Neurophysiological studies of autogenous sural nerve grafts.

Tallis, Ray; Staniforth, P.; Fisher, T.R.

doi:10.1136/jnnp.41.8.677

Cited by 25 publications

(9 citation statements)

References 12 publications

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“…Electronic averaging of up to 1000 recordings allowed the small sensory action potentials (0.05-0.1 pV) to be distinguished from background noise (see also Buchthal and Kuhl, 1979;Krarup et al, 1990). This tech- (Ballantyne and Campbell, 1973;Tallis et al, 1978). The earliest time at which a sensory nerve action potential (CSAP) evoked by electrical stimulation at the base of digit II could be recorded was similar for all three repair groups (direct suture 56-154 d, nerve guide 83-118 d, or nerve graft 75-98 d).…”

Section: Resultsmentioning

confidence: 82%

Monkey median nerve repaired by nerve graft or collagen nerve guide tube

et al. 1995

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Nerve regeneration was followed in 15 median and 1 ulnar nerve of eight Macaca fascicularis monkeys by serial electrophysiological assessments over a period of three and a half years. Nerve gaps of 5 mm at the wrist were bridged by collagen-based nerve guides, nerve autografts, or direct suture repairs. Thenar muscle reinnervation occurred between 50 and 70 d for all groups, indicating axonal elongation rates of approximately 1 mm/d. The recovery rates of the compound muscle action potential (CMAP) and the compound sensory action potential (CSAP) amplitudes were significantly slower after direct suture repair compared to the other two procedures, although the final levels of recovery were all comparable. Similar results were achieved in one median and one ulnar nerve following nerve guide repair of a 15 mm nerve gap. The functional reinnervation of Pacinian corpuscles was detected in all cases following either nerve graft or nerve guide repair, with similar amplitudes and latencies of the tactile evoked CSAP for both types of repair. Histological analysis demonstrated a significant increase in the number of myelinated axons in the median nerve distal to the nerve lesions following both nerve graft and nerve guide repairs compared to proximal and normal controls, with significant reductions of fiber diameter and corresponding increases in g-ratio. The return of a bimodal frequency distribution of myelinated axon fiber diameter was confirmed by three-dimensional surface plots which illustrate the frequency distribution of the relationship between fiber diameter and g-ratio. These combined results demonstrate that nerve regeneration after repair of a 5 mm nerve gap with a collagen nerve guide in the nonhuman primate is similar to that after graft repair, and the final level of physiological recovery for both repair procedures is comparable to direct suture repair of the median nerve.

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Section: Resultsmentioning

confidence: 82%

Monkey median nerve repaired by nerve graft or collagen nerve guide tube

et al. 1995

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“…This is in agreement with previous estimates (the advance of Tinel's sign and of returning sensibility, Seddon et al, 1943;Bowden and Sholl, 1954). With percutaneous recording it took 2.5-4 times longer before the first sensory potential could be distinguished from noise (Ballantyne and Campbell, 1973;Tallis et al, 1978).…”

Section: Discussionmentioning

confidence: 99%

“…They used percutaneous recording, and a sensory potential was not detected until 10 months after suture. Similarly, Tallis et al (1978) did not find a sensory potential until 18 months after a graft had been inserted. In both studies the maximum sensory and motor conduction velocity recovered to 70-85% of normal; the amplitude of the sensory potential returned to 15% of normal.…”

mentioning

confidence: 94%

Nerve conduction, tactile sensibility, and the electromyogram after suture or compression of peripheral nerve: a longitudinal study in man.

Buchthal¹,

Kühl²

1979

Journal of Neurology, Neurosurgery & Psychiatry

133

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SUMMARYIn three patients sequential studies were performed of sensory and motor conduction after complete section and suture of the median nerve at the wrist and in one patient after partial section of the nerve. The sensory potential evoked by stimuli to digits III and I and recorded proximal to the suture line at the wrist appeared after a delay of three to four months, corresponding to a growth rate of 1.5-2.0 mm per day. From early in the course of regeneration the sensory potential was dispersed in 40 components. In the adult patient the cumulative amplitude increased for two years slowly and thereafter at a two times faster rate. Amplitude and tactile sensibility were normal after 40 months, but the sensory potential was still five times more dispersed than normal. The overall increase in the amplitude of the sensory potentials in children aged 10 and 12 years was three times faster than in the adults. In the adults and in the children the maximum sensory conduction velocity was 10-25% of normal. It then increased at 3% per month during the first two years, and thereafter 10 times slower. Forty months after suture in the adults and 13-19 months after suture in the children the conduction velocity had reached 65-75% of normal. The pattern of discrete electrical activity during voluntary effort and the prolonged duration of motor unit potentials indicate persistent enlargement of the reinnervated motor units by peripheral sprouting. The sensory potential recovered five times faster after a compressive nerve lesion than after section and suture as seen in another patient with an affection of the ulnar nerve at the elbow. Normal tactile sensibility was attained 10 times faster than after section and suture. Maximum sensory and motor conduction velocity recovered within one year from 60-70% to 80-90% of normal.Regeneration of peripheral nerve after section occurs by the outgrowth of axons from the proximal stump (Cajal, 1928;Young, 1942;Guth, 1956; Schr6der, 1975). Animal studies indicate that in the early phase of regeneration the nerve fibres have small axons, thin myelin sheaths, a short internodal length, and a slow conduction velocity (Berry et al.,

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“…The observation that the amplitude of the CAP increases with ongoing regeneration {2, 4, 40) receives support from single-unit analysis: All types of afferents generate significantly larger action potentials during late regeneration than during early regeneration 128). Progressive increase of the CAPs during the process of regeneration is the result of two factors: an increasingly greater number of axons regrowing toward the periphery, and the larger action potentials generated by the axons as their size recovers.…”

Section: Functional Considerationsmentioning

confidence: 94%

Human cutaneous mechanoreceptors during regeneration: Physiology and interpretation

Mackel

1985

Annals of Neurology

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Percutaneous microneurography was used to record activity from single cutaneous afferents reinnervating the glabrous skin of the hand. Recordings were obtained from 6 months to 10 years after complete transsection of the median andlor ulnar nerves with subsequent repair. Transitional properties in the discharge behavior and receptive field characteristics of regenerating afferents were detected during the early stages of regeneration, when axonal maturation was still in progress; these may contribute to the slow time course of sensory recovery. Properties of reinnervated receptors long after nerve repair, when regeneration can be considered complete, indicated a correlation between electrophysiological findings and the final state of clinical recovery. The insights into the neural basis of sensory deficits provided by single-unit microneurography are not yielded by conventional study of the compound action potentials. This technique reveals new information about the pathophysiological nature of peripheral nerve injury and leads to a reinterpretation of clinical deficits.Mackel R: Human cutaneous mechanoreceptors during regeneration: physiology and interpretation.Ann Neurol 18:165-172, 1985 Tactile sensory performance is limited by the encoding capabilities of mechanoreceptive afferents. These limits can be assessed by studying directly the activity of single afferents in peripheral nerves and by correlating this activity with the sensations reported by the subjects 121, 25, 461. Recently, studies of individual regenerated cutaneous afferents reinnervating the gla-

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Neurophysiological studies of autogenous sural nerve grafts.

Cited by 25 publications

References 12 publications

Monkey median nerve repaired by nerve graft or collagen nerve guide tube

Monkey median nerve repaired by nerve graft or collagen nerve guide tube

Nerve conduction, tactile sensibility, and the electromyogram after suture or compression of peripheral nerve: a longitudinal study in man.

Human cutaneous mechanoreceptors during regeneration: Physiology and interpretation

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