macrophages in the diabetic distal sciatic nerve. The macrophages were found that they could stimulate the secretion of nerve growth factor, platelet-derived growth factor, and transforming growth factor-β in dissected sciatic nerve segments. The ES at a higher frequency could also increase cutaneous blood flow in the ipsilateral hindpaw to the injury. These results indicated that a high-frequency ES could be necessary to heal severed diabetic peripheral nerve with a long gap to be repaired.
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Affiliation(s)
- Chia-Hong Kao
- Lab of Biomaterials, School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jia-Jin J. Chen
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Yuan-Man Hsu
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
| | - Da-Tian Bau
- Lab of Biomaterials, School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Terry Fox Cancer Research Lab, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Hsu Yao
- Lab of Biomaterials, School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
- Department of Biomedical Informatics, Asia University, Wufeng District, Taichung, Taiwan
| | - Yueh-Sheng Chen
- Lab of Biomaterials, School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
- Department of Biomedical Informatics, Asia University, Wufeng District, Taichung, Taiwan
- * E-mail:
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Rui B, Guo S, Zeng B, Wang J, Chen X. An implantable electrical stimulator used for peripheral nerve rehabilitation in rats. Exp Ther Med 2013; 6:22-28. [PMID: 23935712 PMCID: PMC3735806 DOI: 10.3892/etm.2013.1110] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/08/2013] [Indexed: 12/11/2022] Open
Abstract
This study evaluated an implantable electrical stimulator using a sciatic nerve injury animal model, and ethological, electrophysiological and histological assessments. Forty Sprague-Dawley rats were used in the study, and were subjected to crushing of the right sciatic nerve with a micro-vessel clamp. Electrical stimulators were implanted in twenty of the rats (the implantation group), while the remaining twenty rats were assigned to the control group. At three and six weeks following the surgery, the sciatic nerve function index (SFI) and the motor nerve conduction velocity (MCV) were demonstrated to be significantly higher in the implantation group compared with the control group (P<0.05). Histological analysis, using hematoxylin and eosin (H&E) staining, showed the typical pathological atrophy, and an assessment of the nerve that had been crushed revealed distal axonal breakdown in the control group. These results suggest that the implantable electrical stimulator was effective, and was suitable for implantation in a Sprague-Dawley rat model.
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Affiliation(s)
- Biyu Rui
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233
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ZHANG XU, XIN NA, TONG LEI, TONG XIAOJIE. Electrical stimulation enhances peripheral nerve regeneration after crush injury in rats. Mol Med Rep 2013; 7:1523-7. [DOI: 10.3892/mmr.2013.1395] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 03/21/2013] [Indexed: 11/06/2022] Open
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Haastert-Talini K, Grothe C. Electrical Stimulation for Promoting Peripheral Nerve Regeneration. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2013; 109:111-24. [DOI: 10.1016/b978-0-12-420045-6.00005-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Sun H, Yang T, Li Q, Zhu Z, Wang L, Bai G, Li D, Li Q, Wang W. Dexamethasone and vitamin B(12) synergistically promote peripheral nerve regeneration in rats by upregulating the expression of brain-derived neurotrophic factor. Arch Med Sci 2012; 8. [PMID: 23185205 PMCID: PMC3506245 DOI: 10.5114/aoms.2012.31623] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Dexamethasone and vitamin B(12) are currently used in the clinic to treat peripheral nerve damage but their mechanisms of action remain incompletely understood. In this study we hypothesized that dexamethasone and vitamin B(12) promote the production of endogenous neurotrophic factors, thereby enhancing peripheral nerve repair. MATERIAL AND METHODS Ninety-six adult male Wistar rats were employed to establish a sciatic nerve injury model. They were then randomly divided into 4 groups to be subjected to different treatment: saline (group A), dexamethasone (group B), vitamin B(12) (group C), and dexamethasone combined with vitamin B(12) (group D). The walking behavior of rats was evaluated by footprint analysis, and the nerve regeneration was assessed by electrophysiological analysis and ultrastructural examination. The expression of brain-derived neurotrophic factor (BDNF), glial cell-derived neurotrophic factor, NT-3 and IL-6 in the injured sciatic nerves was detected by immunohistochemical and RT-PCR analysis. RESULTS Dexamethasone and vitamin B(12) promoted the regeneration of myelinated nerve fibers and the proliferation of Schwann cells. Furthermore, dexamethasone and vitamin B(12) promoted the recovery of sciatic functional index and sensory nerve conduction velocity, and upregulated BDNF expression in the injured sciatic nerves. CONCLUSIONS Dexamethasone and vitamin B(12) promote peripheral nerve repair in a rat model of sciatic nerve injury through the upregulation of BDNF expression. These findings provide new insight into the neurotrophic effects of dexamethasone and vitamin B(12) and support the application of these agents in clinical treatment of peripheral nerve injury.
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Affiliation(s)
- Hongzhi Sun
- Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou, China
| | - Tao Yang
- Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou, China
| | - Qing Li
- Department of Renal Medicine, Third Affiliated Hospital of Liaoning Medical University, Jinzhou, China
| | - Zhitu Zhu
- Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou, China
| | - Lei Wang
- Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou, China
| | - Guang Bai
- Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou, China
| | - Dongsheng Li
- Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou, China
| | - Qiang Li
- Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou, China
| | - Wei Wang
- Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou, China
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Hoang NS, Sar C, Valmier J, Sieso V, Scamps F. Electro-acupuncture on functional peripheral nerve regeneration in mice: a behavioural study. Altern Ther Health Med 2012; 12:141. [PMID: 22937957 PMCID: PMC3479081 DOI: 10.1186/1472-6882-12-141] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 07/08/2012] [Indexed: 12/13/2022]
Abstract
Background The improvement of axonal regeneration is a major objective in the treatment of peripheral nerve injuries. The aim of this study was to evaluate the effects of electro-acupuncture on the functional recovery of sensorimotor responses following left sciatic nerve crush in mice. Methods Sciatic nerve crush was performed on seven week old female mice. Following the injury, the control group was untreated while the experimental group received an electro-acupuncture application to the injured limb under isoflurane anesthesia at acupoints GB 30 and GB 34. Mechanical and heat sensitivity tests were performed to evaluate sensory recovery. Gait analysis was performed to assess sensorimotor recovery. Results Our results show that normal sensory recovery is achieved within five to six weeks with a two-week period of pain preceding the recovery to normal sensitivity levels. While electro-acupuncture did not accelerate sensory recovery, it did alleviate pain-related behaviour but only when applied during this period. Application before the development of painful symptoms did not prevent their occurrence. The analysis of gait in relation to the sensory tests suggests that the electro-acupuncture specifically improved motor recovery. Conclusions This study demonstrates that electro-acupuncture exerts a positive influence on motor recovery and is efficient in the treatment of pain symptoms that develop during target re-innervation.
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Lee TH, Pan H, Kim IS, Kim JK, Cho TH, Oh JH, Yoon YB, Lee JH, Hwang SJ, Kim SJ. Functional regeneration of a severed peripheral nerve with a 7-mm gap in rats through the use of an implantable electrical stimulator and a conduit electrode with collagen coating. Neuromodulation 2012; 13:299-304; discussion 305. [PMID: 21992887 DOI: 10.1111/j.1525-1403.2010.00296.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This paper examined the efficacy of an implantable electrical stimulator in rats for the functional regeneration of peripheral nerves. MATERIALS AND METHODS The implantable electrical stimulator was fabricated on a polyimide-based conduit with an integrated electrode, a stimulation chip, and a battery; 3 mg/mL of collagen gel was coated onto the conduit surface and electrical stimulation (20 µ A, 100 µ s, and 100 Hz biphasic current) was continuously applied between the nerve stumps for four weeks. The stimulator was tested on a severed sciatic nerve with a 7-mm gap in rats. The effects of both the electrical stimulation and the collagen application were examined. RESULTS Functionality was evaluated through walk track assessments and by recording the action potential of the regenerated nerve. Immunohistochemical staining of the regenerated nerve was done using peripheral myelin protein 22. CONCLUSION The results suggest that the functional recovery of a severed peripheral nerve by the proposed implantable electrical stimulator was achieved through electrical current stimulation along the use of a collagen coating on the conduit surface.
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Affiliation(s)
- Tae Hyung Lee
- School of Electrical Engineering and Computer Science, Seoul National University, Seoul, Korea
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Leoni ASL, Mazzer N, Guirro RRDJ, Jatte FG, Chereguini PAC, Monte-Raso VV. High voltage pulsed current stimulation of the sciatic nerve in rats: analysis by the SFI. ACTA ORTOPEDICA BRASILEIRA 2012; 20:93-7. [PMID: 24453588 PMCID: PMC3718424 DOI: 10.1590/s1413-78522012000200007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Accepted: 03/19/2010] [Indexed: 11/22/2022]
Abstract
Objective To analyze the efficiency of high voltage pulsed current (HVPC) with early application in three different sites, in the regeneration of the sciatic nerve in rats submitted to crush injury, the sciatic functional index (SFI) was used to assess the functional recovery. Methods After crushing of the nerve, 57 animals were submitted to cathodal HVPC at frequency of 50Hz and voltage of 100V, 20 minutes per day, 5 days per week. The rats were divided into five groups: control group; ganglion group; ganglion + muscle group; muscle group; and sham group. The SFI was determined weekly for seven weeks, from the preoperative period to the 6th postoperative week. Results Compared with the control group, the results showed a significantly better performance of group 2 for the first 3 weeks; group 3 showed significantly better performance in the third week; and group 4 showed a significantly negative performance during the 4th and 6th weeks. Conclusion Early application of HVPC had a positive effect in the treatment of the spinal cord region and the sciatic nerve root ganglion with a dispersive electrode on the contralateral lumbar region or on the gastrocnemius. However, HVPC had a negative effect in the treatment with an active electrode on the gastrocnemius and a dispersive electrode on the contralateral thigh. Level of evidence II, Prospective comparative study.
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Affiliation(s)
- Anita Sofia Leite Leoni
- Department of Health Sciences Applied to the Musculoskeletal System of the School of Medicine of Ribeirão Preto of Universidade de São Paulo - São Paulo, Brazil
| | - Nilton Mazzer
- Department of Health Sciences Applied to the Musculoskeletal System of the School of Medicine of Ribeirão Preto of Universidade de São Paulo - São Paulo, Brazil
| | - Rinaldo Roberto de Jesus Guirro
- Department of Health Sciences Applied to the Musculoskeletal System of the School of Medicine of Ribeirão Preto of Universidade de São Paulo - São Paulo, Brazil
| | - Fernanda Guadallini Jatte
- Department of Health Sciences Applied to the Musculoskeletal System of the School of Medicine of Ribeirão Preto of Universidade de São Paulo - São Paulo, Brazil
| | - Paulo Augusto Costa Chereguini
- Laboratory of Human Learning, Interactive Multimedia and Computerized Education of Universidade Federal de São Carlos - São Paulo, Brazil
| | - Vanessa Vilela Monte-Raso
- Postdoctoral Course of the School of Medicine of Ribeirão Preto of Universidade de São Paulo - São Paulo, Brazil
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Dadon-Nachum M, Melamed E, Offen D. Stem cells treatment for sciatic nerve injury. Expert Opin Biol Ther 2011; 11:1591-7. [DOI: 10.1517/14712598.2011.628933] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Johnson MI, Bjordal JM. Transcutaneous electrical nerve stimulation for the management of painful conditions: focus on neuropathic pain. Expert Rev Neurother 2011; 11:735-53. [PMID: 21539490 DOI: 10.1586/ern.11.48] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The management of neuropathic pain is challenging, with medication being the first-line treatment. Transcutaneous electrical nerve stimulation (TENS) is an inexpensive, noninvasive, self-administered technique that is used as an adjunct to medication. Clinical experience suggests that TENS is beneficial providing it is administered at a sufficiently strong intensity, close to the site of pain. At present, there are too few randomized controlled trials on TENS for neuropathic pain to judge effectiveness. The findings of systematic reviews of TENS for other pain syndromes are inconclusive because trials have a low fidelity associated with inadequate TENS technique and infrequent treatments of insufficient duration. The use of electrode arrays to spatially target stimulation more precisely may improve the efficacy of TENS in the future.
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Affiliation(s)
- Mark I Johnson
- Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, LS1 3HE, UK.
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Kim IS, Song YM, Cho TH, Pan H, Lee TH, Kim SJ, Hwang SJ. Biphasic Electrical Targeting Plays a Significant Role in Schwann Cell Activation. Tissue Eng Part A 2011; 17:1327-40. [DOI: 10.1089/ten.tea.2010.0519] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- In Sook Kim
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Yun Mi Song
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Tae Hyung Cho
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hui Pan
- Department of Maxillofacial Cell and Developmental Biology, Seoul National University, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Brain Korea 21 2nd Program for Craniomaxillofacial Life Science, Seoul National University, Seoul, Republic of Korea
| | - Tae Hyung Lee
- School of Electrical Engineering and Computer Science, Seoul National University, Seoul, Republic of Korea
| | - Sung June Kim
- School of Electrical Engineering and Computer Science, Seoul National University, Seoul, Republic of Korea
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Maxillofacial Cell and Developmental Biology, Seoul National University, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Brain Korea 21 2nd Program for Craniomaxillofacial Life Science, Seoul National University, Seoul, Republic of Korea
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Parizotto NA. Is electrical stimulation a consolidated treatment for denervated muscles and functional recovery after nerve injuries? Muscle Nerve 2011; 43:299-300. [PMID: 21254103 DOI: 10.1002/mus.21833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Nociceptive behaviors were induced by electrical stimulation of the dura mater surrounding the superior sagittal sinus in conscious adult rats and reduced by morphine and rizatriptan benzoate. Brain Res 2011; 1368:151-8. [DOI: 10.1016/j.brainres.2010.10.059] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 10/14/2010] [Accepted: 10/14/2010] [Indexed: 11/17/2022]
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Pereira Lopes FR, Frattini F, Marques SA, Almeida FMD, de Moura Campos LC, Langone F, Lora S, Borojevic R, Martinez AMB. Transplantation of bone-marrow-derived cells into a nerve guide resulted in transdifferentiation into Schwann cells and effective regeneration of transected mouse sciatic nerve. Micron 2010; 41:783-90. [PMID: 20728816 DOI: 10.1016/j.micron.2010.05.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 05/18/2010] [Accepted: 05/19/2010] [Indexed: 12/28/2022]
Abstract
Peripheral nerves possess the capacity of self-regeneration after traumatic injury. Nevertheless, the functional outcome after peripheral-nerve regeneration is often poor, especially if the nerve injuries occur far from their targets. Aiming to optimize axon regeneration, we grafted bone-marrow-derived cells (BMDCs) into a collagen-tube nerve guide after transection of the mouse sciatic nerve. The control group received only the culture medium. Motor function was tested at 2, 4, and 6 weeks after surgery, using the sciatic functional index (SFI), and showed that functional recovery was significantly improved in animals that received the cell grafts. After 6 weeks, the mice were anesthetized, perfused transcardially, and the sciatic nerves were dissected and processed for transmission electron microscopy and light microscopy. The proximal and distal segments of the nerves were compared, to address the question of improvement in growth rate; the results revealed a maintenance and increase of nerve regeneration for both myelinated and non-myelinated fibers in distal segments of the experimental group. Also, quantitative analysis of the distal region of the regenerating nerves showed that the numbers of myelinated fibers, Schwann cells (SCs) and g-ratio were significantly increased in the experimental group compared to the control group. The transdifferentiation of BMDCs into Schwann cells was confirmed by double labeling with S100/and Hoechst staining. Our data suggest that BMDCs transplanted into a nerve guide can differentiate into SCs, and improve the growth rate of nerve fibers and motor function in a transected sciatic-nerve model.
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Gigo-Benato D, Russo TL, Geuna S, Domingues NRSR, Salvini TF, Parizotto NA. Electrical stimulation impairs early functional recovery and accentuates skeletal muscle atrophy after sciatic nerve crush injury in rats. Muscle Nerve 2010; 41:685-93. [DOI: 10.1002/mus.21549] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Baptista AF, Goes BT, Menezes D, Gomes FCA, Zugaib J, Stipursky J, Gomes JRS, Oliveira JÃT, Vannier-Santos MA, Martinez AMB. PEMF fails to enhance nerve regeneration after sciatic nerve crush lesion. J Peripher Nerv Syst 2009; 14:285-93. [DOI: 10.1111/j.1529-8027.2009.00240.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Asensio-Pinilla E, Udina E, Jaramillo J, Navarro X. Electrical stimulation combined with exercise increase axonal regeneration after peripheral nerve injury. Exp Neurol 2009; 219:258-65. [PMID: 19500575 DOI: 10.1016/j.expneurol.2009.05.034] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 04/24/2009] [Accepted: 05/22/2009] [Indexed: 12/11/2022]
Abstract
Although injured peripheral axons are able to regenerate, functional recovery is usually poor after nerve transection. In this study we aim to elucidate the role of neuronal activity, induced by nerve electrical stimulation and by exercise, in promoting axonal regeneration and modulating plasticity in the spinal cord after nerve injury. Four groups of adult rats were subjected to sciatic nerve transection and suture repair. Two groups received electrical stimulation (3 V, 0.1 ms at 20 Hz) for 1 h, immediately after injury (ESa) or during 4 weeks (1 h daily; ESc). A third group (ES+TR) received 1 h electrical stimulation and was submitted to treadmill running during 4 weeks (5 m/min, 2 h daily). A fourth group performed only exercise (TR), whereas an untreated group served as control (C). Nerve conduction, H reflex and algesimetry tests were performed at 1, 3, 5, 7 and 9 weeks after surgery, to assess muscle reinnervation and changes in excitability of spinal cord circuitry. Histological analysis was made at the end of the follow-up. Groups that received acute ES and/or were forced to exercise in the treadmill showed higher levels of muscle reinnervation and increased numbers of regenerated myelinated axons when compared to control animals or animals that received chronic ES. Combining ESa with treadmill training significantly improved muscle reinnervation during the initial phase. The facilitation of the monosynaptic H reflex in the injured limb was reduced in all treated groups, suggesting that the maintenance of activity helps to prevent the development of hyperreflexia.
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Affiliation(s)
- Elena Asensio-Pinilla
- Group of Neuroplasticity and Regeneration, Institute of Neurosciences and Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Ronchi G, Nicolino S, Raimondo S, Tos P, Battiston B, Papalia I, Varejão ASP, Giacobini-Robecchi MG, Perroteau I, Geuna S. Functional and morphological assessment of a standardized crush injury of the rat median nerve. J Neurosci Methods 2009; 179:51-7. [PMID: 19428511 DOI: 10.1016/j.jneumeth.2009.01.011] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Revised: 01/10/2009] [Accepted: 01/13/2009] [Indexed: 12/25/2022]
Abstract
The availability of effective experimental models for investigating nerve regeneration and designing new strategies for promoting this unique repair process is important. The aim of this study was to standardize a rat median nerve crush injury model using a non-serrated clamp exerting a compression force of 17.02 MPa for a duration of 30s. Results showed that functional recovery, evaluated by grasping test, was already detectable at day-12 and progressively increased until day-28 after which animal performance plateaued until the end of testing (day-42), reaching a range of 75-80% of pre-operative values. Morphological analysis on the median nerve segments, distal to the crush lesion, which were withdrawn at the end of the experiment showed that regenerated nerve fibers are significantly more numerous and densely packed; they are also smaller and have a thinner myelin sheath compared to controls. Together, these results provide a baseline characterization of the crush median nerve injury experimental model for its employment in the investigation of nerve regeneration research, especially when a reproducible regeneration process is required, such as for the study of biological mechanisms of peripheral nerve fiber regeneration or development of new therapeutic agents for promoting posttraumatic nerve repair.
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Affiliation(s)
- G Ronchi
- Department of Animal and Human Biology, University of Turin, Italy
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