Electrical stimulation enhances peripheral nerve regeneration after crush injury in rats

Abstract

Injured peripheral nerves have the ability to regenerate; however, there is conflicting evidence with regard to whether electrical stimulation (ES) accelerates or hinders neural regeneration. To study the effect of ES on peripheral nerve regeneration following nerve crush injury, 54 Wistar rats were randomly divided into three groups (n=18/group); the control, crush and crush+ES group. Four weeks after surgery, the sciatic functional index (SFI), compound muscle action potential (CMAP) conduction velocity and amplitude in the regenerated nerve, nerve histomorphometry, and levels of myelin protein zero (P0) mRNA and protein at the crush site were assessed. The rats exposed to crush+ES had a significantly increased CMAP conduction velocity, enhanced myelin sheath thickness and increased P0 mRNA and protein levels compared with the rats exposed to crush alone. However, the CMAP amplitude and axonal diameter were similar in the crush and crush+ES rats. Findings of this study demonstrated that the application of ES (3 V, 0.1 ms, 20 Hz, 1 h) immediately after nerve injury accelerates remyelination and may provide a therapeutic clinical strategy.

The Parameters of Transcutaneous Electrical Nerve Stimulation Are Critical to Its Regenerative Effects When Applied Just after a Sciatic Crush Lesion in Mice

“…As this is an indirect measure of functional nerve transmission, our data cannot distinguish between the influences of Low-TENS in sensory and motor function. However, several studies showed a positive correlation between improvement of morphological and functional components following peripheral nerve injury [30–32]. In fact, the accuracy of a sensory motor function depends on the integrity of its morphological and functional components.…”

“…Although our data are not conclusive, they provide evidence that Low-TENS used early after injury, just once, can accelerate peripheral nerve regeneration. Evidence indicates that early and brief protocols favor the regenerative process of peripheral nerves [17, 18, 32]. Furthermore, frequency of the electric current seems to be another important factor to improve nerve regeneration, with low frequencies being preferable [19, 20, 31].…”

Electrical stimulation of sciatic nerve after decompression. Does the time of intervention counts?

“…The RCT studies cited in this article have produced contradictory results [4], [5], [6], [7], [8]. The evidence suggests that early and brief protocols favor the regenerative process of the peripheral nerves [16], [17]. Also frequency seems to be another factor in peripheral nerve regeneration, favoring the low-TENS amplitudes [6], [18].…”

Vascularized Muscle Flap to Reduce Wound Breakdown During Flexible Electrode-Mediated Functional Electrical Stimulation After Peripheral Nerve Injury

“…Devices delivering functional electrical stimulation (FES) have been developed to prevent muscle atrophy and enhance functional recovery during peripheral nerve injury (4,5). Electrical stimulation of the proximal nerve stump accelerates nerve outgrowth across the injury site but the distal denervated muscles for extended periods of time become atrophied, diminishing the potential for optimal functional recovery (6)(7)(8)(9)(10). Direct electrical stimulation of the denervated muscle may reduce muscle atrophy and increase the number of functional motor units available for recovery (4,(11)(12)(13)(14)(15).…”