The use of electrical stimulation to enhance recovery following peripheral nerve injury.

IF 2.8 3区 医学 Q2 CLINICAL NEUROLOGY
Muscle & Nerve Pub Date : 2024-12-01 Epub Date: 2024-09-30 DOI:10.1002/mus.28262
Paige B Hardy, Bonnie Y Wang, K Ming Chan, Christine A Webber, Jenna-Lynn B Senger
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引用次数: 0

Abstract

Peripheral nerve injury is common and can have devastating consequences. In severe cases, functional recovery is often poor despite surgery. This is primarily due to the exceedingly slow rate of nerve regeneration at only 1-3 mm/day. The local environment in the distal nerve stump supportive of nerve regrowth deteriorates over time and the target end organs become atrophic. To overcome these challenges, investigations into treatments capable of accelerating nerve regrowth are of great clinical relevance and are an active area of research. One intervention that has shown great promise is perioperative electrical stimulation. Postoperative stimulation helps to expedite the Wallerian degeneration process and reduces delays caused by staggered regeneration at the site of nerve injury. By contrast, preoperative "conditioning" stimulation increases the rate of nerve regrowth along the nerve trunk. Over the past two decades, a rich body of literature has emerged that provides molecular insights into the mechanism by which electrical stimulation impacts nerve regeneration. The end result is upregulation of regeneration-associated genes in the neuronal body and accelerated transport to the axon front for regrowth. The efficacy of brief electrical stimulation on patients with peripheral nerve injuries was demonstrated in a number of randomized controlled trials on compressive, transection and traction injuries. As approved equipment to deliver this treatment is becoming available, it may be feasible to deploy this novel treatment in a wide range of clinical settings.

利用电刺激促进周围神经损伤后的恢复。
周围神经损伤是一种常见病,可造成严重后果。在严重的病例中,尽管进行了手术,但功能恢复往往很差。这主要是由于神经再生的速度非常缓慢,每天只有 1-3 毫米。随着时间的推移,支持神经再生的远端神经残端局部环境会恶化,目标末端器官也会萎缩。为了克服这些挑战,研究能够加速神经再生的治疗方法具有重要的临床意义,也是一个活跃的研究领域。围手术期电刺激是一种前景广阔的干预措施。术后电刺激有助于加快 Wallerian 退化过程,减少神经损伤部位交错再生造成的延迟。相比之下,术前 "调节 "刺激可提高神经干的神经再生速度。在过去二十年中,出现了大量文献,从分子角度揭示了电刺激影响神经再生的机制。其最终结果是上调神经元体中与再生相关的基因,并加速向轴突前端的运输以促进再生。针对压迫性损伤、横断性损伤和牵引性损伤的多项随机对照试验都证明了短暂电刺激对周围神经损伤患者的疗效。随着这种治疗方法的设备逐渐获得批准,在广泛的临床环境中应用这种新型治疗方法也许是可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Muscle & Nerve
Muscle & Nerve 医学-临床神经学
CiteScore
6.40
自引率
5.90%
发文量
287
审稿时长
3-6 weeks
期刊介绍: Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.
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