Timing of Applying Electrical Stimulation Is an Important Factor Deciding the Success Rate and Maturity of Regenerating Rat Sciatic Nerves

Yeh, Chun-Chieh; Lin, Yu Ching; Tsai, Fuu Jen; Huang, Chih Yang; Yao, Chun Hsu; Chen, Yueh Sheng

doi:10.1177/1545968310376758

Cited by 48 publications

(27 citation statements)

References 23 publications

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“…It was discovered that introducing a seven-day incubation (delayed ES) period following cell seeding led to an increased rate of regeneration and resulted in enhanced maturity of the neural components within the growth conduit. 98 The number of myelinated axons that successfully grew across the 10 mm nerve gap was twofold greater in the delayed ES group than in the immediate ES group. 98 The same study also showed that the nerves were larger and the amount of blood vessels and revascularization was greater in the delayed ES group than in the immediate ES group.…”

Section: Effect Of Electrical Stimulation On Neuronsmentioning

confidence: 87%

“…98 The number of myelinated axons that successfully grew across the 10 mm nerve gap was twofold greater in the delayed ES group than in the immediate ES group. 98 The same study also showed that the nerves were larger and the amount of blood vessels and revascularization was greater in the delayed ES group than in the immediate ES group. 98 These accounts highlight the importance of temporal relationships in ES experimental design in the optimization of NGCs.…”

Section: Effect Of Electrical Stimulation On Neuronsmentioning

confidence: 87%

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Peripheral Nerve Regeneration Strategies: Electrically Stimulating Polymer Based Nerve Growth Conduits

Anderson

Shelke

Manoukian

et al. 2015

Crit Rev Biomed Eng

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Treatment of large peripheral nerve damages ranges from the use of an autologous nerve graft to a synthetic nerve growth conduit. Biological grafts, in spite of many merits, show several limitations in terms of availability and donor site morbidity, and outcomes are suboptimal due to fascicle mismatch, scarring, and fibrosis. Tissue engineered nerve graft substitutes utilize polymeric conduits in conjunction with cues both chemical and physical, cells alone and or in combination. The chemical and physical cues delivered through polymeric conduits play an important role and drive tissue regeneration. Electrical stimulation (ES) has been applied toward the repair and regeneration of various tissues such as muscle, tendon, nerve, and articular tissue both in laboratory and clinical settings. The underlying mechanisms that regulate cellular activities such as cell adhesion, proliferation, cell migration, protein production, and tissue regeneration following ES is not fully understood. Polymeric constructs that can carry the electrical stimulation along the length of the scaffold have been developed and characterized for possible nerve regeneration applications. We discuss the use of electrically conductive polymers and associated cell interaction, biocompatibility, tissue regeneration, and recent basic research for nerve regeneration. In conclusion, a multifunctional combinatorial device comprised of biomaterial, structural, functional, cellular, and molecular aspects may be the best way forward for effective peripheral nerve regeneration.

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Section: Effect Of Electrical Stimulation On Neuronsmentioning

confidence: 87%

Section: Effect Of Electrical Stimulation On Neuronsmentioning

confidence: 87%

Peripheral Nerve Regeneration Strategies: Electrically Stimulating Polymer Based Nerve Growth Conduits

Anderson

Shelke

Manoukian

et al. 2015

Crit Rev Biomed Eng

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“…Previous studies have shown that electrical stimulation of regenerating nerves initiated at day 8 after nerve repair had significantly more axons than controls receiving no ES [22]. However, in this study, percutaneous ES was used on the animals, which may not have stimulated the transected nerves effectively.…”

Section: Introductionmentioning

confidence: 85%

Electrical Stimulation Promotes Regeneration of Defective Peripheral Nerves after Delayed Repair Intervals Lasting under One Month

Kou

Zhang

et al. 2014

PLoS ONE

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BackgroundElectrical stimulation (ES) has been proven to be an effective means of enhancing the speed and accuracy of nerve regeneration. However, these results were recorded when the procedure was performed almost immediately after nerve injury. In clinical settings, most patients cannot be treated immediately. Some patients with serious trauma or contaminated wounds need to wait for nerve repair surgery. Delays in nerve repair have been shown to be associated with poorer results than immediate surgery. It is not clear whether electrical stimulation still has any effect on nerve regeneration after enough time has elapsed.MethodsA delayed nerve repair model in which the rats received delayed nerve repair after 1 day, 1 week, 1 month, and 2 months was designed. At each point in time, the nerve stumps of half the rats were bridged with an absorbable conduit and the rats were given 1 h of weak electrical stimulation. The other half was not treated. In order to analyze the morphological and molecular differences among these groups, 6 ES rats and 6 sham ES rats per point in time were killed 5 days after surgery. The other rats in each group were allowed to recover for 6 weeks before the final functional test and tissue observation.ResultsThe amounts of myelinated fibers in the distal nerve stumps decreased as the delay in repair increased for both ES rats and sham ES rats. In the 1-day-delay and 1-week-delay groups, there were more fibers in ES rats than in sham ES rats. And the compound muscle action potential (CMAP) and motor nerve conduction velocity (MNCV) results were better for ES rats in these two groups. In order to analyze the mechanisms underlying these differences, Masson staining was performed on the distal nerves and quantitative PCR on the spinal cords. Results showed that, after delays in repair of 1 month and 2 months, there was more collagen tissue hyperplasia in the distal nerve in all rats. The brain-derived neurotrophic factor (BDNF) and trkB expression levels in the spinal cords of ES rats were higher than in sham ES rats. However, these differences decreased as the delay in repair increased.ConclusionsElectrical stimulation does not continue to promote nerve regeneration after long delays in nerve repair. The effective interval for nerve regeneration after delayed repair was found to be less than 1 month. The mechanism seemed to be related to the expression of nerve growth factors and regeneration environment in the distal nerves.

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“…Experimental approaches to enhance recovery have focused on transection and nerve gap injuries, variously investigating pharmacologic agents, 2 neurotrophic factors, 3 novel scaffolds, and conduits, 4 blockade of factors that inhibit regeneration, 5 cellular transplantation, 6,7 and electrical stimulation. 8–12 …”

mentioning

confidence: 99%

Axonal regeneration and motor neuron survival after microsurgical nerve reconstruction

et al. 2012

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Rodent models are used extensively for studying nerve regeneration, but little is known about how sprouting and pruning influence peripheral nerve fiber counts and motor neuron pools. The purpose of this study was to identify fluctuations in nerve regeneration and neuronal survival over time. One hundred and forty-four Lewis rats were randomized to end-to-end repair or nerve grafting (1.5 cm graft) after sciatic nerve transection. Quantitative histomorphometry and retrograde labeling of motor neurons were performed at 1, 3, 6, 9, 12, and 24 months and supplemented by electron microscopy. Fiber counts and motor neuron counts increased between 1 and 3 months, followed by plateau. End-to-end repair resulted in persistently higher fiber counts compared to the grafting for all time points (P < 0.05). Percent neural tissue and myelin width increased with time while fibrin debris dissipated. In conclusion, these data detail the natural history of regeneration and demonstrate that overall fiber counts may remain stable despite pruning.

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Timing of Applying Electrical Stimulation Is an Important Factor Deciding the Success Rate and Maturity of Regenerating Rat Sciatic Nerves

Abstract: A short delay in the onset of ES may improve the recovery of a severe peripheral nerve injury, which should be considered as a way of augmenting rehabilitative approaches.

Cited by 48 publications

References 23 publications

Peripheral Nerve Regeneration Strategies: Electrically Stimulating Polymer Based Nerve Growth Conduits

Peripheral Nerve Regeneration Strategies: Electrically Stimulating Polymer Based Nerve Growth Conduits

Electrical Stimulation Promotes Regeneration of Defective Peripheral Nerves after Delayed Repair Intervals Lasting under One Month

Axonal regeneration and motor neuron survival after microsurgical nerve reconstruction

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