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Functional Recovery after Sciatic Nerve Laceration and Direct or Transcutaneous Electrical Stimulation in Mice
Jenny C. Lin, MD, PhD; Anne-Marie Pion, MD; Andree-Anne Roy, MD; Eric Beaumont, PhD;
University of Montreal, Montreal, QC, Canada
Purpose: Direct electrical nerve stimulation for one hour at 20Hz increases the rate of peripheral nerve regeneration in rats after nerve laceration and repair. In a clinical setting, however, this would require either lengthening surgery time or using implanted electrodes that must subsequently be removed. This study examines whether transcutaneous electrical stimulation is as effective as direct electrical stimulation for improving functional recovery after sciatic nerve laceration and repair in a mouse model.
Methods: Three groups of eight C57Bl/6 mice underwent right sciatic nerve laceration and immediate repair. Group 1 received no further treatment. Group 2 received direct electrical stimulation on the proximal sciatic nerve at 20Hz for one hour. Group 3 had their wounds repaired, then underwent transcutaneous electrical stimulation at 20Hz for one hour. In all cases, stimulation was carried out at 90% of motor threshold. Prior to surgery, and then every 2 weeks after the surgery for a total of 12 weeks, the functional recovery of the affected hindlimb was evaluated using a walking-track analysis and kinematic study. Electrophysiological and histological parameters were also used at the end of the study period to evaluate muscle recovery.
Results: Previously, we have shown that electrical recordings from the lumbar spinal cord after transcutaneous electrical stimulation induces the same electrical response as does direct electrical stimulation of the sciatic nerve, suggesting that both may be effective in accelerating axonal regeneration following nerve laceration and repair. In this current study, kinematic analysis showed that the groups of mice receiving either direct or trans-cutaneous electrical stimulation after sciatic nerve laceration and repair demonstrated significantly better functional recovery as early as 6 weeks after injury than mice having only immediate nerve repair. There was no significant difference between the group of mice receiving transcutaneous electrical stimulation or those receiving direct electrical stimulation.
Conclusion: This functional study demonstrates that one hour of trans-cutaneous electrical stimulation (20Hz) over the proximal end of the repaired sciatic nerve in mice is equally beneficial for functional muscle recovery after nerve laceration as is direct electrical stimulation of the nerve. Clinically, the use of transcutaneous electrical stimulation for nerve injured patients would permit more flexibility in the application of this promising therapy for accelerating nerve regeneration.
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