Strategies to promote peripheral nerve regeneration: electrical stimulation and/or exercise

Gordon, Tessa; English, Arthur W.

doi:10.1111/ejn.13005

Cited by 245 publications

(213 citation statements)

References 124 publications

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“…The answer to the question is generally assumed to be that regenerating axons fail to reinnervate target muscles due to irreversible denervation atrophy with ultimate fat replacement [2,25,28]. Experimentally, we asked the question of the consequences of the long periods of isolation of the injured neurons that regenerate their lost axons from their denervated targets (chronic axotomy of the neurons), the long periods of denervation of the Schwann cells in the distal nerve stumps (chronic Schwann cell denervation), and, finally, the chronic denervation of the muscles (chronic muscle denervation).…”

Section: The Window Of Opportunity For Nerve Regeneration Is Restrictedmentioning

confidence: 99%

Electrical Stimulation to Enhance Axon Regeneration After Peripheral Nerve Injuries in Animal Models and Humans

2016

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Injured peripheral nerves regenerate their lost axons but functional recovery in humans is frequently disappointing. This is so particularly when injuries require regeneration over long distances and/or over long time periods. Fat replacement of chronically denervated muscles, a commonly accepted explanation, does not account for poor functional recovery. Rather, the basis for the poor nerve regeneration is the transient expression of growth-associated genes that accounts for declining regenerative capacity of neurons and the regenerative support of Schwann cells over time. Brief low-frequency electrical stimulation accelerates motor and sensory axon outgrowth across injury sites that, even after delayed surgical repair of injured nerves in animal models and patients, enhances nerve regeneration and target reinnervation. The stimulation elevates neuronal cyclic adenosine monophosphate and, in turn, the expression of neurotrophic factors and other growth-associated genes, including cytoskeletal proteins. Electrical stimulation of denervated muscles immediately after nerve transection and surgical repair also accelerates muscle reinnervation but, at this time, how the daily requirement of long-duration electrical pulses can be delivered to muscles remains a practical issue prior to translation to patients. Finally, the technique of inserting autologous nerve grafts that bridge between a donor nerve and an adjacent recipient denervated nerve stump significantly improves nerve regeneration after delayed nerve repair, the donor nerves sustaining the capacity of the denervated Schwann cells to support nerve regeneration. These reviewed methods to promote nerve regeneration and, in turn, to enhance functional recovery after nerve injury and surgical repair are sufficiently promising for early translation to the clinic.

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Section: The Window Of Opportunity For Nerve Regeneration Is Restrictedmentioning

confidence: 99%

Electrical Stimulation to Enhance Axon Regeneration After Peripheral Nerve Injuries in Animal Models and Humans

2016

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“…It has been demonstrated that exercise and electrical stimulation both promote peripheral nerve regeneration, 25 and an explanation for this finding might be that both of them enhance neuroplasticity.…”

Section: Fig 10mentioning

confidence: 99%

Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes

Socolovsky

Malessy

Lopez

et al. 2017

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OBJECTIVE Neuroplasticity is analyzed in this article as the capacity of the CNS to adapt to external and internal stimuli. It is being increasingly recognized as an important factor for the successful outcome of nerve transfers. Better-known factors are the number of axons that cross the coaptation site, the time interval between trauma and repair, and age. Neuroplasticity is mediated initially by synaptic and neurotransmitter changes. Over time, the activation of previously existing but lowly active connections in the brain cortex contributes further. Dendritic sprouting and axonal elongation might also take place but are less likely to be prominent. METHODS The authors reviewed different factors that play roles in neuroplasticity and functional regeneration after specific nerve transfers. RESULTS The authors found that these different factors include, among others, the distance between cortical areas of the donor and receptor neurons, the presence versus absence of preexisting lowly active interneuronal connections, gross versus fine movement restoration, rehabilitation, brain trauma, and age. CONCLUSIONS The potential for plasticity should be taken into consideration by surgeons when planning surgical strategy and postoperative rehabilitation, because its influence on results cannot be denied.

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“…Recently, low-intensity electrical stimulation has attracted more and more attentions, and its effects have been investigated widely (Deans et al 2007;Anastassiou et al 2010;Gordon and English 2016). Some studies have proposed SR as a key mechanism in optimizing the performance of specific functional electric stimulation devices, such as hearing implants (Morse and Roper 2000;Zeng et al 2000).…”

Section: Introductionmentioning

confidence: 99%

Weak electric fields detectability in a noisy neural network

et al. 2016

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We investigate the detectability of weak electric field in a noisy neural network based on Izhikevich neuron model systematically. The neural network is composed of excitatory and inhibitory neurons with similar ratio as that in the mammalian neocortex, and the axonal conduction delays between neurons are also considered. It is found that the noise intensity can modulate the detectability of weak electric field. Stochastic resonance (SR) phenomenon induced by white noise is observed when the weak electric field is added to the network. It is interesting that SR almost disappeared when the connections between neurons are cancelled, suggesting the amplification effects of the neural coupling on the synchronization of neuronal spiking. Furthermore, the network parameters, such as the connection probability, the synaptic coupling strength, the scale of neuron population and the neuron heterogeneity, can also affect the detectability of the weak electric field. Finally, the model sensitivity is studied in detail, and results show that the neural network model has an optimal region for the detectability of weak electric field signal.

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Strategies to promote peripheral nerve regeneration: electrical stimulation and/or exercise

Cited by 245 publications

References 124 publications

Electrical Stimulation to Enhance Axon Regeneration After Peripheral Nerve Injuries in Animal Models and Humans

Electrical Stimulation to Enhance Axon Regeneration After Peripheral Nerve Injuries in Animal Models and Humans

Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes

Weak electric fields detectability in a noisy neural network

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