Intraoperative 1-Hour Electrical Nerve Stimulation Enhances Outcomes of Nerve–Muscle-Endplate Band Grafting Technique for Muscle Reinnervation

2017 ◽  
Vol 33 (08) ◽  
pp. 533-543 ◽  
Author(s):  
Jingming Chen ◽  
Themba Nyirenda ◽  
Liancai Mu ◽  
Stanislaw Sobotka
Keyword(s):  
Nerve Regeneration ◽  
Functional Recovery ◽  
Nerve Stimulation ◽  
Muscle Force ◽  
Force Measurement ◽  
Nerve Branch ◽  
Electrical Nerve Stimulation ◽  
Muscle Reinnervation ◽  
The Mean ◽  
Nerve Muscle

Background Increasing evidence suggests that 1-hour electrical nerve stimulation during surgery improves nerve regeneration and functional recovery. However, it remains unknown if this approach has beneficial effects on the outcomes of our recently developed nerve–muscle-endplate band grafting-native motor zone (NMEG-NMZ) technique for muscle reinnervation. Methods In this study, NMEG-NMZ transplantation was performed in a rat model. The right sternomastoid muscle was experimentally denervated and immediately reinnervated by implanting a NMEG harvested from the ipsilateral sternohyoid (SH) muscle into the NMZ of the target muscle. Before implantation of the NMEG, the SH nerve branch innervating the NMEG was subjected to intraoperative 1-hour continuous electrical stimulation (20 Hz). Three months after surgery, the degree of functional recovery was evaluated with muscle force measurement and the extent of nerve regeneration and endplate reinnervation was examined using histological and immunohistochemical methods. Results A combination of NMEG-NMZ with electrical nerve stimulation resulted in a greater degree of functional recovery than the NMEG-NMZ alone. The mean muscle force of the treated muscles was 90% of the contralateral control. The muscle mass was recovered up to 90% of the control. The mean number and percentage of area of the regenerated axons in the treated muscles was computed to be 81 and 84% of the control muscles, respectively. On average, 83% of the denervated endplates in the treated muscles were reinnervated by regenerated axons. Conclusion Intraoperative brief nerve stimulation promotes nerve regeneration, endplate reinnervation, and functional recovery of the muscles reinnervated with NMEG-NMZ technique.

scholarly journals Nerve-Muscle-Endplate Band Grafting: A New Technique for Muscle Reinnervation

2011 ◽  
Vol 69 (suppl_2) ◽  
pp. ons208-ons224 ◽  
Author(s):  
Liancai Mu ◽  
Stanislaw Sobotka ◽  
Hungxi Su
Keyword(s):  
Functional Recovery ◽  
Axonal Regeneration ◽  
Neuromuscular Junctions ◽  
Force Measurement ◽  
Recovery Period ◽  
Motor Endplate ◽  
Adult Rats ◽  
Nerve Branch ◽  
Muscle Reinnervation ◽  
Nerve Muscle

Abstract BACKGROUND Because currently existing reinnervation methods result in poor functional recovery, there is a great need to develop new treatment strategies. OBJECTIVE To investigate the efficacy of our recently developed nerve-muscle-endplate band grafting (NMEG) technique for muscle reinnervation. METHODS Twenty-five adult rats were used. Sternohyoid (SH) and sternomastoid (SM) muscles served as donor and recipient muscle, respectively. Neural organization of the SH and SM muscles and surgical feasibility of the NMEG technique were determined. An NMEG contained a muscle block, a nerve branch with nerve terminals, and a motor endplate band with numerous neuromuscular junctions. After a 3-month recovery period, the degree of functional recovery was evaluated with a maximal tetanic force measurement. Retrograde horseradish peroxidase tracing was used to track the origin of the motor innervation of the reinnervated muscles. The reinnervated muscles were examined morphohistologically and immunohistochemically to assess the extent of axonal regeneration. RESULTS Nerve supply patterns and locations of the motor endplate bands in the SH and SM muscles were documented. The results demonstrated that the reinnervated SM muscles gained motor control from the SH motoneurons. The NMEG technique yielded extensive axonal regeneration and significant recovery of SM muscle force-generating capacity (67% of control). The mean wet weight of the NMEG-reinnervated muscles (87% of control) was greater than that of the denervated SM muscles (36% of control). CONCLUSION The NMEG technique resulted in successful muscle reinnervation and functional recovery. This technique holds promise in the treatment of muscle paralysis.

scholarly journals Limb Muscle Reinnervation with the Nerve-Muscle-Endplate Grafting Technique: An Anatomical Feasibility Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Liancai Mu ◽  
Jingming Chen ◽  
Jing Li ◽  
Stanislaw Sobotka ◽  
Themba Nyirenda
Keyword(s):  
Functional Recovery ◽  
Peroneal Nerve ◽  
Muscle Force ◽  
Recovery Period ◽  
Foot Drop ◽  
Nerve Supply ◽  
Nerve Injuries ◽  
Adult Rats ◽  
Nerve Branch ◽  
Nerve Muscle

Background. Peroneal nerve injuries results in tibialis anterior (TA) muscle paralysis. TA paralysis could cause “foot drop,” a disabling condition that can make walking difficult. As current treatment methods result in poor functional recovery, novel treatment approaches need to be studied. The aim of this study was to explore anatomical feasibility of limb reinnervation with our recently developed nerve-muscle-endplate grafting (NMEG) in the native motor zone (NMZ). Methods. As the NMEG-NMZ technique involves in nerves and motor endplates (MEPs), the nerve supply patterns and locations of the MEP bands within the gastrocnemius (GM) and TA muscles of rats were investigated using Sihler’s stain and whole-mount acetylcholinesterase (AChE) staining, respectively. Five adult rats underwent TA nerve transaction. The denervated TA was reinnervated by transferring an NMEG pedicle from the ipsilateral lateral GM. At the end of a 3-month recovery period, maximal muscle force was measured to document functional recovery. Results. The results showed that the TA was innervated by the deep peroneal nerve. A single MEP band was located obliquely in the middle of the TA. The GM was composed of two neuromuscular compartments, lateral (GM-l) and medial (GM-m), each of which was innervated by a separate nerve branch derived from the tibial nerve and had a vertically positioned MEP band. The locations of MEP bands in the GM and TA muscles and nerve supply patterns demonstrated that an NMEG pedicle can be harvested from the GM-l and implanted into the NMZ within the TA muscle. The NMEG-NMZ pilot study showed that this technique resulted in optimal muscle force recovery. Conclusion. NMEG-NMZ surgery is feasible for limb reinnervation. Specifically, the denervated TA caused by peroneal nerve injuries can be reinnervated with a NMEG from the GM-l.

scholarly journals The Parameters of Transcutaneous Electrical Nerve Stimulation Are Critical to Its Regenerative Effects When Applied Just after a Sciatic Crush Lesion in Mice

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Diana Cavalcante Miranda de Assis ◽  
Êmyle Martins Lima ◽  
Bruno Teixeira Goes ◽  
João Zugaib Cavalcanti ◽  
Alaí Barbosa Paixão ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Regeneration ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Peripheral Nerve Regeneration ◽  
Light And Electron Microscopy ◽  
Nerve Crush ◽  
Electrical Nerve Stimulation ◽  
The Right ◽  
Crush Lesion

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.

scholarly journals Gambaran Peningkatan Fungsional Pasien Bell’s Palsy Setelah Pemberian Kombinasi Transcutaneous Electrical Nerve Stimulation (Tens) Dan Exercise : Literature Review

2021 ◽  
Vol 1 ◽  
pp. 1243-1249
Author(s):  
Adinda Sofiaputri ◽  
Lia Dwi Prafitri
Keyword(s):  
Literature Review ◽  
Facial Nerve ◽  
Functional Recovery ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Bell’S Palsy ◽  
Google Scholar ◽  
Bell's Palsy ◽  
Electrical Nerve Stimulation ◽  
Post Test

AbstractBell's palsy is an acute weakness or paralysis of the peripheral facial nerve with no known cause. The incidence of Bell's palsy is about 40-70% of all acute peripheral facial nerve palsy, the average prevalence ranges from 10-30% per 100,000 population per year) Data collected from 4 hospitals in Indonesia shows that the frequency of Bell's palsy shows 19.55% of all cases of neuropathy. The incidence of Bell's palsy ranges from 23 cases per 100,000 people annually, most of the cases 85 % cured within 1-2 months which occurs in 8% of cases. The literature Review research is to analyze the description of the functional improvement of Bell's Palsy patients after the combination of Transcutaneous Electrical Nerve Stimulation (TENS) and Exercise. The selection of articles in this study used the PICO mnemonic design. 160 reviewed articles via PubMed and google scholar, article search via PubMed (1), Google Scholar (4). Inclusion and exclusion criteria according to keywords, published in 2010-2021. The results of the analysis of the literature review of 5 articles showed that the male gender was at risk of experiencing Bell's palsy, namely 29 (52.7%) compared to the female sex, which was 26 (47.3%). Functional recovery in Bell's palsy from the mean pre-test and post-test scores, it can be seen that the average pre-test is 5.19 and the average post-test is 3.65. Improved functional recovery in Bell's palsy patients after administering TENS with a combination of Exercise with massage methods.Keywords: Bell’s palsy, TENS and Massage AbstrakBell's palsy adalah kelemahan akut atau kelumpuhan saraf wajah perifer tanpa diketahui penyebabnya. Kejadian Bell's palsy sekitar 40-70% dari seluruh kelumpuhan saraf fasialis perifer akut, prevalensi rata-rata berkisar 10-30% per 100.000 penduduk per tahun) Data yang dikumpulkan dari 4 rumah sakit di Indonesia menunjukkan bahwa frekuensi Bell's palsy menunjukkan 19,55 % dari semua kasus neuropati. Angka kejadian Bell's palsy berkisar 23 kasus per 100.000 orang setiap tahunnya, sebagian besar 85% sembuh dalam waktu 1-2 bulan yang terjadi pada 8% kasus. Penelitian Literatur Review ini untuk menganalisis gambaran peningkatan fungsional pasien Bell's Palsy setelah pemberian kombinasi Transcutaneous Electrical Nerve Stimulation (TENS) dan Latihan. Pemilihan artikel dalam penelitian ini menggunakan desain mnemonic PICO. 160 artikel yang diulas melalui PubMed dan google sarjana, pencarian artikel melalui PubMed (1), Google Cendekia (4). Kriteria inklusi dan eksklusi menurut kata kunci, terbit tahun 2010-2021. Hasil analisis literature review dari 5 artikel menunjukkan bahwa jenis kelamin laki-laki berisiko mengalami Bell’s palsy yaitu 29 (52,7%) dibandingkan dengan jenis kelamin perempuan, yaitu 26 (47,3%). Pemulihan fungsional pada Bell's palsy dari rerata skor pre-test dan post-test, terlihat bahwa rata-rata pre-test adalah 5,19 dan rata-rata post-test adalah 3,65. Peningkatan pemulihan fungsional pada pasien Bell's palsy setelah pemberian TENS dengan kombinasi Latihan dengan metode pijat.Kata kunci: Bell’s palsy, TENS dan pijat

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