Does Electrical Stimulation through Nerve Conduits Improve Peripheral Nerve Regeneration?—A Systematic Review

Hasiba-Pappas, Sophie; Kamolz, Lars‐Peter; Luze, Hanna; Nischwitz, Sebastian P.; Holzer-Geissler, Judith C. J.; Tuca, Alexandru; Rienmüller, Theresa Margarethe; Polz, Mathias; Ziesel, Daniel; Winter, Raimund

doi:10.3390/jpm13030414

Cited by 8 publications

(4 citation statements)

References 47 publications

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“…Conductive conduits enhance neural tissue mimicry and ES signal transmission. However, conductivity alone is not enough to repair without the use of an ES application 67 . This was in line with our findings that indicate conductivity alone is not sufficient to improve functional recovery.…”

Section: Discussionmentioning

confidence: 99%

Electrical stimulation enhances sciatic nerve regeneration using a silk-based conductive scaffold beyond traditional nerve guide conduits

Soltani Khaboushan,

Azimzadeh,

Behboodi Tanourlouee

et al. 2024

Sci Rep

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Despite recent advancements in peripheral nerve regeneration, the creation of nerve conduits with chemical and physical cues to enhance glial cell function and support axonal growth remains challenging. This study aimed to assess the impact of electrical stimulation (ES) using a conductive nerve conduit on sciatic nerve regeneration in a rat model with transection injury. The study involved the fabrication of conductive nerve conduits using silk fibroin and Au nanoparticles (AuNPs). Collagen hydrogel loaded with green fluorescent protein (GFP)-positive adipose-derived mesenchymal stem cells (ADSCs) served as the filling for the conduit. Both conductive and non-conductive conduits were applied with and without ES in rat models. Locomotor recovery was assessed using walking track analysis. Histological evaluations were performed using H&E, luxol fast blue staining and immunohistochemistry. Moreover, TEM analysis was conducted to distinguish various ultrastructural aspects of sciatic tissue. In the ES + conductive conduit group, higher S100 (p < 0.0001) and neurofilament (p < 0.001) expression was seen after 6 weeks. Ultrastructural evaluations showed that conductive scaffolds with ES minimized Wallerian degeneration. Furthermore, the conductive conduit with ES group demonstrated significantly increased myelin sheet thickness and decreased G. ratio compared to the autograft. Immunofluorescent images confirmed the presence of GFP-positive ADSCs by the 6th week. Locomotor recovery assessments revealed improved function in the conductive conduit with ES group compared to the control group and groups without ES. These results show that a Silk/AuNPs conduit filled with ADSC-seeded collagen hydrogel can function as a nerve conduit, aiding in the restoration of substantial gaps in the sciatic nerve with ES. Histological and locomotor evaluations indicated that ES had a greater impact on functional recovery compared to using a conductive conduit alone, although the use of conductive conduits did enhance the effects of ES.

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Section: Discussionmentioning

confidence: 99%

Electrical stimulation enhances sciatic nerve regeneration using a silk-based conductive scaffold beyond traditional nerve guide conduits

Soltani Khaboushan,

Azimzadeh,

Behboodi Tanourlouee

et al. 2024

Sci Rep

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“…Thus, multiple animal studies defend the beneficial effects of ES with low frequencies and electrodiagnostic tests, revealing a high increase in CMAP scores after ES [ 197 , 198 , 199 , 200 , 201 ].…”

Section: How To Improve Pni Repair?mentioning

confidence: 99%

“…Implementation of these rehabilitation protocols in delayed time frames after PNI could, however, lead to different reactions on axon regeneration and motoneuron synapsis [ 35 , 99 , 197 ].…”

Section: How To Improve Pni Repair?mentioning

confidence: 99%

Early Intensive Neurorehabilitation in Traumatic Peripheral Nerve Injury—State of the Art

Gouveia,

Cardoso,

Carvalho

et al. 2024

Animals

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Traumatic nerve injuries are common lesions that affect several hundred thousand humans, as well as dogs and cats. The assessment of nerve regeneration through animal models may provide information for translational research and future therapeutic options that can be applied mutually in veterinary and human medicine, from a One Health perspective. This review offers a hands-on vision of the non-invasive and conservative approaches to peripheral nerve injury, focusing on the role of neurorehabilitation in nerve repair and regeneration. The peripheral nerve injury may lead to hypersensitivity, allodynia and hyperalgesia, with the possibility of joint contractures, decreasing functionality and impairing the quality of life. The question remains regarding how to improve nerve repair with surgical possibilities, but also considering electrical stimulation modalities by modulating sensory feedback, upregulation of BDNF, GFNF, TrKB and adenosine monophosphate, maintaining muscle mass and modulating fatigue. This could be improved by the positive synergetic effect of exercises and physical activity with locomotor training, and other physical modalities (low-level laser therapy, ultrasounds, pulsed electromagnetic fields, electroacupuncture and others). In addition, the use of cell-based therapies is an innovative treatment tool in this field. These strategies may help avoid situations of permanent monoplegic limbs that could lead to amputation.

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“…Implementation of these rehabilitation protocols in delayed time frames after PNI could, however, lead to different reactions on axon regeneration and motoneuron synapsis [35,99,197].…”

Section: Combination Of Electrical Stimulation and Locomotor Trainingmentioning

confidence: 99%

Early Intensive Neurorehabilitation in Traumatic Peripheral Nerve Injury – State of the Art

Gouveia,

Cardoso,

Carvalho

et al. 2024

Preprint

View full text Add to dashboard Cite

Traumatic nerve injuries are common lesions that affect several hundred thousand humans, as well as dogs and cats. The assessment of nerve regeneration trough animal models may provide information for translational research and future therapeutic options that can be applied mutually in veterinary and human medicine, in a one health perspective. This review offers a hands-on vision about the non-invasive and conservative approaches on peripheral nerve injury, focusing the role of neurorehabilitation in nerve repair and regeneration. The peripheral nerve injury may lead to hypersensitivity, allodynia and hyperalgesia, with the possibility of joint contractures, decreasing functionality and impairing the quality of life. The question remains regarding how to improve nerve repair with surgical possibilities, but also considering electrical stimulation modalities by modulating sensory feedback, upregulation BDNF, GFNF, TrKB and adenosine monophosphate, maintaining muscle mass and modulating fatigue. This could be improved by the positive synergetic effect of exercises and physical activity with locomotor training, and other physical modalities, such as low-level laser therapy and ultrasounds. In addition, the use of cell-based therapies is an innovative treatment tool in this field. These strategies may help avoiding situations of permanent monoplegic limbs that could lead to amputation.

show abstract

Does Electrical Stimulation through Nerve Conduits Improve Peripheral Nerve Regeneration?—A Systematic Review

Cited by 8 publications

References 47 publications

Electrical stimulation enhances sciatic nerve regeneration using a silk-based conductive scaffold beyond traditional nerve guide conduits

Electrical stimulation enhances sciatic nerve regeneration using a silk-based conductive scaffold beyond traditional nerve guide conduits

Early Intensive Neurorehabilitation in Traumatic Peripheral Nerve Injury—State of the Art

Early Intensive Neurorehabilitation in Traumatic Peripheral Nerve Injury – State of the Art

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