Electrical Stimulation: Enhancing Axonal Growth following Peripheral Nerve Injury.

IF 0.5 Q4 SURGERY Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2024-10-01 Epub Date: 2024-08-30 DOI:10.1142/S2424835524400034
Roy S Horowitz, Zachary D Randall, Christopher J Dy
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Abstract

Electrical stimulation has been integrated in recent decades into rehabilitation protocols following neuromuscular injuries. Existing literature supports the utilisation of prolonged or continuous stimulation generated by implantable or transcutaneous devices for chronic pain subsidence and muscle trophism maintenance, which improve outcomes following microsurgical interventions. Newer uses include brief electrical stimulation for peripheral nerve injury. Brief electrical stimulation has shown promise in expediting regeneration of both torn and crushed nerve axons in the murine model and has been incorporated into a limited number of clinical studies. Augmentation of the natural response of an injured peripheral nerve by electrical stimulation has the potential to accelerate regeneration, presumably leading to improved function and clinical outcomes. We review the existing literature on intraoperative utilisation of electrical stimulation to enhance regeneration, such as neural mechanisms of action and their microscopic effect in animal models, as well as results from initial human studies. Level of Evidence: Level V (Therapeutic).

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电刺激:增强外周神经损伤后的轴突生长。
近几十年来,电刺激已被纳入神经肌肉损伤后的康复方案。现有文献支持利用植入式或经皮装置产生的长时间或持续刺激来缓解慢性疼痛和维持肌肉萎缩,从而改善显微外科干预后的疗效。较新的用途包括针对周围神经损伤的短暂电刺激。在小鼠模型中,短暂的电刺激在加速撕裂和粉碎的神经轴突再生方面显示出前景,并已被纳入数量有限的临床研究中。通过电刺激增强损伤周围神经的自然反应有可能加速再生,从而改善功能和临床效果。我们回顾了有关术中利用电刺激促进再生的现有文献,如动物模型的神经作用机制和微观效果,以及初步人体研究的结果。证据等级:五级(治疗)。
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304
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