Therapeutic strategies for brachial plexus injury

Hong, Hui; Chen, Shuangqin; Wu, Lin; Dou, Shiying; Chen, Qianlan; Li, Yihui; Xiao, Zijian; H, Wu; Chen, Shuangxi

doi:10.5114/fn.2021.111996

Cited by 5 publications

(3 citation statements)

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“…In situ reimplantation of the avulsed nerve is gaining increasing attention because of its simplicity and minimal side effects of injury (Carlstedt et al, 2000;Gu et al, 2004). However, in situ reimplantation alone does not provide satisfactory postoperative functional recovery (Huang et al, 2021). Quantification of viable ventral motor neuron counts and survival rates, and the number of FG-labeled ventral horn motor neurons on the injured side in control, AST, FC, and AST + FC groups at 6 weeks after BPA.…”

Section: Discussionmentioning

confidence: 99%

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Astaxanthin-folic acid combined treatment potentiates neuronal regeneration and functional recovery after brachial plexus avulsion and reimplantation

Huang

et al. 2022

Front. Neurosci.

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Brachial plexus avulsion (BPA), which commonly occurs in neonatal birth injuries and car accidents, severely disrupts spinal cord segments and nerve roots. Avulsion is usually located in the transitional zone at the junction of spinal nerve roots and starting point of the spinal cord, which places heavy disability burdens on patients due to sensory and motor function loss in the innervated areas. Primary mechanical injuries and secondary pathogenesis, such as inflammatory infiltration and oxidative stress, lead to inefficient management and poor prognosis. Astaxanthin (AST) has a strong ability to bleach singlet oxygen and capture free radicals, quench singlet oxygen and trap free radicals, and folic acid (FC) can effectively inhibit the inflammatory response. This study aimed to investigate the therapeutic effects of AST and FC on BPA. The 24 h after BPA was considered the acute phase of the injury, and the combination of AST and FC had the best therapeutic effect due to the synergistic effect of AST’s antioxidant and FC’s anti-inflammatory properties. At 6 weeks after BPA, AST-FC promoted the recovery of biceps motor functions, increased myofiber diameter, enlarged the amplitude of musculocutaneous nerve-biceps compound action potential, and improved Terzis grooming test (TGT) scores. Meanwhile, more functional ventral horn motor neurons in the spinal cord were maintained. In conclusion, AST-FC combined therapy has a potential role in the clinical management of BPA since it can effectively alleviate oxidative stress and the inflammatory response in the acute phase of BPA, increase the survival rate of neurons, and promote neuronal regeneration and recovery of motor functions in the late stage of BPA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Astaxanthin-folic acid combined treatment potentiates neuronal regeneration and functional recovery after brachial plexus avulsion and reimplantation

Huang

et al. 2022

Front. Neurosci.

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“…Surgical repair is only performed in preparation for the treatment of BPI; rehabilitation is the beginning of treatment and is necessary after surgery [ 14 ]. Due to differences in the condition of patients with BPI, physical therapy should be used to relieve pain, eliminate swelling, prevent scar adhesion, and joint contracture; promote nerve regeneration; and prevent muscle atrophy and joint stiffness [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Naprapathy in Brachial Plexus Injury: Protocol for a Randomized Clinical Trial

Xiao¹,

Zhao²,

Huang³

et al. 2023

JMIR Res Protoc

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Background Clinical rehabilitation for brachial plexus injury is difficult in terms of chronic pain and dysfunction. Physiotherapy is considered a routine intervention for rehabilitation. Common physical therapy may require a variety of instruments. One approach that does not need instruments, but belongs to the field of complementary and alternative medicine, is naprapathy. Naprapathy, also called Tuina in China, has been applied in rehabilitation after brachial plexus injury for a long time. Naprapathy can relieve chronic neuropathic pain, promote local blood circulation, and improve body edema. Naprapathy can passively help improve motor functions in patients with peripheral nerve injury. However, the efficacy of naprapathy in improving rehabilitation after brachial plexus injury is unclear. Objective This study aims to evaluate the additional value of naprapathy when combined with conventional physical therapy for the treatment of brachial plexus injury. Methods This will be a single-center randomized controlled trial. A total of 116 eligible patients with brachial plexus injury will be randomly divided into an experimental group (naprapathy plus physical therapy group) or a control group (physical therapy group). The participants will be followed up for 4 weeks of treatment. Observation outcomes will include the visual analog scale score, upper limb index, electromyography findings, and adverse reactions, among others. The measuring points for outcomes will be the baseline and the completion of treatment. In addition, a quality control group independent from the research team will be set up to control the quality of the trial. Finally, the data will be analyzed using SPSS software (version 21.0; IBM Corp). Results The study is recruiting participants. The first participant was enrolled in September 2021. As of January 2023, a total of 100 participants have been enrolled. The trial is expected to be completed by September 2023. The study protocol was approved by the Ethics Review Committee of Yue Yang Hospital affiliated with the Shanghai University of Traditional Chinese Medicine (2021-012). Conclusions One limitation of this trial is that we will be unable to achieve strict double-blinding because of the features of naprapathy. The trial aims to contribute reliable evidence for decision-making in naprapathy for treating brachial plexus injury. Trial Registration Chinese Clinical Trial Registry ChiCTR2100043515; http://www.chictr.org.cn/showproj.aspx?proj=122154 International Registered Report Identifier (IRRID) DERR1-10.2196/46054

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Abnormal genes and pathways that drive muscle contracture from brachial plexus injuries: Towards machine learning approach

Fu,

Adili,

Chen

et al. 2024

SLAS Technology

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Therapeutic strategies for brachial plexus injury

Cited by 5 publications

References 100 publications

Astaxanthin-folic acid combined treatment potentiates neuronal regeneration and functional recovery after brachial plexus avulsion and reimplantation

Astaxanthin-folic acid combined treatment potentiates neuronal regeneration and functional recovery after brachial plexus avulsion and reimplantation

Efficacy of Naprapathy in Brachial Plexus Injury: Protocol for a Randomized Clinical Trial

Abnormal genes and pathways that drive muscle contracture from brachial plexus injuries: Towards machine learning approach

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