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The potential of electrical stimulation to promote functional recovery after peripheral nerve injury — comparisons between rats and humans

  • Conference paper
How to Improve the Results of Peripheral Nerve Surgery

Part of the book series: Acta Neurochirurgica Supplementum ((NEUROCHIRURGICA,volume 100))

Abstract

The declining capacity for injured peripheral nerves to regenerate their axons with time and distance is accounted for, at least in part, by the chronic axotomy of the neurons and Schwann cell denervation prior to target reinnervation. A largely unrecognized site of delay is the surgical suture site where, in rats, 4 weeks is required for all neurons to regenerate their axons across the site. Low frequency stimulation for just 1 h after surgery accelerates this axon crossing in association with upregulation of neurotrophic factors in the neurons. We translated these findings to human patients by examining the number of reinnervated motor units in the median nerve-innervated thenar muscles before and after carpel tunnel release surgery in a randomized controlled trial. Motor unit number estimates (MUNE) in patients with moderate and severe carpal tunnel syndrome were significantly lower than normal. This number increased significantly by 6–8 months after surgery and reached normal values by 12 months in contrast to a non-significant increase in the control unstimulated group. Tests including the Purdue Pegboard Test verified the more rapid functional recovery after stimulation. The data indicate a feasible strategy to promote axonal regeneration in humans that has the potential to improve functional outcomes, especially in combination with strategies to sustain the regenerative capacity of neurons and the support of Schwann cells over distance and time.

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Authors and Affiliations

  1. Center for Neuroscience, 525 Heritage Medical Research Center, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada, T6G 2S2

    T. Gordon

  2. Division of Physical Medicine & Rehabilitation, Centre for Neuroscience, Faculty of Medicine, University of Alberta, Alberta, Canada

    N. Amirjani

  3. Department of Orthopaedics Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

    T. M. Brushart & K. M. Chan

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  1. T. Gordon
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  2. T. M. Brushart
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  3. N. Amirjani
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  4. K. M. Chan
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Editors and Affiliations

  1. Wiener Privatklinik, Vienna, Austria

    H. Millesi  & R. Schmidhammer  & 

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Gordon, T., Brushart, T.M., Amirjani, N., Chan, K.M. (2007). The potential of electrical stimulation to promote functional recovery after peripheral nerve injury — comparisons between rats and humans. In: Millesi, H., Schmidhammer, R. (eds) How to Improve the Results of Peripheral Nerve Surgery. Acta Neurochirurgica Supplementum, vol 100. Springer, Vienna. https://doi.org/10.1007/978-3-211-72958-8_1

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  • DOI: https://doi.org/10.1007/978-3-211-72958-8_1

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-72955-7

  • Online ISBN: 978-3-211-72958-8

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