Localization of the nerves innervating the pelvic floor muscles: An application to pelvic pain treatment

Hu, Xiangnan; Hu, Shuangjiang; Wang, Meng; Xiong, Wei; Yang, Shengbo

doi:10.1002/ca.23935

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…INDRs may serve as an alternative target of BTX-A blocking injections for muscle spasticity (6)(7)(8). Therefore, INDR localization has become a research focus (9,10). Some studies revealed that the excitation of muscle spindles could exacerbate muscle spasticity via the α-γ loop (11) and that muscle spindle abundance is high in INDRs but are not evenly distributed (12).…”

Section: Introductionmentioning

confidence: 99%

The highest region of muscle spindle abundance should be the optimal target of botulinum toxin A injection to block muscle spasms in rats

Li²,

Yang³

et al. 2023

Front. Neurol.

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PurposeThe effective relief of muscle spasticity requires prompt solutions in rehabilitation medicine. This study aimed to reveal that the highest region of muscle spindle abundance is the optimal target of botulinum toxin A (BTX-A) injections for relieve muscle spasm.MethodsSixty adult, male Sprague–Dawley rats with lower limbs spasm caused by stroke after modeling, weighing (200 ± 20) g, were included in this study. The modelrats were divided into four groups: muscle spasm model group (group A), model rats treated with BTX-A injections into the middle of the muscle belly (group B), model rats treated with BTX-A injections into the center of the intramuscular nerve-dense region (INDR) (group C), and model rats treated with BTX-A injection into the center of the highest region of muscle spindle abundance (HRMSA) (group D). Groups B, C, and D were further divided into two subgroups: the 3rd and 6th days after BTX-A injection. The rats in each group were assigned modified Ashworth scale scores (MAS), and the changes in gastrocnemius muscle tone, wet muscle weight, and cross-sectional area of muscle fiber were detected.ResultsMuscle spindle abundance was the highest in the upper part of the INDR. Group B experienced no significant changes in MAS, muscle tone, wet muscle weight, or cross-sectional area of the muscle fiber. Conversely, groups C and D experienced a decrease in these indicators. Group C experienced the most significant decrease in wet muscle weight and cross-sectional area of muscle fibers. Group D experienced the most notable decrease in MAS and muscle tone. There were no significant differences in the indicators between the 3rd and 6th days after BTX-A injections in group B and there were significant differences in the improvement in the indicators between the two subgroups in groups C and D, with group D experiencing more notable intersubgroup differences.ConclusionThe efficacy of BTX-A injections into the HRMSA is significantly superior to that of conventional BTX-A injections into the middle of the belly muscle or the INDR in the treatment of muscle spasms. Hence, HRMSA should be the optimal target of BTX-A to relieve muscle spasms.

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Section: Introductionmentioning

confidence: 99%

The highest region of muscle spindle abundance should be the optimal target of botulinum toxin A injection to block muscle spasms in rats

Li²,

Yang³

et al. 2023

Front. Neurol.

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“…However, the INDR is a broader region and requires a high‐dose injection of BTX‐A, which can produce side effects such as antibodies and muscle fibrosis (Kroumpouzos et al., 2021 ). It has been suggested that the muscle spindle plays a vital role in muscle spasticity and that BTX‐A could maximise the blockade of intrafusal muscle fibres and minimise the effects on extrafusal muscle fibres (He et al., 2022 ; Hu et al., 2022 ; Phadke et al., 2013 ). Muscle spindles grow at different rates and are highly abundant in the INDR but are not uniformly distributed (Banks, 2006 ).…”

Section: Introductionmentioning

confidence: 99%

Localisation of the centre of the highest region of muscle spindle abundance of anterior forearm muscles

Zhou,

Jia,

Chen

et al. 2023

Journal of Anatomy

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The centre of the highest region of muscle spindle abundance (CHRMSA) in the intramuscular nerve‐dense region has been suggested as the optimal target location for injecting botulinum toxin A to block muscle spasms. The anterior forearm muscles have a high incidence of spasticity. However, the CHRMSA in the intramuscular nerve‐dense region of the forearm anterior muscle group has not been defined. This study aimed to accurately define the body surface position and the depth of CHRMSA in an intramuscular nerve‐dense region of the anterior forearm muscles. Twenty‐four adult cadavers (57.7 ± 11.5 years) were included in this study. The curved line close to the skin connecting the medial and lateral epicondyles of the humerus was designated as the horizontal reference line (H line), and the line connecting the medial epicondyle of the humerus and the ulnar styloid was defined as the longitudinal reference line (L line). Modified Sihler's staining, haematoxylin–eosin staining and computed tomography scanning were employed to determine the projection points (P and P′) of the CHRMSAs on the anterior and posterior surfaces of the forearm. The positions (PH and PL) of point P projected onto the H and L lines, and the depth of each CHRMSA, were determined using the Syngo system. The PH of the CHRMSA of the ulnar head of pronator teres, humeral head of pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, ulnar part of flexor digitorum superficialis, radial part of flexor digitorum superficialis, flexor pollicis longus, ulnar part of flexor digitorum profundus, radial portion of flexor digitorum profundus and pronator quadratus muscles were located at 42.48%, 45.52%, 41.20%, 19.70%, 7.77%, 25.65%, 47.42%, 53.47%, 12.28%, 38.41% and 51.68% of the H line, respectively; the PL were located at 18.38%, 12.54%, 28.83%, 13.43%, 17.65%, 32.76%, 57.32%, 64.12%, 20.05%, 45.94% and 88.71% of the L line, respectively; the puncture depths were located at 21.92%, 27.25%, 23.76%, 18.04%, 15.49%, 31.36%, 26.59%, 41.28%, 38.72%, 45.14% and 53.58% of the PP' line, respectively. The percentage values are the means of individual values. We recommend that the body surface puncture position and depth of the CHRMSA are the preferred locations for the intramuscular injection of botulinum toxin A to block anterior forearm muscle spasms.

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Anatomical Study of the Inferior Oblique Muscle and Its Innervation: Morphometric Characteristics, Anatomical Variations, and Histological Evaluation of the Nerve to the Inferior Oblique Muscle

Haładaj,

Tubbs,

Varga

2024

Brain Sciences

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Background: This report aims to supplement the existing knowledge on the inferior oblique muscle. In particular, this study presents detailed anatomical and histological data concerning the muscle’s entry point (or entry zone) of the nerve to the inferior oblique muscle. Particular attention was paid to the topographical relationships of the nerve to the inferior oblique muscle (NTIO), including the location of its entry point to the muscle’s belly and its anatomical variations. Methods: Sixty orbits from cadaveric hemi-heads fixed in 10% formalin were studied. The course of the NTIO was traced along the lateral border of the inferior rectus muscle as far as its entry point to the inferior oblique muscle. Particular attention was paid to the various ways in which the NTIO’s muscular sub-branches penetrated between the fibers of the inferior oblique muscle. Results: Three types of NTIO entries to the inferior oblique muscle’s belly were distinguished. In the most common type (48.3%), the nerve entered the muscle’s inferior (orbital) surface. In the next most common type (36.7%), terminal muscular sub-branches of the NTIO joined the superior (also referred to as ocular or global) surface of the inferior oblique muscle. In the remaining four cases (15%), the terminal sub-branches of the NTIO were divided into two main groups (superior and inferior) that joined both the superior and inferior surfaces of the muscle. Histological examination confirmed that the distal part of the NTIO shows a characteristic arcuate course (angulation) just before reaching the muscle’s belly. The process for splitting and forming separate muscular sub-branches of the NTIO was observed for all the examined histological specimens at the level of the nerve’s angulation. Conclusions: The presented findings enhance the understanding of the anatomical variations and precise distribution of motor sub-branches reaching the inferior oblique muscle, which may deepen anatomical knowledge and potentially enhance the management of ocular motor disorders.

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Localization of the nerves innervating the pelvic floor muscles: An application to pelvic pain treatment

Cited by 3 publications

References 31 publications

The highest region of muscle spindle abundance should be the optimal target of botulinum toxin A injection to block muscle spasms in rats

The highest region of muscle spindle abundance should be the optimal target of botulinum toxin A injection to block muscle spasms in rats

Localisation of the centre of the highest region of muscle spindle abundance of anterior forearm muscles

Anatomical Study of the Inferior Oblique Muscle and Its Innervation: Morphometric Characteristics, Anatomical Variations, and Histological Evaluation of the Nerve to the Inferior Oblique Muscle

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