Biology Reference
In-Depth Information
CHAPTER FIVE
Electrical Stimulation for
Promoting Peripheral Nerve
Regeneration
,
†
*
Hannover Medical School, Institute of Neuroanatomy, Hannover, Germany
†
,
†
,1
, Claudia Grothe
*
Kirsten Haastert-Talini
*
Center for Systems Neuroscience (ZSN), Hannover, Germany
1
Corresponding author: e-mail address: Haastert.kirsten@mh-hannover.de
Contents
1.
Introduction
112
2. Ways to Apply Electrical Stimuli to the Reconstructed Nerve
112
2.1
Transcutaneous/percutaneous stimulation
112
2.2
Direct, brief, low-frequency electrical stimulation
113
2.3
Electrical stimulation via the synthetic nerve graft
114
2.4
Electrical stimulation combined with other treatments
115
3.
Biological Effects of Electrical Stimulation of Injured Peripheral Nerves
117
3.1
General effect on axonal regeneration
117
3.2
Impact of electrical stimulation on expression of neurotrophic factors
118
3.3
Impact of electrical stimulation on Schwann cells
119
4.
Clinical Experiences
120
Acknowledgment
121
References
121
Abstract
The peripheral nervous system has the intrinsic capacity to regenerate axons into target
tissues, and peripheral nerves severely damaged or transected can be reconstructed by
microsurgical techniques. The aim of peripheral nerve surgery is to pave way for fast and
most possible thorough functional recovery. However, full functional recovery is rarely
seen and several reasons for this have already been discovered. Based on these discov-
eries, therapeutic strategies supplementary to nerve microsurgery have been conceived
with electrical stimulation of the denervated muscles or the proximal nerve stump or
reconstructed area itself being among them. This chapter shortly describes the com-
monly accepted reasons for incomplete functional recovery and reviews the effects
of varying electrical stimulation paradigms on the essentials for axonal regeneration
and functional target reinnervation. We conclude the chapter with promising examples
where electrical stimulation did already demonstrate to accelerate and increase func-
tional recovery in the clinic.
