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targeted muscle reinnervation

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https://www.readbyqxmd.com/read/29871787/current-concepts-in-upper-extremity-amputation
#1
REVIEW
Sarah N Pierrie, R Glenn Gaston, Bryan J Loeffler
Advances in motor vehicle safety, trauma care, combat body armor, and cancer treatment have enhanced the life expectancy and functional expectations of patients with upper-extremity amputations. Upper-extremity surgeons have multiple surgical options to optimize the potential of emerging prosthetic technologies for this diverse patient group. Targeted muscle reinnervation is an evolving technique that improves control of myoelectric prostheses and can prevent or treat symptomatic neuromas. This review addresses current strategies for the care of patients with amputations proximal to the wrist with an emphasis on recent advancements in surgical techniques and prostheses...
June 2, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29747672/two-ways-to-improve-myoelectric-control-for-a-transhumeral-amputee-after-targeted-muscle-reinnervation-a-case-study
#2
Yang Xu, Dingguo Zhang, Yang Wang, Juntao Feng, Wendong Xu
BACKGROUND: Myoelectric control of multifunctional prostheses is challenging for individuals with high-level amputations due to insufficient surface electromyography (sEMG) signals. A surgical technique called targeted muscle reinnervation (TMR) has achieved impressive improvements in myoelectric control by providing more sEMG control signals. In this case, some channels of sEMG signals are coupled after TMR, which limits the performance of conventional amplitude-based control for upper-limb prostheses...
May 10, 2018: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29722323/end-to-end-and-end-to-side-neurorrhaphy-between-thick-donor-nerves-and-thin-recipient-nerves-an-axon-regeneration-study-in-a-rat-model
#3
Tohru Tateshita, Kazuki Ueda, Akiyoshi Kajikawa
During nerve reconstruction, nerves of different thicknesses are often sutured together using end-to-side neurorrhaphy and end-to-end neurorrhaphy techniques. In this study, the effect of the type of neurorrhaphy on the number and diameter of regenerated axon fibers was studied in a rat facial nerve repair model. An inflow-type end-to-side and end-to-end neurorrhaphy model with nerve stumps of different thicknesses (2:1 diameter ratio) was created in the facial nerve of 14 adult male Sprague-Dawley rats. After 6 and 12 weeks, nerve regeneration was evaluated in the rats using the following outcomes: total number of myelinated axons, average minor axis diameter of the myelinated axons in the central and peripheral sections, and axon regeneration rate...
April 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29659058/polyethylene-glycol-solutions-rapidly-restore-and-maintain-axonal-continuity-neuromuscular-structures-and-behaviors-lost-after-sciatic-nerve-transections-in-female-rats
#4
Michelle Mikesh, Cameron L Ghergherehchi, Robert Louis Hastings, Amir Ali, Sina Rahesh, Karthik Jagannath, Dale R Sengelaub, Richard C Trevino, David M Jackson, George D Bittner
Complete severance of major peripheral mixed sensory-motor nerve proximally in a mammalian limb produces immediate loss of action potential conduction and voluntary behaviors mediated by the severed distal axonal segments. These severed distal segments undergo Wallerian degeneration within days. Denervated muscles atrophy within weeks. Slowly regenerating (∼1 mm/day) outgrowths from surviving proximal stumps that often nonspecifically reinnervate denervated targets produce poor, if any, restoration of lost voluntary behaviors...
July 2018: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/29618798/differential-expression-of-micrornas-and-other-small-rnas-in-muscle-tissue-of-patients-with-als-and-healthy-age-matched-controls
#5
Anja Kovanda, Lea Leonardis, Janez Zidar, Blaž Koritnik, Leja Dolenc-Groselj, Stanislava Ristic Kovacic, Tomaž Curk, Boris Rogelj
Amyotrophic lateral sclerosis is a late-onset disorder primarily affecting motor neurons and leading to progressive and lethal skeletal muscle atrophy. Small RNAs, including microRNAs (miRNAs), can serve as important regulators of gene expression and can act both globally and in a tissue-/cell-type-specific manner. In muscle, miRNAs called myomiRs govern important processes and are deregulated in various disorders. Several myomiRs have shown promise for therapeutic use in cellular and animal models of ALS; however, the exact miRNA species differentially expressed in muscle tissue of ALS patients remain unknown...
April 4, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29605954/development-of-targeted-muscle-reinnervation-model-in-hind-limb-amputated-rats
#6
Rohit Garg, Safak Uygur, Joanna Cwykiel, Maria Siemionow
BACKGROUND:  Targeted muscle reinnervation (TMR) is a novel approach to postamputation neuroma pain; however, this has not been explicitly studied. The purpose of this study was to develop a TMR model in hind limb amputated rats. METHODS:  Ten hind limbs from 5 Sprague Dawley cadaver rats were used. Sciatic nerve, main branches of the sciatic nerve (common peroneal, tibial, sural), motor branches from the sciatic nerve to the biceps femoris and cauda femoris, gluteal nerve and its motor branches to the semimembranosus, and biceps femoris and femoral nerve were dissected to look for consistent nerve anatomy that can be used for TMR in the rat hind limb amputation model...
April 1, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29579026/targeted-muscle-reinnervation-considerations-for-future-implementation-in-adolescents-and-younger-children
#7
Kevin J Zuo, Michael P Willand, Emily S Ho, Sandra Ramdial, Gregory H Borschel
Prosthetic options for patients with proximal upper limb absence are limited. Current above-elbow prostheses may restore basic motor functions for crucial activities, but they are cumbersome to operate, lack sensory feedback, and are often abandoned. Targeted muscle reinnervation is a novel surgical procedure that enhances the ability of patients with above-elbow amputations to intuitively control a myoelectric prosthesis. By transferring multiple severed peripheral nerves to a robust target muscle, targeted muscle reinnervation restores physiologic continuity and enables more intuitive prosthetic control...
June 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29510418/immunohistochemical-detection-of-motor-endplates-in-the-long-term-denervated-muscle
#8
Liancai Mu, Jingming Chen, Jing Li, Themba Nyirenda, Mary Fowkes, Stanislaw Sobotka
BACKGROUND:  We have demonstrated that the native motor zone (NMZ) within a muscle is an ideal target for performing nerve-muscle-endplate band grafting (NMEG) to restore motor function of a denervated muscle. This study was designed to determine spatiotemporal alterations of the myofibers, motor endplates (MEPs), and axons in the NMZ of long-term denervated muscles for exploring if NMEG-NMZ technique would have the potential for delayed reinnervation. METHODS:  Sternomastoid (SM) muscles of adult female Sprague-Dawley rats ( n  = 21) were experimentally denervated and denervation-induced changes in muscle weight, myofiber size, MEPs, and intramuscular nerve axons were evaluated histomorphometrically and immunohistochemically at the end of 3, 6, and 9 months after denervation...
June 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29451204/conundrums-and-confusions-regarding-how-polyethylene-glycol-fusion-produces-excellent-behavioral-recovery-after-peripheral-nerve-injuries
#9
REVIEW
George D Bittner, Dale R Sengelaub, Cameron L Ghergherehchi
Current Neuroscience dogma holds that transections or ablations of a segment of peripheral nerves produce: (1) Immediate loss of axonal continuity, sensory signaling, and motor control; (2) Wallerian rapid (1-3 days) degeneration of severed distal axons, muscle atrophy, and poor behavioral recovery after many months (if ever, after ablations) by slowly-regenerating (1 mm/d), proximal-stump outgrowths that must specifically reinnervate denervated targets; (3) Poor acceptance of microsutured nerve allografts, even if tissue-matched and immune-suppressed...
January 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29440680/an-allogeneic-off-the-shelf-therapeutic-strategy-for-peripheral-nerve-tissue-engineering-using-clinical-grade-human-neural-stem-cells
#10
C O'Rourke, A G E Day, C Murray-Dunning, L Thanabalasundaram, J Cowan, L Stevanato, N Grace, G Cameron, R A L Drake, J Sinden, J B Phillips
Artificial tissues constructed from therapeutic cells offer a promising approach for improving the treatment of severe peripheral nerve injuries. In this study the effectiveness of using CTX0E03, a conditionally immortalised human neural stem cell line, as a source of allogeneic cells for constructing living artificial nerve repair tissue was tested. CTX0E03 cells were differentiated then combined with collagen to form engineered neural tissue (EngNT-CTX), stable aligned sheets of cellular hydrogel. EngNT-CTX sheets were delivered within collagen tubes to repair a 12 mm sciatic nerve injury model in athymic nude rats...
February 13, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29219188/toxicity-trial-of-canine-posterior-cricoarytenoid-intramuscular-vincristine-injections
#11
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
#12
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
#13
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...
February 2018: 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
#14
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
#15
Dario Farina, Anna Margherita Castronovo, Ivan Vujaklija, Agnes Sturma, Stefan Salminger, Christian Hofer, Oskar Aszmann
We compared the behavior 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 nonphysiological 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 transhumeral 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...
November 15, 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
#16
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
#17
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
#18
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
#19
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
#20
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
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