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targeted muscle reinnervation

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https://www.readbyqxmd.com/read/29219188/toxicity-trial-of-canine-posterior-cricoarytenoid-intramuscular-vincristine-injections
#1
Randal C Paniello, Neel K Bhatt, Rebecca Chernock
OBJECTIVES/HYPOTHESIS: In animal studies, intramuscular vincristine injections have been shown to block reinnervation of the denervated target muscle. This application could be used selectively to influence recovery patterns following injury of recurrent laryngeal nerves (RLNs). However, vincristine is currently Food and Drug Administration approved only for intravenous use. A formal toxicity trial of intramuscular injections was performed. STUDY DESIGN: Animal study...
December 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29188681/targeted-muscle-reinnervation-for-improved-control-of-myoelectric-upper-limb-prostheses
#2
G Vadalà, G Di Pino, L Ambrosio, L Diaz Balzani, V Denaro
Targeted muscle reinnervation (TMR) is a novel surgical technique developed to improve the control of myoelectric upper limb prostheses. Nerves transected by the amputation, which retain their original motor pathways even after being severed, are redirected to residual denervated muscles that serve as target for consequent reinnervation. Once the process is complete, reinnervated muscles will contract upon voluntary activation of transferred nerves while attempting to move missing regions of the amputated limb, generating EMG signals that can be recorded and used to control a prosthetic device...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29104116/putative-roles-of-soluble-trophic-factors-in-facial-nerve-regeneration-target-reinnervation-and-recovery-of-vibrissal-whisking
#3
REVIEW
Habib Bendella, Svenja Rink, Maria Grosheva, Levent Sarikcioglu, Tessa Gordon, Doychin N Angelov
It is well-known that, after nerve transection and surgical repair, misdirected regrowth of regenerating motor axons may occur in three ways. The first way is that the axons enter into endoneurial tubes that they did not previously occupy, regenerate through incorrect fascicles and reinnervate muscles that they did not formerly supply. Consequently the activation of these muscles results in inappropriate movements. The second way is that, in contrast with the precise target-directed pathfinding by elongating motor nerves during embryonic development, several axons rather than a single axon grow out from each transected nerve fiber...
November 8, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/29062019/myoelectric-pattern-recognition-outperforms-direct-control-for-transhumeral-amputees-with-targeted-muscle-reinnervation-a-randomized-clinical-trial
#4
Levi J Hargrove, Laura A Miller, Kristi Turner, Todd A Kuiken
Recently commercialized powered prosthetic arm systems hold great potential in restoring function for people with upper-limb loss. However, effective use of such devices remains limited by conventional (direct) control methods, which rely on electromyographic signals produced from a limited set of muscles. Targeted Muscle Reinnervation (TMR) is a nerve transfer procedure that creates additional recording sites for myoelectric prosthesis control. The effects of TMR may be enhanced when paired with pattern recognition technology...
October 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29054880/common-synaptic-input-to-motor-neurons-and-neural-drive-to-targeted-reinnervated-muscles
#5
D Farina, A M Castronovo, I Vujaklija, A Sturma, S Salminger, C Hofer, O C Aszmann
We compared the behaviour of motor neurons innervating their physiological muscle targets with motor neurons from the same spinal segment whose axons were surgically redirected to remnant muscles (targeted muscle reinnervation). The objective was to assess whether motor neurons with non-physiological innervation receive similar synaptic input and could be voluntary controlled as motor neurons with natural innervation. For this purpose, we acquired high-density EMG signals from the biceps brachii in 5 male trans-humeral amputees who underwent targeted reinnervation of this muscle by the ulnar nerve and from the first dorsal interosseous muscle of 5 healthy individuals to investigate the natural innervation of the ulnar nerve...
October 20, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29053875/current-state-of-the-surgical-treatment-of-terminal-neuromas
#6
Graham C Ives, Theodore A Kung, Bao Tram Nghiem, Daniel C Ursu, David L Brown, Paul S Cederna, Stephen W P Kemp
Painful terminal neuromas resulting from nerve injury following amputation are common. However, there is currently no universally accepted gold standard of treatment for this condition. A comprehensive literature review is presented on the treatment of terminal neuromas. Four categories of terminal neuroma surgical procedures are assessed: epineurial closure; nerve transposition with implantation; neurorrhaphy, and alternate target reinnervation. Significant patient and case studies are highlighted in each section, focusing on surgical technique and patient outcome metrics...
October 19, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28831329/targeted-muscle-reinnervation-to-improve-pain-prosthetic-tolerance-and-bioprosthetic-outcomes-in-the-amputee
#7
REVIEW
J Byers Bowen, Corinne E Wee, Jaclyn Kalik, Ian L Valerio
Scope and Significance: There are ∼185,000 amputations each year and nearly 2 million amputees currently living in the United States. Approximately 25% of these amputees will experience chronic pain issues secondary to localized neuroma pain and/or phantom limb pain. Problem: The significant discomfort caused by neuroma and phantom limb pain interferes with prosthesis wear, subjecting amputees to the additional physical and psychological morbidity associated with chronic immobility. Although numerous neuroma treatments are described, none of these methods are consistently effective in eliminating symptoms...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28813784/longitudinal-high-density-emg-classification-case-study-in-a-glenohumeral-tmr-subject
#8
Meike A Schweisfurth, Jennifer Ernst, Ivan Vujaklija, Arndt F Schilling, Dario Farina, Oskar C Aszmann, Gunther Felmerer
Targeted muscle reinnervation (TMR) represents a breakthrough interface for prosthetic control in high-level upper-limb amputees. However, clinically, it is still limited to the direct motion-wise control restricted by the number of reinnervation sites. Pattern recognition may overcome this limitation. Previous studies on EMG classification in TMR patients experienced with myocontrol have shown greater accuracy when using high-density (HD) recordings compared to conventional single-channel derivations. This case study investigates the potential of HD-EMG classification longitudinally over a period of 17 months post-surgery in a glenohumeral amputee...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28769755/broadband-prosthetic-interfaces-combining-nerve-transfers-and-implantable-multichannel-emg-technology-to-decode-spinal-motor-neuron-activity
#9
Konstantin D Bergmeister, Ivan Vujaklija, Silvia Muceli, Agnes Sturma, Laura A Hruby, Cosima Prahm, Otto Riedl, Stefan Salminger, Krisztina Manzano-Szalai, Martin Aman, Michael-Friedrich Russold, Christian Hofer, Jose Principe, Dario Farina, Oskar C Aszmann
Modern robotic hands/upper limbs may replace multiple degrees of freedom of extremity function. However, their intuitive use requires a high number of control signals, which current man-machine interfaces do not provide. Here, we discuss a broadband control interface that combines targeted muscle reinnervation, implantable multichannel electromyographic sensors, and advanced decoding to address the increasing capabilities of modern robotic limbs. With targeted muscle reinnervation, nerves that have lost their targets due to an amputation are surgically transferred to residual stump muscles to increase the number of intuitive prosthetic control signals...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28767716/factors-associated-with-interest-in-novel-interfaces-for-upper-limb-prosthesis-control
#10
Susannah M Engdahl, Cynthia A Chestek, Brian Kelly, Alicia Davis, Deanna H Gates
BACKGROUND: Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual's decision to try one. METHODS: We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc...
2017: PloS One
https://www.readbyqxmd.com/read/28657487/delayed-spinal-cord-brachial-plexus-reconnection-after-c7-ventral-root-avulsion-the-effect-of-reinnervating-motoneurons-rescued-by-riluzole-treatment
#11
Balázs Gloviczki, Dénes G Török, Gábor Márton, László Gál, Tamás Bodzay, Sándor Pintér, Antal Nógrádi
Ventral root avulsion induces dramatic loss of the affected spinal cord motoneurons. The neuroprotective effect of riluzole has been previously proven on the injured motoneurons: the vast majority of them can be rescued even when they have no possibility to regenerate their axons. In this study the number of injured motoneurons rescued by riluzole treatment and their capacity to reinnervate the denervated forelimb muscles was investigated. Surgical reconnection with a peripheral nerve graft between the affected spinal cord segment and the C7 spinal nerve was established immediately or with 1- and 3-week delay after avulsion...
August 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28638701/reinnervation-of-denervated-muscle-by-implantation-of-nerve-muscle-endplate-band-graft-to-the-native-motor-zone-of-the-target-muscle
#12
Liancai Mu, Stanislaw Sobotka, Jingming Chen, Themba Nyirenda
INTRODUCTION: Motor endplate reinnervation is critical for restoring motor function of the denervated muscle. We developed a novel surgical technique called nerve-muscle-endplate band grafting (NMEG) for muscle reinnervation. METHODS: Experimentally denervated sternomastoid muscle in the rat was reinnervated by transferring a NMEG from the ipsilateral sternohyoid muscle to the native motor zone (NMZ) of the target muscle. A NMEG pedicle contained a block of muscle (~ 6 × 6 × 3 mm), a nerve branch with axon terminals, and a motor endplate band with numerous neuromuscular junctions...
June 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28579692/targeted-muscle-reinnervation-for-the-upper-and-lower-extremity
#13
Todd A Kuiken, Ann K Barlow, Levi Hargrove, Gregorgy A Dumanian
Myoelectric devices are controlled by electromyographic signals generated by contraction of residual muscles, which thus serve as biological amplifiers of neural control signals. Although nerves severed by amputation continue to carry motor control information intended for the missing limb, loss of muscle effectors due to amputation prevents access to this important control information. Targeted Muscle Reinnervation (TMR) was developed as a novel strategy to improve control of myoelectric upper limb prostheses...
June 2017: Techniques in Orthopaedics: TIO
https://www.readbyqxmd.com/read/28396957/-transcutaneous-osseointegrated-prosthesis-top-after-limb-amputation-status-quo-and-perspectives
#14
Christian Willy, Christian Krettek
The majority of transfemoral and transtibial amputees can be functionally fitted with conventional suspension sockets; however, due to socket problems using conventional stump care, 60% of the patients have limited function and even in younger patients approximately one sixth are unable to wear the prosthesis daily. After the introduction of transcutaneous osseointegrated prostheses (TOP) the inherent problems of socket-stump care can be avoided for these patients. Against this background this article reviews the recent clinical development of TOP in Sweden, Germany, the Netherlands, Australia and USA currently in nine centers...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28293499/proximal-versus-distal-nerve-transfer-for-biceps-reinnervation-a-comparative-study-in-a-rat-s-brachial-plexus-injury-model
#15
Aleksandra M McGrath, Johnny Chuieng-Yi Lu, Tommy Naj-Jen Chang, Frank Fang, David Chwei-Chin Chuang
BACKGROUND: The exact role of proximal and distal nerve transfers in reconstruction strategies of brachial plexus injury remains controversial. We compared proximal with distal nerve reconstruction strategies in a rat model of brachial plexus injury. METHODS: In rats, the C6 spinal nerve with a nerve graft (proximal nerve transfer model, n = 30, group A) and 50% of ulnar nerve (distal nerve transfer model, n = 30, group B) were used as the donor nerves. The targets were the musculocutaneous nerve and the biceps muscle...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28269705/real-time-evaluation-of-a-myoelectric-control-method-for-high-level-upper-limb-amputees-based-on-homologous-leg-movements
#16
Kenneth R Lyons, Sanjay S Joshi
Electromyography-based gesture classification methods for control of advanced upper limb prostheses are limited either to individuals with amputations distal to the elbow or to those willing to undergo targeted muscle reinnervation surgery. Based on the natural similarity between gestures of the lower leg and the arm and on established methods in electromyography-based gesture classification, we propose a noninvasive system with which users control an upper limb prosthesis via homologous movements of the leg and foot...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227966/real-time-evaluation-of-a-myoelectric-control-method-for-high-level-upper-limb-amputees-based-on-homologous-leg-movements
#17
Kenneth R Lyons, Sanjay S Joshi, Kenneth R Lyons, Sanjay S Joshi, Sanjay S Joshi, Kenneth R Lyons
Electromyography-based gesture classification methods for control of advanced upper limb prostheses are limited either to individuals with amputations distal to the elbow or to those willing to undergo targeted muscle reinnervation surgery. Based on the natural similarity between gestures of the lower leg and the arm and on established methods in electromyography-based gesture classification, we propose a noninvasive system with which users control an upper limb prosthesis via homologous movements of the leg and foot...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28203223/impaired-axonal-regeneration-in-diabetes-perspective-on-the-underlying-mechanism-from-in-vivo-and-in-vitro-experimental-studies
#18
REVIEW
Kazunori Sango, Hiroki Mizukami, Hidenori Horie, Soroku Yagihashi
Axonal regeneration after peripheral nerve injury is impaired in diabetes, but its precise mechanisms have not been elucidated. In this paper, we summarize the progress of research on altered axonal regeneration in animal models of diabetes and cultured nerve tissues exposed to hyperglycemia. Impaired nerve regeneration in animal diabetes can be attributed to dysfunction of neurons and Schwann cells, unfavorable stromal environment supportive of regenerating axons, and alterations of target tissues receptive to reinnervation...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28111229/surgical-repair-in-humans-after-traumatic-nerve-injury-provides-limited-functional-neural-regeneration-in-adults
#19
REVIEW
Winnie A Palispis, Ranjan Gupta
Traumatic nerve injuries result in devastating loss of neurologic function with unpredictable functional recovery despite optimal medical management. After traumatic nerve injury and denervation, regenerating axons must traverse a complex environment in which they encounter numerous barriers on the way to reinnervation of their target muscle. Outcomes of surgical intervention alone have unfortunately reached a plateau, resulting in often unsatisfactory functional recovery. Over the past few decades, many improvements were developed to supplement and boost the results of surgical repair...
April 2017: Experimental Neurology
https://www.readbyqxmd.com/read/27879592/reinnervated-split-muscle-technique-for-creating-additional-myoelectric-sites-in-an-animal-model
#20
Maria Florencia Deslivia, Hyun-Joo Lee, Rizki Fajar Zulkarnain, Bin Zhu, Arnold Adikrishna, In-Ho Jeon, Keehoon Kim
BACKGROUND: This study proposes a novel reinnervated split-muscle operation to create additional myoelectric sites as sources of command signals of myoelectric prostheses for enhanced dexterous hand-to-wrist motions. The aim of this study was to investigate the postprocedure electromyographic properties of the muscles as distinct myoelectric sites in a rat model. METHODS: The reinnervated split-muscle group (n = 6) had the gastrocnemius muscle separated along its longitudinal axis and nerves transferred to each new muscle (peroneal nerve to lateral muscle head and tibial to medial one); the non-split-muscle group (n = 6) only had nerve transfers with its muscle intact...
December 2016: Plastic and Reconstructive Surgery
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