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Radiologia 2020Imaging studies of peripheral nerves have increased considerably in the last ten years. In addition to the classical and still valid study by ultrasound, new... (Review)
Review
Imaging studies of peripheral nerves have increased considerably in the last ten years. In addition to the classical and still valid study by ultrasound, new neurographic techniques developed from conventional morphological sequences (including 3D isotropic studies with fat suppression) are making it possible to assess different peripheral nerves and plexuses, including small sensory and/or motor branches, with great precision. Diffusion-weighted sequences and diffusion tensor imaging have opened a new horizon in neurographic studies. This new approach provides morphological and functional information about the internal structure and pathophysiology of the peripheral nerves and diseases that involve them. This update reviews the different MR neurography techniques available for the study of the peripheral nerves, with special emphasis on new sequences based on diffusion.
Topics: Adult; Brachial Plexus; Diffusion Magnetic Resonance Imaging; Diffusion Tensor Imaging; Female; Humans; Lumbosacral Plexus; Magnetic Resonance Imaging; Male; Middle Aged; Peripheral Nerves; Peripheral Nervous System Diseases; Tomography, X-Ray Computed; Ultrasonography
PubMed: 31611009
DOI: 10.1016/j.rx.2019.06.005 -
Cold Spring Harbor Perspectives in... Feb 2020This review describes work from several research groups in which ultrasound is being used to target the peripheral nervous system and perform neuromodulation... (Review)
Review
This review describes work from several research groups in which ultrasound is being used to target the peripheral nervous system and perform neuromodulation noninvasively. Although these techniques are in their infancy compared to implant-based and electrical nerve stimulation, if successful this new noninvasive method for neuromodulation could solve many of the challenges facing the field of bioelectronic medicine. The work outlined herein shows results in which two different (potentially therapeutic) targets are stimulated, a neuroimmune pathway within the spleen and a nutrient/sensory pathway within the liver. Both data and discussion are provided that compare this new noninvasive technique to implant-based nerve stimulation.
Topics: Afferent Pathways; Animals; Humans; Neuroimmunomodulation; Peripheral Nerves; Spleen; Ultrasonic Therapy
PubMed: 31138539
DOI: 10.1101/cshperspect.a034215 -
IUBMB Life Sep 2017Evidence was controversial about whether nerve stimulation (NS) can optimize ultrasound guidance (US)-guided nerve blockade for peripheral nerve block. This review aims... (Meta-Analysis)
Meta-Analysis Review
Evidence was controversial about whether nerve stimulation (NS) can optimize ultrasound guidance (US)-guided nerve blockade for peripheral nerve block. This review aims to explore the effects of the two combined techniques. We searched EMBASE (from 1974 to March 2015), PubMed (from 1966 to Mar 2015), Medline (from 1966 to Mar 2015), the Cochrane Central Register of Controlled Trials and clinicaltrials.gov. Finally, 15 randomized trials were included into analysis involving 1,019 lower limb and 696 upper limb surgery cases. Meta-analysis indicated that, compared with US alone, USNS combination had favorable effects on overall block success rate (risk ratio [RR] 1.17; confidence interval [CI] 1.05 to 1.30, P = 0.004), sensory block success rate (RR 1.56; CI 1.29 to 1.89, P < 0.00001), and block onset time (mean difference [MD] -3.84; CI -5.59 to -2.08, P < 0.0001). USNS guidance had a longer procedure time in both upper and lower limb nerve block (MD 1.67; CI 1.32 to 2.02, P < 0.00001; MD 1.17; CI 0.95 to 1.39, P < 0.00001) and more patients with anesthesia supplementation (RR 2.5; CI 1.02 to 6.13, P = 0.05). USNS guidance trends to result in a shorter block onset time than US alone as well as higher block success rate, but no statistical difference was demonstrated, as more data are required. © 2017 IUBMB Life, 69(9):720-734, 2017.
Topics: Anesthesia; Anesthetics; Humans; Lower Extremity; Nerve Block; Pain; Peripheral Nerves; Randomized Controlled Trials as Topic; Ultrasonography; Upper Extremity
PubMed: 28714206
DOI: 10.1002/iub.1654 -
Anatomical Record (Hoboken, N.J. : 2007) Aug 2019Detailed anatomic investigation of peripheral nerve topography underlies the correct application of intraoperative neuromonitoring (IONM) and ultrasonography, both...
Detailed anatomic investigation of peripheral nerve topography underlies the correct application of intraoperative neuromonitoring (IONM) and ultrasonography, both well-established methods to prevent nerve palsy during surgical operations and to elucidate pathomechanisms in disease. In this study, we analyzed the anatomy of selected peripheral nerves in the head and neck regions to improve the outcome of endocrine and migraine surgeries. Anatomic dissections of 204 hemilarynges were performed to study the topography of the inferior laryngeal nerve (ILN). Measurements were taken from the lower rim of the cricoid and from the Zuckerkandl tubercle to the beginning of the furcation of the ILN. For the analysis of peripheral nerves contributing to migraine pathogenesis, 22 hemifaces were investigated by dissection and ultrasonography. The supratrochlear and supraorbital nerves and their relationship to the corrugator supercilii muscle are described. For identification of the ILN, the cricoid offers a suitable intraoperative landmark. A single branch existed in 5% of specimens on the left side and in 3% on the right side. Bifurcation was present in 72.5% and 62% and trifurcation in 18% and 29% of cases, respectively. IONM signals from the vagus nerve were positive if derived proximal to and negative if derived distal to the branching off of a nonrecurrent ILN (nrILN). By ultrasonographic identification of a brachiocephalic trunk, an nrILN could be excluded. For migraine surgery, possible compression points of the supratrochlear and supraorbital nerves were identified, and a workflow algorithm for ultrasound visualization of these nerves is provided. Anat Rec, 302:1325-1332, 2019. © 2019 Wiley Periodicals, Inc.
Topics: Animals; Cadaver; Humans; Hypoparathyroidism; Microsurgery; Migraine Disorders; Neuroimaging; Peripheral Nerves; Thyroidectomy; Ultrasonography; Vocal Cord Paralysis
PubMed: 30951264
DOI: 10.1002/ar.24125 -
Experimental Neurology Mar 2015Following peripheral nerve injury, the distal nerve is primed for regenerating axons by generating a permissive environment replete with glial cells, cytokines, and... (Review)
Review
Following peripheral nerve injury, the distal nerve is primed for regenerating axons by generating a permissive environment replete with glial cells, cytokines, and neurotrophic factors to encourage axonal growth. However, increasing evidence demonstrates that regenerating axons within peripheral nerves still encounter axonal-growth inhibitors, such as chondroitin sulfate proteoglycans. Given the generally poor clinical outcomes following peripheral nerve injury and reconstruction, the use of pharmacological therapies to augment axonal regeneration and overcome inhibitory signals has gained considerable interest. Joshi et al. (2014) have provided evidence for preferential or modality-specific (motor versus sensory) axonal growth and regeneration due to inhibitory signaling from Rho-associated kinase (ROCK) pathway regulation. By providing inhibition to the ROCK signaling pathway through Y-27632, they demonstrate that motor neurons regenerating their axons are impacted to a greater extent compared to sensory neurons. In light of this evidence, we briefly review the literature regarding modality-specific axonal regeneration to provide context to their findings. We also describe potential and novel barriers, such as senescent Schwann cells, which provide additional axonal-growth inhibitory factors for future consideration following peripheral nerve injury.
Topics: Animals; Axons; Humans; Nerve Regeneration; Neural Pathways; Peripheral Nerve Injuries; Peripheral Nerves
PubMed: 25681572
DOI: 10.1016/j.expneurol.2015.02.001 -
Acta Pharmacologica Sinica Oct 2020Peripheral nerve injury (PNI), one of the most common concerns following trauma, can result in a significant loss of sensory or motor function. Restoration of the... (Review)
Review
Peripheral nerve injury (PNI), one of the most common concerns following trauma, can result in a significant loss of sensory or motor function. Restoration of the injured nerves requires a complex cellular and molecular response to rebuild the functional axons so that they can accurately connect with their original targets. However, there is no optimized therapy for complete recovery after PNI. Supplementation with exogenous growth factors (GFs) is an emerging and versatile therapeutic strategy for promoting nerve regeneration and functional recovery. GFs activate the downstream targets of various signaling cascades through binding with their corresponding receptors to exert their multiple effects on neurorestoration and tissue regeneration. However, the simple administration of GFs is insufficient for reconstructing PNI due to their short half‑life and rapid deactivation in body fluids. To overcome these shortcomings, several nerve conduits derived from biological tissue or synthetic materials have been developed. Their good biocompatibility and biofunctionality made them a suitable vehicle for the delivery of multiple GFs to support peripheral nerve regeneration. After repairing nerve defects, the controlled release of GFs from the conduit structures is able to continuously improve axonal regeneration and functional outcome. Thus, therapies with growth factor (GF) delivery systems have received increasing attention in recent years. Here, we mainly review the therapeutic capacity of GFs and their incorporation into nerve guides for repairing PNI. In addition, the possible receptors and signaling mechanisms of the GF family exerting their biological effects are also emphasized.
Topics: Animals; Axons; Clinical Trials as Topic; Humans; Nerve Growth Factors; Nerve Regeneration; Peripheral Nerve Injuries; Peripheral Nerves; Schwann Cells; Signal Transduction
PubMed: 32123299
DOI: 10.1038/s41401-019-0338-1 -
BioMed Research International 2016Peripheral nerve injury is a common clinical entity, which may arise due to traumatic, tumorous, or even iatrogenic injury in craniomaxillofacial surgery. Despite... (Review)
Review
Peripheral nerve injury is a common clinical entity, which may arise due to traumatic, tumorous, or even iatrogenic injury in craniomaxillofacial surgery. Despite advances in biomaterials and techniques over the past several decades, reconstruction of nerve gaps remains a challenge. Autografts are the gold standard for nerve reconstruction. Using autografts, there is donor site morbidity, subsequent sensory deficit, and potential for neuroma development and infection. Moreover, the need for a second surgical site and limited availability of donor nerves remain a challenge. Thus, increasing efforts have been directed to develop artificial nerve guidance conduits (ANCs) as new methods to replace autografts in the future. Various synthetic conduit materials have been tested in vitro and in vivo, and several first- and second-generation conduits are FDA approved and available for purchase, while third-generation conduits still remain in experimental stages. This paper reviews the current treatment options, summarizes the published literature, and assesses future prospects for the repair of peripheral nerve injury in craniomaxillofacial surgery with a particular focus on facial nerve regeneration.
Topics: Animals; Biocompatible Materials; Evidence-Based Medicine; Facial Bones; Facial Nerve Injuries; Guided Tissue Regeneration; Humans; Nerve Regeneration; Peripheral Nerves; Plastic Surgery Procedures; Tissue Engineering; Tissue Scaffolds; Treatment Outcome
PubMed: 27556032
DOI: 10.1155/2016/3856262 -
Cells Aug 2021Despite the progressive advances, current standards of treatments for peripheral nerve injury do not guarantee complete recovery. Thus, alternative therapeutic...
Despite the progressive advances, current standards of treatments for peripheral nerve injury do not guarantee complete recovery. Thus, alternative therapeutic interventions should be considered. Complementary and alternative medicines (CAMs) are widely explored for their therapeutic value, but their potential use in peripheral nerve regeneration is underappreciated. The present systematic review, designed according to guidelines of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, aims to present and discuss the current literature on the neuroregenerative potential of CAMs, focusing on plants or herbs, mushrooms, decoctions, and their respective natural products. The available literature on CAMs associated with peripheral nerve regeneration published up to 2020 were retrieved from PubMed, Scopus, and Web of Science. According to current literature, the neuroregenerative potential of , , , , and are the most widely studied. Various CAMs enhanced proliferation and migration of Schwann cells , primarily through activation of MAPK pathway and FGF-2 signaling, respectively. Animal studies demonstrated the ability of CAMs to promote peripheral nerve regeneration and functional recovery, which are partially associated with modulations of neurotrophic factors, pro-inflammatory cytokines, and anti-apoptotic signaling. This systematic review provides evidence for the potential use of CAMs in the management of peripheral nerve injury.
Topics: Animals; Biological Products; Complementary Therapies; Humans; Nerve Regeneration; Peripheral Nerve Injuries; Peripheral Nerves; Signal Transduction
PubMed: 34571842
DOI: 10.3390/cells10092194 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Jan 2017To review the mechanism and effects of cell autophagy in the pathophysiology changes of peripheral nerve injury. (Review)
Review
OBJECTIVE
To review the mechanism and effects of cell autophagy in the pathophysiology changes of peripheral nerve injury.
METHODS
The recent literature about cell autophagy in peripheral nerve injury and regeneration was extensively reviewed and summarized.
RESULTS
The researches through drugs intervention and gene knockout techniques have confirmed that the Schwann cell autophagy influences the myelin degeneration, debris clearance, inflammatory cells infiltration, and axon regeneration through JNK/c-Jun pathway. To adjust autophagy process could slow down the Wallerian degeneration, maintain the integrity of injured nerve, while the effect on axon regeneration is still controversial.
CONCLUSION
The Schwann cell autophagy plays a key role in the pathophysiology changes of peripheral nerve injury, the further study of its mechanism could provide new methods for the therapy of peripheral nerve injury.
Topics: Autophagy; Humans; Myelin Sheath; Nerve Regeneration; Peripheral Nerve Injuries; Peripheral Nerves; Schwann Cells; Wallerian Degeneration
PubMed: 29798641
DOI: 10.7507/1002-1892.201611136 -
International Journal of Molecular... Feb 2024Oxygen is compulsory for mitochondrial function and energy supply, but it has numerous more nuanced roles. The different roles of oxygen in peripheral nerve regeneration... (Review)
Review
Oxygen is compulsory for mitochondrial function and energy supply, but it has numerous more nuanced roles. The different roles of oxygen in peripheral nerve regeneration range from energy supply, inflammation, phagocytosis, and oxidative cell destruction in the context of reperfusion injury to crucial redox signaling cascades that are necessary for effective axonal outgrowth. A fine balance between reactive oxygen species production and antioxidant activity draws the line between physiological and pathological nerve regeneration. There is compelling evidence that redox signaling mediated by the Nox family of nicotinamide adenine dinucleotide phosphate (NADPH) oxidases plays an important role in peripheral nerve regeneration. Further research is needed to better characterize the role of Nox in physiological and pathological circumstances, but the available data suggest that the modulation of Nox activity fosters great therapeutic potential. One of the promising approaches to enhance nerve regeneration by modulating the redox environment is hyperbaric oxygen therapy. In this review, we highlight the influence of various oxygenation states, i.e., hypoxia, physoxia, and hyperoxia, on peripheral nerve repair and regeneration. We summarize the currently available data and knowledge on the effectiveness of using hyperbaric oxygen therapy to treat nerve injuries and discuss future directions.
Topics: Humans; Oxygen; Hyperoxia; Reactive Oxygen Species; NADPH Oxidases; Hypoxia; Peripheral Nerves; Nerve Regeneration
PubMed: 38396709
DOI: 10.3390/ijms25042030