Biology Reference
In-Depth Information
The present review has surveyed the findings that describe the effects of
shock waves on intact and injured peripheral nerves. Although only limited
information is available on the mechanism of action of shock wave treatment
on peripheral nerves, improved vascularization does not appear to play a
direct role in promoting axon regeneration after axotomy. Axonal regener-
ation in the peripheral nerves is known to be promoted by several cellular
and molecular components of the nerve, including the coupling of integrin
molecules situated on the axonal growth cone membrane with the abundant
extracellular molecules (
Lefcort, Venstrom, McDonald, & Reichardt, 1992;
Low, N´gr´di, Vrbov
´
, & Greensmith, 2003; Tomaselli et al., 1993
), the
proliferation of activated Schwann cells in the degenerated distal stump of
the nerve (
Stoll and M¨ ller, 1999
), and the clear role played by activated
macrophages (
Dailey, Avellino, Benthem, Silver, & Kliot, 1998; Horie
et al., 2004; Hughes and Perry, 2000
) in the removal of myelin debris
(
Fig. 3.4
). We therefore suggest that ESWT may augment and potentiate
the mechanisms described earlier in a regenerating peripheral nerve seg-
ment. It is to be expected that ESWT will become more widely used in
the treatment of injuries and pathological conditions affecting peripheral
nerves.
ACKNOWLEDGMENTS
The authors are indebted to the Lorenz B¨hler Fonds for financial support. The excellent
artwork of Mr. G´bor M´rton is gratefully acknowledged. We thank Dr. David Durham
for a critical reading of the chapter.
REFERENCES
