• Title/Summary/Keyword: Peripheral nerve function

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Clinical Assessment of Pain and Sensory Function in Peripheral Nerve Injury and Recovery: A Systematic Review of Literature

  • John, Albin A.;Rossettie, Stephen;Rafael, John;Cox, Cameron T.;Ducic, Ivica;Mackay, Brendan J.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.427-439
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    • 2022
  • Peripheral nerve injuries (PNIs) often present with variable symptoms, making them difficult to diagnose, treat, and monitor. When neurologic compromise is inadequately assessed, suboptimal treatment decisions can result in lasting functional deficits. There are many available tools for evaluating pain and functional status of peripheral nerves. However, the literature lacks a detailed, comprehensive view of the data comparing the clinical utility of these modalities, and there is no consensus on the optimal algorithm for sensory and pain assessment in PNIs. We performed a systematic review of the literature focused on clinical data, evaluating pain and sensory assessment methods in peripheral nerves. We searched through multiple databases, including PubMed/Medline, Embase, and Google Scholar, to identify studies that assessed assessment tools and explored their advantages and disadvantages. A total of 66 studies were selected that assessed various tools used to assess patient's pain and sensory recovery after a PNI. This review may serve as a guide to select the most appropriate assessment tools for monitoring nerve pain and/or sensory function both pre- and postoperatively. As the surgeons work to improve treatments for PNI and dysfunction, identifying the most appropriate existing measures of success and future directions for improved algorithms could lead to improved patient outcomes.

Effects of Gentianae Macrophyllae Radix on the functional recovery and expression of BDNF and c-Fos after sciatic crushed nerve injury in rats

  • Cho, Hyun-Chol;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Korean Medicine
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    • v.30 no.3
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    • pp.28-38
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    • 2009
  • Background : Peripheral nerve injuries are a commonly encountered clinical problem and often result in a chronic pain and severe functional deficits. Objective : The aim of this study was to evaluate the effects of Gentianae Macrophyllae Radix (G. M. Radix) on the pain control and the recovery of the locomotor function that results from the sciatic crushed nerve injury in rats. Method : Using rats, we crushed their sciatic nerve, and then orally administered the aqueous extract of G. M. Radix. The effects of G. M. Radix on the recovery locomotor function were investigated by walking track analysis. The effects of G. M. Radix on pain control were investigated by brain-derived neurotrophic factor (BDNF) expression in the sciatic nerve, and c-Fos expression in the paraventricular nucleus (PVN) of the hypothalamus and in the ventrolateral periaqueductal gray (vlPAG). Result : G. M. RADIX facilitates motor function from the locomotor deficit, and thereby increased BDNF expression and suppressed painful stimuli in the PVN and vlPAG after sciatic crushed nerve injury. Conclusion : It is suggested that G. M. Radix might aid recovery locomotor function and control pain after sciatic crushed nerve injury. Further studies on identifying specific the component in G.M. Radix associated with enhanced neural activity in the peripheral nerve injury may be helpful to develop therapeutic strategies for the treatment of peripheral nerve injury.

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Peripheral Nerve Regeneration Through Nerve Conduit Composed of Alginate-Collagen-Chitosan

  • Kim, Sang-Wan;Bae, Hong-Ki;Nam, Hye-Sung;Chung, Dong-June;Choung, Pill-Hoon
    • Macromolecular Research
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    • v.14 no.1
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    • pp.94-100
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    • 2006
  • Although the peripheral nerve system has a relatively good regenerating capacity compared to the central nerve system, peripheral nerve repair remains a clinical challenge as restoration of normal nerve function is highly variable. Synthetic tubular nerve conduits were designed as an alternative repair method in order to replace the need for an isograft. These nerve conduits guide regenerating axons from the proximal toward the distal end, maintain within growth-promoting molecules released by the nerve stumps, and protect regenerating axons from infiltrating scar tissue. In this work, we prepared cinnamoylated alginate (CA)-collagen-chitosan nerve conduit using the lyophilization method to generate a controllable parallel channel in the center and then investigated its influence on peripheral nerve regeneration in an animal study. At 12 weeks after implantation, histological study showed that tissue cable was continuously bridging the gap of the sciatic nerve in all rats. Our newly developed nerve conduit is a promising tool for use in peripheral nerve regeneration and provides a suitable experimental model for future clinical application.

Systematic Review on Effect of Peripheral Sensory Nerve Stimulation on Upper Extremity Function for Stroke Patients (뇌졸중 환자의 상지 기능 향상을 위한 말초감각신경자극의 효과에 관한 체계적 고찰)

  • Kim, Sun-Ho;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.5 no.2
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    • pp.11-22
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    • 2016
  • Objective: This study is executed systematic review targeted at international journals intended to investigate on effect of peripheral sensory nerve stimulation on upper extremity function for stroke patients. Method: After literature search, researchers selected for 10 studies registered up to October 2015 based on PubMed database, using the following search terms: peripheral nerve stimulation, electrical stimulation, sensory stimulation, somatosensory stimulation, stroke, hemiplegia, hemiparesis and hand, arm, upper limb. Result: There were significant improves of upper extremity function and positive effect on the cortical activation in the use of peripheral sensory nerve stimulation. Conclusion: domestic studies in future requires a study of the method for measuring more accurately the effect of peripheral sensory nerve stimulation in RCT studies applying various intervention.

EXPERIMENTAL STUDY OF PERIPHERAL NERVE REGENERATION BY USING NON-TUBULAR NATURAL CELLULOSE MEMBRANE NERVE CONDUIT (비관형 천연 셀룰로오스막 도관을 이용한 말초신경 재생에 대한 실험적 연구)

  • Kim, Soung-Min;Lee, Jong-Ho;Lee, Suk-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.4
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    • pp.295-307
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    • 2006
  • Styela clava, called non-native tunicate or sea squirt, is habitat which include bays and harbors in Korea and several sites in the sea faced world. We fabricate cellulose membrane nerve conduit (CMNC) from this native sea squirt skin, and evaluate the capacity of promoting peripheral nerve regeneration in the rat sciatic nerve defect model. After processing the pure cellulose membrane from the sea squirt skin as we already published before, CMNC was designed as a non-tubular sheet with 14 mm length and 4 mm width. Total eleven male Spraque-Dawley rats (12 weeks, weighing 250 to 300g) were divided into sham group (n=2), silicone tube grafted control group (n=3) and experimental group (n=6). Each CMNC grafted nerve was evaluated after 4, 8 and 12 weeks in the experimental group, and after 12 weeks, sciatic function was evaluated with sciatic function index (SFI) and gait analysis, and histomorphology of nerve conduit and the innervated tissues of sciatic nerve were all examined using image analyzer and electromicroscopic methods in the all groups. The regenerated axon and nerve sheath were found only in the inner surface of the CMNC after 4 weeks and became more thicker after 8 and 12 weeks. In the TEM study, CMNC grafted group showed more abundant organized myelinated nerve fibers with thickened extracellular matrix than silicone conduit grafted group after 12 weeks. The sciatic function index (SFI) and ankle stance angle (ASA) in the functional evaluation were $-47.2{\pm}3.9$, $35.5^{\circ}{\pm}4.9^{\circ}$ in CMNC grafted group (n=2) and $-80.4{\pm}7.4$, $29.2^{\circ}{\pm}5.3^{\circ}$ in silicone conduit grafted group (n=3), respectively. And the myelinated axon was 41.59% in CMNC group and 9.51% in silicone conduit group to the sham group. The development of a bioactive CMNC to replace autogenous nerve grafts offers a potential and available approach to improved peripheral nerve regeneration. As we already published before, small peptide fragment derived from the basement membrane matrix proteins of squirt skin, which is a kind of anchoring protein composed of glycocalyx, induced the effective axonal regeneration with rapid growth of Schwann cells beneath the inner surface of CMNC. So the possibilities of clinical application as a peripheral nerve regeneration will be able to be suggested.

Analysis of Peripheral Nerve Function and Echogenicity of Skeletal Muscle in Type II Diabetic Patient's (제2형 당뇨환자의 말초신경기능 및 골격근의 Echogenicity 분석)

  • Yoon, Se-Won;Hwang, Tae-Yeun;Kim, Young-Nam;Yoon, Hee-Jong;Jeong, Jin-Gyu;Kim, Tae-Youl
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.4 no.1
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    • pp.13-25
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    • 2006
  • This study aims to suggest clinical basis of physical therapy of neuromuscular system complication in type diabetic patients through a variety II of analysis methods including echogenicity using ultrasound image and measurement of peripheral nerve function to their neuromuscular system and provide basic materials for preparing evaluation of physical therapy and intervention program. Subjects of this study were 75 type II diabetic patients between 40 and 80 years old and it obtained the following results through echogenisity and function of peripheral nerve. Incidence of neuropathy in type II diabetes was 55.8% in men and 53.1% in women, and total incidence of neuropathy was 54.7%. Echogenicity of patients with neuropathy was significantly increased compared to that of patients with neuropahty. It was also found that there were correlations between function of peripheral nerve and echogenicity of tibialis anterior and gastrocnemius muscle. In addition, it will be important for physical therapists to divide type II diabetic patients into neuropathy and myopathy and interpret and approach changes of neuro-muscular system from comprehensive side.

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A Study on the design of functional electrical stimulation system for hemiplegic patients (편마비환자를 위한 휴대용 자극시스템 설계에 관한 연구)

  • Kim, N.H.;Park, J.K.;Kwon, J.W.;Jang, Y.K.;Hong, S.H.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.11
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    • pp.99-102
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    • 1996
  • The ultimate object of FES is on the recovering function of body and shape demaged from desease or injury to original state. On this study, object is recovering of gait function of the disabled who, especially, have gait disturbance. Paralyzed muscle from the central nerve disable, if peripheral nerves which be in the lower part of the harmed are activated, muscle contraction is possible. The traumatic trouble, peripheral nerves aren't connected to a central nerve but origin of peripheral nerve cells which are in the lower part of the harmed are alive, react on stimulation. We design 4-channel stimulator, being based on standard stimuli pattern. stimulator is manufactured with compact size and light weight to portable.

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Effects of Herbal Bath on Functional Recovery and c-Fos Expression in the Ventrolateral Periaqueductal Gray Region of the Brain after Sciatic Crushed-Nerve Injury in Rats

  • Ryu, Moon-Sang;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Korean Medicine
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    • v.27 no.4
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    • pp.116-124
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    • 2006
  • Peripheral nerve injuries are a commonly encountered clinical problem and often result in chronic pain and severe functional deficits. At the Dept. of Oriental Rehab. Medicine, we have used for pain control a herbal bath containing the following herbs: Harpagophytum radix, Atractylodes japonica and Corydalis tuber. In the present study, we investigated the effects of this herbal bath on the recovery rate of the locomotor function and the expression of c-Fos in the ventrolateral periaqueductal gray (vIPAG) region of the brain following sciatic crushed nerve injury in rats. In the present study, characteristic gait change with decreasing of the sciatic function index (SFI) was observed and c-Fos expression in the vIPAG was suppressed following sciatic crushed nerve injury in rats. Immersion into herbal bath enhanced SFI value and restored c-Fos expression in the vIPAG to the control value. These results suggest the herbal bath might activate neurons in the vIPAG, and could facilitate functional recovery from peripheral nerve injury.

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Preventive Mechanism of Sodium Molybdate Against Peripheral Neurotoxicity of Lead (Sodium molybdate의 납중독성 말초 신경계독성 예방기전)

  • Chung, Myung-Kiu;Kang, Soon-Kook;Kim, Myung-Nyu
    • Journal of Environmental Science International
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    • v.9 no.3
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    • pp.209-214
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    • 2000
  • The preventive effects of sodium molybdate on the acute toxicity of lead were studied by investigating tissue accumulation of lead, changes of nerve conduction velocity and concentrations of metabolites related to function of sciatic nerve in rats treated with lead, sodium molybdate and both, respectively. In lead-intoxicated rat, the conduction velocity, myo-inositol concentration and $Na^{+}/K^{+}$ ATPase activity of sciatic nerve were decreased by about 33 %, 48 % and 58 %, respectively. However, sodium molybdate treatment significantly normalized the conduction velocity, $Na^{+}/K^{+}$ ATPase activity and myo-inositol concentration of sciatic nerve in lead-intoxicated rat. Also, sodium molybdate treatment decreased the contents of lead in blood and sciatic nerve through promotion of urinary excretion of lead. But sodium molybdate treatment did not affect the glucose concentration in sciatic nerve. These results suggest that sodium molybdate prevented peripheral neuropathy not only by reducing lead contents in sciatic nerve and blood, but also by enhancing $Na^{+}/K^{+}$ ATPase activity in sciatic nerve.

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Rat Peripheral Nerve Regeneration Using Nerve Guidance Channel by Porcine Small Intestinal Submucosa

  • Yi, Jin-Seok;Lee, Hyung-Jin;Lee, Hong-Jae;Lee, Il-Woo;Yang, Ji-Ho
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.65-71
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    • 2013
  • Objective : In order to develop a novel nerve guidance channel using porcine small intestinal submucosa (SIS) for nerve regeneration, we investigated the possibility of SIS, a tissue consisting of acellular collagen material without cellular immunogenicity, and containing many kinds of growth factors, as a natural material with a new bioactive functionality. Methods : Left sciatic nerves were cut 5 mm in length, in 14 Sprague-Dawley rats. Grafts between the cut nerve ends were performed with a silicone tube (Silicon group, n=7) and rolled porcine SIS (SIS group, n=7). All rats underwent a motor function test and an electromyography (EMG) study on 4 and 10 weeks after grafting. After last EMG studies, the grafts, including proximal and distal nerve segments, were retrieved for histological analysis. Results : Foot ulcers, due to hypesthesia, were fewer in SIS group than in Silicon group. The run time tests for motor function study were 2.67 seconds in Silicon group and 5.92 seconds in SIS group. Rats in SIS group showed a better EMG response for distal motor latency and amplitude than in Silicon group. Histologically, all grafts contained some axons and myelination. However, the number of axons and the degree of myelination were significantly higher in SIS group than Silicon group. Conclusion : These results show that the porcine SIS was an excellent option as a natural biomaterial for peripheral nerve regeneration since this material contains many kinds of nerve growth factors. Furthermore, it could be used as a biocompatible barrier covering neural tissue.