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Peripheral nerve injury

Erika M Walsh, Denzel Cole, Kiranya E Tipirneni, Kirby I Bland, Neha Udayakumar, Benjamin B Kasten, Stephanie L Bevans, Benjamin M McGrew, Joshua J Kain, Quyen T Nguyen, Eben L Rosenthal, Jason M Warram
MINI: Fluorescence-based nerve enhancement has advanced rapidly with potential for continued utilization and progression in translational research, though the ideal agent remains elusive. This review details the agents for fluorescence-guided nerve imaging in both preclinical and clinical use to identify factors important in selecting nerve-specific fluorescent agents for surgical procedures. OBJECTIVE: This review details the agents for fluorescence-guided nerve imaging in both preclinical and clinical use to identify factors important in selecting nerve-specific fluorescent agents for surgical procedures...
January 10, 2019: Annals of Surgery
Tim Godel, Mirko Pham, Henrich Kele, Moritz Kronlage, Daniel Schwarz, Merle Brunée, Sabine Heiland, Martin Bendszus, Philipp Bäumer
PURPOSE: By applying diffusor tensor imaging (DTI) in patients with anterior interosseous nerve syndrome (AINS), this proof of principle study aims to quantify the extent of structural damage of a peripheral nerve at the anatomical level of individual fascicles. METHODS: In this institutional review board approved prospective study 13 patients with spontaneous AINS were examined at 3 Tesla including a transversal T2-weighted turbo-spin-echo and a spin-echo echo-planar-imaging pulse sequence of the upper arm level...
January 9, 2019: NeuroImage: Clinical
Mark A Mahan
Stretch injuries are among the most devastating forms of peripheral nerve injury; unfortunately, the scientific understanding of nerve biomechanics is widely and impressively conflicting. Experimental models are unique and disparate, victim to different testing conditions, and thus yield gulfs between conclusions. The details of the divergent reports on nerve biomechanics are essential for critical appraisal as we try to understand clinical stretch injuries in light of research evidence. These conflicts preclude broad conclusion, but they highlight a duality in thought on nerve stretch and, within the details, some agreement exists...
January 11, 2019: Journal of Neurosurgery
Robyn S Weisman, Nirav P Bhavsar, Kathleen A Schuster, Ralf E Gebhard
BACKGROUND AND OBJECTIVES: The exact mechanism of peripheral nerve blocks causing/leading to nerve injury remains controversial. Evidence from animal experiments suggests that intrafascicular injection resulting in high injection pressure has the potential to rupture nerve fascicles and may consequently cause permanent nerve injury and neurological deficits. The B-Smart (BS) in-line manometer and the CompuFlo (CF) computerized injection pump technology are two modalities used for monitoring pressure during regional anesthesia...
January 2019: Regional Anesthesia and Pain Medicine
Meghana Yajnik, Alex Kou, Seshadri C Mudumbai, Tessa L Walters, Steven K Howard, T Edward Kim, Edward R Mariano
BACKGROUND AND OBJECTIVES: Perioperative peripheral nerve injury (PNI) is a known complication in patients undergoing surgery with or without regional anesthesia. The incidence of new PNI in a Veterans Affairs (VA) inpatient surgical population has not been previously described; therefore, the incidence, risk factors, and clinical course of new PNI in this cohort are unknown. We hypothesized that peripheral nerve blocks do not increase PNI incidence. METHODS: We conducted a 5-year review of a Perioperative Surgical Home database including all consecutive surgical inpatients...
January 2019: Regional Anesthesia and Pain Medicine
Raphael R Perim, Gordon S Mitchell
Acute intermittent hypoxia (AIH) elicits distinct mechanisms of phrenic motor plasticity initiated by brainstem neural network activation versus local (spinal) tissue hypoxia. With moderate AIH (mAIH), hypoxemia activates the carotid body chemoreceptors and (subsequently) brainstem neural networks associated with the peripheral chemoreflex, including medullary raphe serotonergic neurons. Serotonin release and receptor activation in the phrenic motor nucleus then elicits phrenic long-term facilitation (pLTF)...
January 10, 2019: Respiratory Physiology & Neurobiology
Gerburg Keilhoff, Ricardo Pirex Mbou, Benjamin Lucas, Lorenz Schild
Motor neuron damage caused by diseases, traumatic insults or de-afferentation of the spinal cord is often incurable due to the poor intrinsic regenerative capacity. Moreover, regenerated peripheral nerves often do not reach normal functionality. Here, we investigated cardiolipin in the process of neuro-differentiation, since cardiolipin is closely linked to the mitochondrial energy supply in cells. The NSC-34 hybrid cell line, produced by fusing neuroblastoma cells with primary spinal cord motor neurons, was used, since it shares several morphological and physiological characteristics with mature primary motor neurons...
January 10, 2019: Neuroscience
Cristiana R Carvalho, Joana Silva-Correia, Joaquim M Oliveira, Rui L Reis
The recent progress in biomaterials science and development of tubular conduits (TCs) still fails in solving the current challenges in the treatment of peripheral nerve injuries (PNIs), in particular when disease-related and long-gap defects need to be addressed. Nanotechnology-based therapies that seemed unreachable in the past are now being considered for the repair and reconstruction of PNIs, having the power to deliver bioactive molecules in a controlled manner, to tune cellular behavior, and ultimately guide tissue regeneration in an effective manner...
January 10, 2019: Advanced Drug Delivery Reviews
David H Cisewski, Stephen Alerhand
BACKGROUND: In the midst of a nationwide opioid epidemic, focus has been placed on identifying and utilizing safe, effective opioid-free analgesic alternatives. Lower-extremity peripheral nerve blockades are common and often involve both motor and sensory anesthesia, resulting in leg weakness and ambulatory difficulty. The aim of this case report is to describe an ultrasound-guided peripheral nerve block technique (superficial cutaneous anesthesia in a lateral (leg) distribution within the emergency department ['SCALD-ED' block]) that provides motor-sparing, purely sensory anesthesia after a superficial injury to the lateral leg in patients presenting to the emergency department...
January 8, 2019: Journal of Emergency Medicine
Jean Carlos Debastiani, André Junior Santana, Lucinéia de Fátima Chasko Ribeiro, Rose Meire Costa Brancalhão, Gladson Ricardo Flor Bertolini
OBJECTIVE: To verify the action of sericin associated to swim exercise with overload, on sciatic nerve repair in Wistar rats, after 22 days of nerve compression. METHODS: Forty animals been composed of five groups: control, injury, injury-sericin, injury-swimming and injury-sericin-swimming. During the lesion procedure, sericin, in hydrolyzed form, applied directly to the injury in the injury-sericin and injury-sericin-swimming groups. Injury-swimming and injury-sericin-swimming groups underwent to 5 days per week for 3 weeks, with a 10% overload of the animal's body weight, and a weekly progressive evolution of swimming time, lasting 15, 20 and 25 min/day...
January 13, 2019: Neurological Research
Masaaki Kitada, Toru Murakami, Shohei Wakao, Gen Li, Mari Dezawa
Direct conversion is considered a promising approach to obtain tissue-specific cells for cell therapies; however, this strategy depends on exogenous gene expression that may cause undesired adverse effects such as tumorigenesis. By optimizing the Schwann cell induction system, which was originally developed for trans-differentiation of bone marrow mesenchymal stem cells into Schwann cells, we established a system to directly convert adult human skin fibroblasts into cells comparable to authentic human Schwann cells without gene introduction...
January 13, 2019: Glia
Joyce T da Silva, Bianca G Evangelista, Rafael A G Venega, David A Seminowicz, Marucia Chacur
Neuropathic pain is driven by abnormal peripheral and central processing, and treatments are insufficiently effective. Antibodies against nerve growth factor (anti-NGF) have been investigated as a potent analgesic treatment for numerous conditions. However, the peripheral and brain effects of anti-NGF in neuropathic pain remain unknown. We examined the effectiveness of anti-NGF in reducing chronic pain by local administration in a rat model of sciatic constriction injury (CCI). NGF and substance P in the dorsal root ganglion (DRG) and spinal cord were evaluated...
February 2019: Behavioural Pharmacology
Stefania Goncalves, Bradley J Goldstein
The olfactory epithelium (OE) is the peripheral organ for the sense of smell, housing primary sensory neurons that project axons from the nose to the brain. Due the presence of a basal stem cell niche, the adult mammalian OE is a dynamic tissue capable of replacing neurons following their loss. Nonetheless, certain conditions, such as blunt head trauma, can result in persistent olfactory loss, thought to be due to shearing of olfactory nerve filaments at the skull base, degeneration, and failures in proper regeneration/reinnervation...
January 11, 2019: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
Fei Yu, You-Lai Yu, Su-Ping Niu, Pei-Xun Zhang, Xiao-Feng Yin, Na Han, Ya-Jun Zhang, Dian-Ying Zhang, Yu-Hui Kou, Bao-Guo Jiang
Multiple regeneration of axonal buds has been shown to exist during the repair of peripheral nerve injury, which confirms a certain repair potential of the injured peripheral nerve. Therefore, a systematic nerve transposition repair technique has been proposed to treat severe peripheral nerve injury. During nerve transposition repair, the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively grow into the repaired distal nerve and target muscle tissues, which is conducive to the recovery of motor function...
April 2019: Neural Regeneration Research
Zhi-Yong Wang, Li-Hua Qin, Wei-Guang Zhang, Pei-Xun Zhang, Bao-Guo Jiang
Qian-Zheng-San, a traditional Chinese prescription consisting of Typhonii Rhizoma, Bombyx Batryticatus, Scorpio, has been found to play an active therapeutic role in central nervous system diseases. However, it is unclear whether Qian-Zheng-San has therapeutic value for peripheral nerve injury. Therefore, we used Sprague-Dawley rats to investigate this. A sciatic nerve crush injury model was induced by clamping the right sciatic nerve. Subsequently, rats in the treatment group were administered 2 mL Qian-Zheng-San (1...
April 2019: Neural Regeneration Research
Jing Fei, Lin Gao, Huan-Huan Li, Qiong-Lan Yuan, Lei-Ji Li
The efficacy of electroacupuncture in the treatment of peripheral facial paralysis is known, but the specific mechanism has not been clarified. Glial cell-derived neurotrophic factor (GDNF) has been shown to protect neurons by binding to N-cadherin. Our previous results have shown that electroacupuncture could increase the expression of N-cadherin mRNA in facial neurons and promote facial nerve regeneration. In this study, the potential mechanisms by which electroacupuncture promotes nerve regeneration were elucidated through assessing the effects of electroacupuncture on GDNF and N-cadherin expression in facial motoneurons of rabbits with peripheral facial nerve crush injury...
April 2019: Neural Regeneration Research
Kijung Sung, Wanlin Yang, Chengbiao Wu
Nerve growth factor (NGF) is a powerful trophic factor that provides essential support for the survival and differentiation of sympathetic and sensory neurons during development. However, NGF also activates nociceptors contributing significantly to inflammatory pain and neuropathic pain after tissue injury. As such anti-NGF based therapies represent a promising strategy for pain management. Because of dose-dependent serious side effects such as back pain, injection site hyperalgesia, clinical trials of using NGF to treat various disorders such as diabetic neuropathies, chemotherapy-induced and human immunodeficiency virus-associated peripheral neuropathies were all discontinued...
April 2019: Neural Regeneration Research
Chun-Lin Mai, Xiao Wei, Ya-Nan Xu, Jun Zhang, Zhen Jia Lin, Zhi Tan, Ying-Tong Meng, Yong-Yong Li, Li-Jun Zhou, Xian-Guo Liu
Accumulating evidence shows that inhibition of glycogen synthase kinase-3beta (GSK-3β) ameliorates cognitive impairments caused by a diverse array of diseases. Our previous work show that spared nerve injury (SNI) that induces neuropathic pain causes short-term memory (STM) deficits.Here,we reported that GSK-3β activity was enhanced in hippocampus and reduced in spinal dorsal horn following SNI, and the changes persisted for at least 45 d. Repetitive applications of selective GSK-3β inhibitors (SB216763, 5 mg/kg, i...
January 11, 2019: Molecular Pain
Tomoyuki Nakasa, Yasunari Ikuta, Yusuke Tsuyuguchi, Yuki Ota, Munekazu Kanemitsu, Nobuo Adachi
BACKGROUND: Arthroscopic ankle arthrodesis (AAA) is minimally invasive surgery, whereby percutaneous screw fixation is used through the medial aspect of the distal tibia to fusion the ankle, but it carries the risk of the saphenous vein and nerve injuries. The near-infrared (NIR) vascular imaging system, the VeinViewer® Flex, projects an image of the vein onto the skin, and the visualization of the vein may reduce the vein and nerve injuries. The purpose of this study is to investigate the risk of the saphenous vein injury by the percutaneous screw insertion during AAA, and to evaluate the effectiveness of the NIR vascular imaging system in the reduction of the saphenous vein injury...
January 7, 2019: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
David Gullotti, Antonella Mangraviti, Jiangyang Zhang, Francesco Volpin, Gabriel Fink, Roey Reiss, Shivani Ahlawat, Alessandro Olivi, Ahmet Hoke, Betty Tyler, Allan Belzberg
BACKGROUND: Peripheral nerve injury is often followed by a highly variable recovery process with respect to both rapidity and efficacy. Identifying post-nerve injury phenomena is key to assessing the merit and timing of surgery as well as to tracking nerve recovery postoperatively. Diffusion Tensor Imaging (DTI) has been investigated in the clinical and research settings as a noninvasive technique to both assess and monitor each patient's unique case of peripheral nerve damage.i NEW METHOD: We identify a MRI-suitable marker for tracking the exact site of either nerve injury or coaptation following surgical repair to aid with DTI analysis...
January 7, 2019: Journal of Neuroscience Methods
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