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International Journal of Molecular... Aug 2020The peripheral nervous system controls the functions of sensation, movement and motor coordination of the body. Peripheral nerves can get damaged easily by trauma or... (Review)
Review
The peripheral nervous system controls the functions of sensation, movement and motor coordination of the body. Peripheral nerves can get damaged easily by trauma or neurodegenerative diseases. The injury can cause a devastating effect on the affected individual and his aides. Treatment modalities include anti-inflammatory medications, physiotherapy, surgery, nerve grafting and rehabilitation. 3D bioprinted peripheral nerve conduits serve as nerve grafts to fill the gaps of severed nerve bodies. The application of induced pluripotent stem cells, its derivatives and bioprinting are important techniques that come in handy while making living peripheral nerve conduits. The design of nerve conduits and bioprinting require comprehensive information on neural architecture, type of injury, neural supporting cells, scaffold materials to use, neural growth factors to add and to streamline the mechanical properties of the conduit. This paper gives a perspective on the factors to consider while bioprinting the peripheral nerve conduits.
Topics: Animals; Bioprinting; Humans; Induced Pluripotent Stem Cells; Peripheral Nerves; Printing, Three-Dimensional; Tissue Engineering; Tissue Scaffolds
PubMed: 32806758
DOI: 10.3390/ijms21165792 -
Anaesthesia Jan 2021The accuracy and reliability of ultrasound are still insufficient to guarantee complete and safe nerve block for all patients. Injection of local anaesthetic close to,... (Review)
Review
The accuracy and reliability of ultrasound are still insufficient to guarantee complete and safe nerve block for all patients. Injection of local anaesthetic close to, but not touching, the nerve is key to outcomes, but the exact relationship between the needle tip and nerve epineurium is difficult to evaluate, even with ultrasound. Ultrasound has insufficient resolution, tissues are difficult to discern due to acoustic impedance and needles are more difficult to see with increased angulation. The limitations of ultrasound have shifted the focus of innovation towards bio-markers that help detect needle tip position by utilising the physical properties of tissues, (e.g. pressure, electrical, optics, acoustic and elastic). Although most are at the laboratory stage and results are as yet only available from phantom or cadaver studies, clinical trials are imminent. For example, fine optical fibres placed within the lumen of block needles can measure needle tip pressure. Electrical impedance differentiates between intraneural and perineural needle tip placement. A new tip tracker needle has a piezo element embedded at its distal end that tracks the needle tip in-plane and out-of-plane as a blue/red or green circle depending on its relative location within the beam. Micro-ultrasound at the tip of the needle is in development. Early images using 40MHz in anaesthetised pigs reveal muscle striation, distinct epineurium and 30-40 fascicles > 75 micron in diameter. The next few years will see a technological revolution in tip-tracking technology that has the potential to improve patient safety and, in doing so, change practice.
Topics: Anesthetics, Local; Animals; Needles; Nerve Block; Peripheral Nerves; Ultrasonography, Interventional
PubMed: 33426657
DOI: 10.1111/anae.15232 -
International Journal of Molecular... Jan 2022Peripheral nerve and spinal cord injuries are potentially devastating traumatic conditions with major consequences for patients' lives. Severe cases of these conditions... (Review)
Review
Peripheral nerve and spinal cord injuries are potentially devastating traumatic conditions with major consequences for patients' lives. Severe cases of these conditions are currently incurable. In both the peripheral nerves and the spinal cord, disruption and degeneration of axons is the main cause of neurological deficits. Biomaterials offer experimental solutions to improve these conditions. They can be engineered as scaffolds that mimic the nerve tissue extracellular matrix and, upon implantation, encourage axonal regeneration. Furthermore, biomaterial scaffolds can be designed to deliver therapeutic agents to the lesion site. This article presents the principles and recent advances in the use of biomaterials for axonal regeneration and nervous system repair.
Topics: Animals; Axons; Biocompatible Materials; Extracellular Matrix; Humans; Nerve Regeneration; Neurons; Peripheral Nerve Injuries; Peripheral Nerves; Spinal Cord; Spinal Cord Injuries; Tissue Scaffolds
PubMed: 35163168
DOI: 10.3390/ijms23031244 -
Trends in Cancer Dec 2020Over the past decade, several landmark reports have demonstrated that the nervous system plays an active role in cancer initiation and progression. These studies... (Review)
Review
Over the past decade, several landmark reports have demonstrated that the nervous system plays an active role in cancer initiation and progression. These studies demonstrate that ablation of specific nerve types (parasympathetic, sympathetic, or sensory) abrogates tumor growth in a tissue-specific manner. Further, many tumor types are more densely innervated than their normal tissues of origin. These striking results raise fundamental questions regarding tumor innervation, how it is initiated, and how it molecularly contributes to disease. In this review, we aim to address what is currently known about the origin of tumor-infiltrating nerves, how they may be recruited to tumors, and how their presence may give rise to aggressive disease.
Topics: Cell Transformation, Neoplastic; Cellular Reprogramming; Disease Progression; Extracellular Vesicles; Humans; Neoplasms; Neural Stem Cells; Peripheral Nerves
PubMed: 32807693
DOI: 10.1016/j.trecan.2020.07.005 -
Acta Bio-medica : Atenei Parmensis Apr 2021Muscle in vein (MIV ) conduits have gradually been employed in the last 20 years as a valuable technique in bridging peripheral nerve gaps after nerve lesions who cannot...
Muscle in vein (MIV ) conduits have gradually been employed in the last 20 years as a valuable technique in bridging peripheral nerve gaps after nerve lesions who cannot undergo a direct tension-free coaptation. The advantages of this procedure comparing to the actual benchmark (autograft) is the sparing of the donor site, and the huge availability of both components (i.e. muscle and veins). Here we present a case serie of four MIV performed at our hospital from 2018 to 2019. The results we obtained in our experi-ence confirmed its effectiveness both in nerve regeneration (as sensibility recovery) and in neuropathic pain eradication. Our positive outcomes encourage its use in selected cases of residual nerve gaps up to 30 mm.
Topics: Humans; Muscles; Nerve Regeneration; Peripheral Nerve Injuries; Peripheral Nerves; Veins
PubMed: 33944845
DOI: 10.23750/abm.v92iS1.9202 -
Journal of Visualized Experiments : JoVE Oct 2021Peripheral nerve interfaces are frequently used in experimental neuroscience and regenerative medicine for a wide variety of applications. Such interfaces can be...
Peripheral nerve interfaces are frequently used in experimental neuroscience and regenerative medicine for a wide variety of applications. Such interfaces can be sensors, actuators, or both. Traditional methods of peripheral nerve interfacing must either tether to an external system or rely on battery power that limits the time frame for operation. With recent developments of wireless, battery-free, and fully implantable peripheral nerve interfaces, a new class of devices can offer capabilities that match or exceed those of their wired or battery-powered precursors. This paper describes methods to (i) surgically implant and (ii) wirelessly power and control this system in adult rats. The sciatic and phrenic nerve models were selected as examples to highlight the versatility of this approach. The paper shows how the peripheral nerve interface can evoke compound muscle action potentials (CMAPs), deliver a therapeutic electrical stimulation protocol, and incorporate a conduit for the repair of peripheral nerve injury. Such devices offer expanded treatment options for single-dose or repeated dose therapeutic stimulation and can be adapted to a variety of nerve locations.
Topics: Animals; Electric Power Supplies; Electric Stimulation Therapy; Peripheral Nerves; Phrenic Nerve; Prostheses and Implants; Rats; Wireless Technology
PubMed: 34747395
DOI: 10.3791/63085 -
SLAS Technology Jun 2023Tissue-engineered nerve guidance conduits (NGCs) are a viable clinical alternative to autografts and allografts and have been widely used to treat peripheral nerve... (Review)
Review
Tissue-engineered nerve guidance conduits (NGCs) are a viable clinical alternative to autografts and allografts and have been widely used to treat peripheral nerve injuries (PNIs). Although these NGCs are successful to some extent, they cannot aid in native regeneration by improving native-equivalent neural innervation or regrowth. Further, NGCs exhibit longer recovery period and high cost limiting their clinical applications. Additive manufacturing (AM) could be an alternative to the existing drawbacks of the conventional NGCs fabrication methods. The emergence of the AM technique has offered ease for developing personalized three-dimensional (3D) neural constructs with intricate features and higher accuracy on a larger scale, replicating the native feature of nerve tissue. This review introduces the structural organization of peripheral nerves, the classification of PNI, and limitations in clinical and conventional nerve scaffold fabrication strategies. The principles and advantages of AM-based techniques, including the combinatorial approaches utilized for manufacturing 3D nerve conduits, are briefly summarized. This review also outlines the crucial parameters, such as the choice of printable biomaterials, 3D microstructural design/model, conductivity, permeability, degradation, mechanical property, and sterilization required to fabricate large-scale additive-manufactured NGCs successfully. Finally, the challenges and future directions toward fabricating the 3D-printed/bioprinted NGCs for clinical translation are also discussed.
Topics: Nerve Regeneration; Peripheral Nerves; Tissue Engineering; Biocompatible Materials
PubMed: 37028493
DOI: 10.1016/j.slast.2023.03.006 -
Journal of Neuroscience Methods Feb 2020Peripheral nerve interfaces have emerged as alternative solutions for a variety of therapeutic and performance improvement applications. The Defense Advanced Research... (Review)
Review
Peripheral nerve interfaces have emerged as alternative solutions for a variety of therapeutic and performance improvement applications. The Defense Advanced Research Projects Agency (DARPA) has widely invested in these interfaces to provide motor control and sensory feedback to prosthetic limbs, identify non-pharmacological interventions to treat disease, and facilitate neuromodulation to accelerate learning or improve performance on cognitive, sensory, or motor tasks. In this commentary, we highlight some of the design considerations for optimizing peripheral nerve interfaces depending on the application space. We also discuss the ethical considerations that accompany these advances.
Topics: Artificial Limbs; Feedback, Sensory; Peripheral Nerves; Prescriptions
PubMed: 31805301
DOI: 10.1016/j.jneumeth.2019.108539 -
Neurologia 2022Guillain-Barré syndrome (GBS) is an acute-onset, immune-mediated disease of the peripheral nervous system. It may be classified into 2 main subtypes: demyelinating... (Review)
Review
INTRODUCTION
Guillain-Barré syndrome (GBS) is an acute-onset, immune-mediated disease of the peripheral nervous system. It may be classified into 2 main subtypes: demyelinating (AIDP) and axonal (AMAN). This study aims to analyse the mechanisms of axonal damage in the early stages of GBS (within 10 days of onset).
DEVELOPMENT
We analysed histological, electrophysiological, and imaging findings from patients with AIDP and AMAN, and compared them to those of an animal model of myelin P2 protein-induced experimental allergic neuritis. Inflammatory oedema of the spinal nerve roots and spinal nerves is the initial lesion in GBS. The spinal nerves of patients with fatal AIDP may show ischaemic lesions in the endoneurium, which suggests that endoneurial inflammation may increase endoneurial fluid pressure, reducing transperineurial blood flow, potentially leading to conduction failure and eventually to axonal degeneration. In patients with AMAN associated with anti-ganglioside antibodies, nerve conduction block secondary to nodal sodium channel dysfunction may affect the proximal, intermediate, and distal nerve trunks. In addition to the mechanisms involved in AIDP, active axonal degeneration in AMAN may be associated with nodal axolemma disruption caused by anti-ganglioside antibodies.
CONCLUSION
Inflammatory oedema of the proximal nerve trunks can be observed in early stages of GBS, and it may cause nerve conduction failure and active axonal degeneration.
Topics: Amantadine; Animals; Axons; Guillain-Barre Syndrome; Neural Conduction; Peripheral Nerves
PubMed: 35779867
DOI: 10.1016/j.nrleng.2020.08.001 -
Neurologia 2022Guillain-Barré syndrome (GBS) is an acute-onset, immune-mediated disease of the peripheral nervous system. It may be classified into 2 main subtypes: demyelinating... (Review)
Review
INTRODUCTION
Guillain-Barré syndrome (GBS) is an acute-onset, immune-mediated disease of the peripheral nervous system. It may be classified into 2 main subtypes: demyelinating (AIDP) and axonal (AMAN). This study aims to analyse the mechanisms of axonal damage in the early stages of GBS (within 10days of onset).
DEVELOPMENT
We analysed histological, electrophysiological, and imaging findings from patients with AIDP and AMAN, and compared them to those of an animal model of myelin P2 protein-induced experimental allergic neuritis. Inflammatory oedema of the spinal nerve roots and spinal nerves is the initial lesion in GBS. The spinal nerves of patients with fatal AIDP may show ischaemic lesions in the endoneurium, which suggests that endoneurial inflammation may increase endoneurial fluid pressure, reducing transperineurial blood flow, potentially leading to conduction failure and eventually to axonal degeneration. In patients with AMAN associated with anti-ganglioside antibodies, nerve conduction block secondary to nodal sodium channel dysfunction may affect the proximal, intermediate, and distal nerve trunks. In addition to the mechanisms involved in AIDP, active axonal degeneration in AMAN may be associated with nodal axolemma disruption caused by anti-ganglioside antibodies.
CONCLUSION
Inflammatory oedema of the proximal nerve trunks can be observed in early stages of GBS, and it may cause nerve conduction failure and active axonal degeneration.
Topics: Animals; Humans; Guillain-Barre Syndrome; Peripheral Nerves; Neural Conduction; Edema; Amantadine
PubMed: 30057217
DOI: 10.1016/j.nrl.2018.06.002