Effects of decompression on behavioral, electrophysiologic, and histomorphologic recovery in a chronic sciatic nerve compression model of streptozotocin-induced diabetic rats

Abstract

PurposeTo determine susceptibility to decompression surgery in diabetic and nondiabetic peripheral neuropathy using a chronic compression neuropathy model.Materials and methodsTwenty-four streptozotocin-induced diabetic rats were randomly divided into three groups: group I, chronic compression of the left sciatic nerve for 4 weeks with decompression; group II, similar without decompression; and group III, sham exposing the sciatic nerve only. The other 24 nondiabetic rats were assigned to groups IV–VI, which received compression–decompression, compression, and the sham operation, respectively. Mixed-nerve-elicited somatosensory evoked potentials (M-SSEPs) and compound muscle action potentials (CMAPs) were measured to verify the compression neuropathy in the posttreatment follow-up. Behavioral observations in thermal hyperalgesia tests were quantified before electrophysiologic examinations. Treated and contralateral nerves were harvested for histomorphologic analysis.ResultsChronic compression of sciatic nerve induced significant reduction of amplitude and increment of latency of M-SSEP and CMAP in both diabetic and nondiabetic rats. Diabetic group changes were more susceptible. Decompression surgery significantly improved both sensory and motor conduction, thermal hyperalgesia, and the mean myelin diameter of the rat sciatic nerve in both diabetic and nondiabetic groups. Near full recovery of motor and sensory function occurred in the nondiabetic rats, but not in the diabetic rats 8 weeks postdecompression.ConclusionBehavioral, electrophysiologic, and histomorphologic findings indicate that decompression surgery is effective in both diabetic and nondiabetic peripheral neuropathy.

A quantitative evaluation of sciatic nerve stiffness after compression by shear wave elastography in diabetic rats

“…The pathogenesis of diabetic neuropathy is complex. Hyperglycemia leads to an excess of intramitochondrial reactive oxygen species, inflammatory reactions, and edema formation in peripheral nerves (21). The double crush hypothesis states that a diabetic nerve is more susceptible to compression than a nondiabetic nerve (7).…”

Obstetric Neuropathy in Diabetic Patients: The “Double Hit Hypothesis”

“…In contrast, the cell bodies of motor neurons are located in the anterior horn of the spinal cord. The blood–neuron interface is less well-protected in the dorsal root ganglion than in the spinal cord [ 20 , 21 , 22 ]. It is noteworthy to point out that surgical decompression can be an effective treatment for diabetic neuropathy [ 23 ].…”

Nerve decompression surgery suppresses TNF‐ɑ expression and T cell infiltration in a rat sciatic nerve chronic constriction injury model

“…5,6 Several studies have reported nerve decompression animal models, established using methods such as removal of ligations after chronic constriction injury (CCI) surgery or removal of silicone that was wrapped around nerves. [7][8][9][10] These studies reported that DS ameliorates mechanical and thermal hypersensitivity. However, despite DS being the gold standard treatment for chronic nerve compression injuries in clinical settings, the molecular mechanisms underlying its effectiveness are not fully understood.…”

“…Decompression surgery (DS) is the standard treatment used to relieve the symptoms of such injuries when conservative treatments are ineffective 5,6 . Several studies have reported nerve decompression animal models, established using methods such as removal of ligations after chronic constriction injury (CCI) surgery or removal of silicone that was wrapped around nerves 7–10 . These studies reported that DS ameliorates mechanical and thermal hypersensitivity.…”