Cryoanalgesia: electrophysiology at different temperatures

Zhou, Linqiu; Shao, Zengwu; Ou, Shihuan

doi:10.1016/s0011-2240(02)00160-8

Cited by 33 publications

(18 citation statements)

References 21 publications

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“…These markers indicated endoneurial and perineurial damage, but the epineurium appeared to remain intact [53]. The lower temperatures have also demonstrated a longer duration of electrophysiological and functional disruption when compared to temperatures warmer than -60°C [53,55]. These findings demonstrate that lower temperatures (<-100°C) creates a third degree nerve injury.…”

Section: Cryoneuromodulationmentioning

confidence: 77%

“…Additionally, a comparative study between crush lesion (a common model of Wallerian degeneration) and cryoneuromodulation treatment on a rat sciatic nerve showed comparable histological results of second degree injury [54]. Examination of tissue exposed to freezing temperature has found that cells are injured, but the surrounding acellular structures remain intact [55]. This feature aids in the preservation of the acellular structures of the endo-, peri-, and epi-neurium; allowing for normal axonal regeneration and return of function.…”

Section: Cryoneuromodulationmentioning

confidence: 99%

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Significance of Clinical Treatments on Peripheral Nerve and its Effect on Nerve Regeneration

Hsu¹

2014

J Neurol Disord

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Some neurological disorders that cannot be managed with medication can alternatively be directly treated either at the sensory and/or motor nerve(s). In particular, chronic pain and/or muscle spasticity are a couple types of symptoms that can potentially be treated at the associated nerve. Various chemicals and medical devices are currently being employed in the clinic to treat peripheral nerves. Treatment of sensory nerves is typically used to attenuate chronic pain symptoms, while motor nerves are targeted for spasticity symptoms. A majority of treatment methods currently used in the field involve nerve injury and denervation of the target tissue through different mechanisms of action. Depending on the type and severity of the treatment, the nerve may or may not fully regenerate to a normal state. This article will review the various types of clinical methods used to treat neurological disorders and discuss the possible outcomes of nerve regeneration.

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Section: Cryoneuromodulationmentioning

confidence: 77%

Section: Cryoneuromodulationmentioning

confidence: 99%

Significance of Clinical Treatments on Peripheral Nerve and its Effect on Nerve Regeneration

Hsu¹

2014

J Neurol Disord

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“…331,332,369−375 It is well known that when corporeal temperature decreases, conduction velocity in sensory pathways is also reduced. 376 This may account for the significant correlation between wave I latency and body temperature in one of our patients. Thus, two facts might explain the progressive delay and disappearance of wave I in BD patients: progressive hypoxic-ischemic dysfunction of the cochlea and the eighth nerve plus hypothermia, often present in BD patients because of the failure of the thermoregulatory mechanisms.…”

Section: Brainstem Auditory Evoked Potentialsmentioning

confidence: 69%

Brain Death

2007

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“…The end result of these routes of neuronal damage is decreased pain sensation as a result of conduction cessation, activation of descending inhibition, blockade of excitatory transmitter systems, or generalized sodium channel blockade (40).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous image-guided cryoablation for the treatment of phantom limb pain in amputees: a pilot study

Prologo

Gilliland

Yamada

et al. 2016

Journal of Vascular and Interventional Radiology

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Purpose-To prospectively evaluate percutaneous image-guided nerve cryoablation for treatment of refractory phantom limb pain (PLP) in a pilot cohort for purposes of deriving parameters to design a larger, randomized, parallel-armed, controlled trial. Materials and Methods-FromJanuary 2015 to January 2016, 21 patients with refractory PLP underwent image-guided percutaneous cryoneurolysis procedures. Visual analog scale scores were documented at baseline and 7, 45, and 180 days after the procedure. Responses to a modified Roland Morris Disability Questionnaire were documented at baseline and 7 and 45 days after the procedure.Results-Technical success rate of the procedures was 100%. There were 6 (29%) minor procedure-related complications. Disability scores decreased from a baseline mean of 11.3 to 3.3 at 45-day follow-up (95% confidence interval 5.8, 10.3; P < .0001). Pain intensity scores decreased from a baseline mean of 6.2 to 2.0 at long-term follow-up (95% confidence interval 2.8, 5.6; P < .0001).Conclusions-Image-guided percutaneous nerve cryoablation is feasible and safe and may represent a new efficacious therapeutic option for patients with phantom pains related to limb loss.Approximately 185,000 amputations are performed each year in the United States, and studies estimate that nearly 3.6 million people will be living with limb loss worldwide by 2050 (1,2). A common complaint among amputees is phantom limb pain (PLP), a phenomenon in which unpleasant sensations, often painful and severe, are perceived to originate from an absent limb. PLP occurs in 50%-80% of amputees, and there is no consistent evidence to support any specific pain control modality or intervention in this setting (1,(3)(4)(5)(6)(7). The objectives of this study were to (a) evaluate the safety and feasibility of HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript a separated 2-step procedural methodology consisting of computed tomography (CT)-guided perineural diagnostic injection and cryoablation in the setting of refractory PLP; (b) confirm the reproducibility of treatment response in relation to the findings of previous studies; and (c) derive estimates for key study parameters, such as recruitment rates, potentially confounding variables, and the treatment effect and its variation to inform the planning and design of a larger, parallel-armed, randomized controlled clinical trial investigating the efficacy of cryoablation for the treatment of PLP. MATERIALS AND METHODSThis study was approved by the university institutional review board and complied with the Health Insurance Portability and Accountability Act. The trial was registered before patient enrollment on ClinicalTrials.gov (NCT02366832). SubjectsSubjects were recruited from January 2015 to January 2016 from local vascular surgery, orthopedic surgery, and physical medicine and rehabilitation practices. All patients reported phantom pains and/or unwanted sensations related to a previously amputated upper or lower limb that were refr...

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Cryoanalgesia: electrophysiology at different temperatures

Cited by 33 publications

References 21 publications

Significance of Clinical Treatments on Peripheral Nerve and its Effect on Nerve Regeneration

Significance of Clinical Treatments on Peripheral Nerve and its Effect on Nerve Regeneration

Brain Death

Percutaneous image-guided cryoablation for the treatment of phantom limb pain in amputees: a pilot study

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