One year of home-based daily FES in complete lower motor neuron paraplegia: recovery of tetanic contractility drives the structural improvements of denervated muscle

Kern, Helmut; Carraro, Ugo; Adami, Nicoletta; Höfer, Christian; Löefler, Stefan; Vogelauer, Michael; Mayr, Winfried; Rupp, Rüdiger; Zampieri, Sandra

doi:10.1179/174313209x385644

Cited by 98 publications

(101 citation statements)

References 21 publications

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“…Nuclear clumps should be considered markers of the long-lasting ability of human muscle fibers to survive to the absence of the nerve. These results provide the rationale to plan research aimed to recover these severely atrophic myofibers, by combining molecular and cellular approaches with functional electrical stimulation that our previous studies shown to restore muscle structure and mass in human long-term denervated and degenerated muscle [4,7,[15][16][17][18][19][20].…”

Section: Resultsmentioning

confidence: 99%

Severely Atrophic Muscle Fibers with Nuclear Clumps Survive many Years in Permanently Denervated Human Muscle

Kern¹,

Carraro²,

Biral³

et al. 2009

TOPATJ

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After complete lumbar-ischiatic spinal cord injury (SCI) the lower motor neuron (LMN) denervated human muscle fibers lose completely the myofibrillar apparatus and the coil distribution of myonuclei that are relocated in groups (nuclear clumps) in the center of these "severely atrophic" muscle fibers. In our cohort of patients, the "severely atrophic" myofibers are frequent in muscle biopsies harvested three to six years after SCI. Up to two years of LMN denervation the muscle fibers with nuclear clumps are 2 ± 5% (mean ± SD) of the total muscle fibers. The percentage increases to 27 ± 9% between three and six years of denervation (p< 0.001), and then abruptly decrease from the 6th year of LMN denervation onward, when fibrosis takes over to neurogenic muscle atrophy. Immunohistochemical analyses show that nuclear grouping occurs in both fast and slow muscle fibers. These results show that human muscle fibers survive permanent denervation much longer than generally accepted.

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Section: Resultsmentioning

confidence: 99%

Severely Atrophic Muscle Fibers with Nuclear Clumps Survive many Years in Permanently Denervated Human Muscle

Kern¹,

Carraro²,

Biral³

et al. 2009

TOPATJ

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“…Sixty years of basic research [1,2] concerning electrostimulationdriven muscle plasticity has, in recent years, prompted clinical trials which investigate the use of long impulse biphasic electrical stimulation as a treatment for human denervated muscle intended to improve tissue trophism and to increase muscle power to a level sufficient to restore standing and step training [3][4][5][6][7][8][9]. These treatments usually start late after denervation because of clinical constraints and/or the outdated beliefs that electrical stimulation is useless in these cases and may actually interfere with eventual myofiber reinnervation.…”

Section: Introductionmentioning

confidence: 99%

Modulation of trophism and fiber type gene expression in denervated muscle activated by different patterns of electrical stimulation. Role of muscle fiber regeneration revisited in 2017

Marcante¹,

Baba²,

Carraro³

et al. 2017

Biol Eng Med

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After sixty and more years of basic research on electrostimulation-induced muscle plasticity, in the last fifteen years a few studies have employed long impulse biphasic electrical stimulation as a treatment for human long-term denervated muscle. Tissue trophism and muscle power are improved to a level sufficient to restore some functions by home based Functional Electrical Stimulation (h-bFES). These treatments usually start late after denervation due to clinical constraints. The changes induced by 1) denervation, 2) spontaneous or induced aneural myogenesis, and 3) long-term electrical stimulation starting either early or late after denervation, in both animal models and in clinic, are here reported once again to attract attention of patients, physiatrists and physiotherapists on achievable results and on limitations of h-bFES for denervated degenerating muscles (DDM). The trophic and functional recovery from severe atrophy/degeneration of long-term denervated muscle by h-bFES of DDM is a fact standing on a sound foundation. Furthermore, a new muscle quantitative color computed tomography (MQC-CT) adds, to functional evidence and to muscle biopsy analyses, the results based on tridimensional analysis of a full skeletal muscle. The differentiation of muscle fibers regenerating in the absence of the nerve is remarkable in animal experiments. If myogenesis in patients could be modulated during the months needed to recover denervated muscle tetanic contractility, it should be possible to substantially abbreviate the time needed to achieve functional recovery of long term denervated human muscle by h-bFES of DDM using the commercial muscle stimulator and the large electrodes now available.

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“…Additional benefits are improved leg cosmetic appearance and enhanced cushioning effect for seating. 51,52 Brain-machine interfaces with neuroprosthetic limbs could help patients with long-term paralysis to perform several of the required activities of daily living. [53][54][55] Sensory afferentation, feedback input, and related cerebral voluntary motor commands -the latter by electroencephalographybrain computer interface -may thus contribute to wireless informational powering of the respective robotic suit engine for bionic standing and gait assistance.…”

Section: Neurotization or Nerve Bridgingmentioning

confidence: 99%

Clinical therapeutic guideline for neurorestoration in spinal cord injury (Chinese version 2016)

Feng¹,

Sun²,

Chen³

et al. 2017

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Abstract:Restoring functions following spinal cord injury (SCI) was the most challenging task in clinical practice in the past. Fortunately, some effective neurorestorative methods have been exploited in acute, subacute, and chronic phase of SCI. There were no clinical neurorestorative therapeutic guidelines available before this document which can be followed by physicians to manage patients with acute, subacute, and chronic SCI. This guideline will be a helpful reference to physicians to implement their neurorestorative strategies that can help to improve the neurological functions in patients with SCI and their quality of life.

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One year of home-based daily FES in complete lower motor neuron paraplegia: recovery of tetanic contractility drives the structural improvements of denervated muscle

Cited by 98 publications

References 21 publications

Severely Atrophic Muscle Fibers with Nuclear Clumps Survive many Years in Permanently Denervated Human Muscle

Severely Atrophic Muscle Fibers with Nuclear Clumps Survive many Years in Permanently Denervated Human Muscle

Modulation of trophism and fiber type gene expression in denervated muscle activated by different patterns of electrical stimulation. Role of muscle fiber regeneration revisited in 2017

Clinical therapeutic guideline for neurorestoration in spinal cord injury (Chinese version 2016)

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