Mechanical Properties of the Human Tibial and Peroneal Nerves Following Stretch With Histological Correlations

Kerns, James M.; Piponov, Hristo; Helder, Cory W.; Amirouche, Farid; Solitro, Giovanni F.; Gonzalez, Mark H.

doi:10.1002/ar.24250

Cited by 31 publications

(26 citation statements)

References 43 publications

(49 reference statements)

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“…The longitudinal displacement of the median nerve in the forearm was 2.3 mm when cervical lateral flexion was applied [ 27 ]. Movement of the joint can modify the elasticity property of the median nerve when enough mechanical stress is applied to it [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Quantifying the Elasticity Properties of the Median Nerve during the Upper Limb Neurodynamic Test 1

Lin

Chen

Deng

et al. 2022

Applied Bionics and Biomechanics

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Background. The upper limb neurodynamic test 1 (ULNT1) consists of a series of movements that are thought to detect an increase in neuromechanical sensitivity. In vivo, no trail was made to quantify the association between the nerve elasticity and different limb postures during ULNT1. Objectives. (1) To investigate the relationship between nerve elasticity and limb postures during ULNT1 and (2) to investigate the intra- and interoperator reliabilities of shear wave elastography (SWE) in quantifying the elasticity of median nerve. Methods. Twenty healthy subjects (mean age: 19.9 ± 1.4 years old) participated in this study. The median nerve was imaged during elbow extension in the following postures: (1) with neutral posture, (2) with wrist extension (WE), (3) with contralateral cervical flexion (CCF), and (4) with both WE and CCF. The intra- and interoperator reliabilities measured by two operators at NP and CCF+WE and intraclass correlation coefficients (ICCs) were calculated. Results. The intraoperator ( ICC = 0.72 – 0.75 ) and interoperator ( ICC = 0.89 – 0.94 ) reliabilities for measuring the elasticity of the median nerve ranged from good to excellent. The mean shear modulus of the median nerve increased by 53.68% from NP to WE+CCF. Conclusion. SWE is a reliable tool to quantify the elasticity of the median nerve. There was acute modulation in the elasticity of the median nerve during the ULNT1 when healthy participants reported substantial discomfort. Further studies need to focus on the elasticity properties of the median nerve in patients with peripheral neuropathic pain.

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Section: Discussionmentioning

confidence: 99%

Quantifying the Elasticity Properties of the Median Nerve during the Upper Limb Neurodynamic Test 1

Lin

Chen

Deng

et al. 2022

Applied Bionics and Biomechanics

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“…1 Peripheral nerves have a wavy, undulating structure that allows for some degree of physiological stretch. 1 38 39 Using human cadaveric tissue, Kerns et al 39 reported differences in undulations patterns at failure between tibial and peroneal nerves. The significantly lower failure stress seen in BP nerve when compared with tibial nerve, in this study, suggests that the BP nerve may have fiber orientations that present a biomechanical disadvantage.…”

Section: Discussionmentioning

confidence: 99%

Effects of Prestretch on Neonatal Peripheral Nerve: An In Vitro Study

Singh

Majmudar

Magee

et al. 2022

J Brachial Plex Peripher Nerve Inj

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Background Characterizing the biomechanical failure responses of neonatal peripheral nerves is critical in understanding stretch-related peripheral nerve injury mechanisms in neonates. Objective This in vitro study investigated the effects of prestretch magnitude and duration on the biomechanical failure behavior of neonatal piglet brachial plexus (BP) and tibial nerves. Methods BP and tibial nerves from 32 neonatal piglets were harvested and prestretched to 0, 10, or 20% strain for 90 or 300 seconds. These prestretched samples were then subjected to tensile loading until failure. Failure stress and strain were calculated from the obtained load-displacement data. Results Prestretch magnitude significantly affected failure stress but not the failure strain. BP nerves prestretched to 10 or 20% strain, exhibiting significantly lower failure stress than those prestretched to 0% strain for both prestretch durations (90 and 300 seconds). Likewise, tibial nerves prestretched to 10 or 20% strain for 300 seconds, exhibiting significantly lower failure stress than the 0% prestretch group. An effect of prestretch duration on failure stress was also observed in the BP nerves when subjected to 20% prestretch strain such that the failure stress was significantly lower for 300 seconds group than 90 seconds group. No significant differences in the failure strains were observed. When comparing BP and tibial nerve failure responses, significantly higher failure stress was reported in tibial nerve prestretched to 20% strain for 300 seconds than BP nerve. Conclusion These data suggest that neonatal peripheral nerves exhibit lower injury thresholds with increasing prestretch magnitude and duration while exhibiting regional differences.

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“…Moreover, although we could have easily applied our crush model to determine these lesion-specific threshold parameters, we chose not to ascertain them due to certain fundamental impediments which diminish the clinical relevancy and application of the results. For instance, determination of these parameters using a rat model alone is in itself a fundamental limitation because the extent of protection afforded by the nerve epineurium varies according to species being investigated and is greater in humans than in rats (Kerns, 2008 ; Alvites et al, 2018 ; Kerns et al, 2019 ). Threshold parameters also vary based on the specific nerve being investigated and on its anatomical location, with crushing parameters likely being greater at or near joints (Alvites et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Compound Motor Action Potentials During a Modest Nerve Crush

Hamad

Boroda

Echenique

et al. 2022

Front. Cell. Neurosci.

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Nerve crush injury results in axonotmesis, characterized by disruption of axons and their myelin sheaths with relative sparing of the nerve’s connective tissue. Despite the widespread use of crush injury models, no standardized method for producing these lesions has been established. We characterize a crush model in which a narrow forceps is used to induce a modest and controlled compressive injury. The instantaneous compound motor action potential (CMAP) is monitored in situ and in real-time, allowing the characterization of neuromuscular response during and after injury. The tibial nerves of 11 anesthetized rats were surgically isolated. After the placement of electrodes, CMAPs were elicited and registered using a modular-data-acquisition system. Dumont-#5 micro-forceps were instrumented with a force transducer allowing force measurement via a digital sensor. Baseline CMAPs were recorded prior to crush and continued for the duration of the experiment. Nerve crushing commenced by gradually increasing the force applied to the forceps. At a target decrease in CMAP amplitude of 70%–90%, crushing was halted. CMAPs were continually recorded for 5–20 min after the termination of the crushing event. Nerves were then fixed for histological assessment. The following post-crush mean values from 19 trials were reported: peak CMAP amplitude decreased by 81.6% from baseline, duration of crush was 17 sec, rate of applied force was 0.03 N/sec, and maximal applied force was 0.5 N. A variety of agonal phenomena were evident post-lesion. Following the initial decrease in CMAP, 8 of 19 trials demonstrated a partial and transient recovery, followed by a further decline. Thirteen trials exhibited a CMAP amplitude near zero at the end of the recording. Twelve trials demonstrated a superimposed EMG background response during and after the crush event, with disappearance occurring within 4–8 min. Qualitative histology assessment at the lesion site demonstrated a correspondence between CMAP response and partial sparing of nerve fibers. By using a targeted decline in CMAP amplitude as the endpoint, researchers may be able to produce controlled, brief, and reproducible crush injuries. This model can also be used to test interventions aimed at enhancing subsequent regeneration and behavioral recovery.

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Mechanical Properties of the Human Tibial and Peroneal Nerves Following Stretch With Histological Correlations

Cited by 31 publications

References 43 publications

Quantifying the Elasticity Properties of the Median Nerve during the Upper Limb Neurodynamic Test 1

Quantifying the Elasticity Properties of the Median Nerve during the Upper Limb Neurodynamic Test 1

Effects of Prestretch on Neonatal Peripheral Nerve: An In Vitro Study

Compound Motor Action Potentials During a Modest Nerve Crush

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