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Early Axonal Area Measurement Predicts Early Nerve Regeneration Outcomes
Michael Neilson, BS1; Yu-Hui Yan, MD2; Lin-Ling Zhang, MD3; Ziyi Wang, MD2; Michael Agresti, MS3; Hani Matloub, MD3; J.G. Yan, MD, PhD3
1University of South Dakota, Vermillion, SD; 2Medical College of Wisconsin, Milwaukee, WI; 3Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI
Background: Study of peripheral nerve injury and regeneration in laboratory animals can be time consuming and expensive. This study determines if it is possible to reduce time and cost for a peripheral nerve regeneration study.
Purpose: To determine if nerve axonal area (NXA) or nerve fiber counting (NFC) correlates with Compound Muscle Action Potential (CMAP) recovery which predicts functional muscular recovery in the early stage of nerve regeneration.
Methods: Two experiments were performed in this study. Experiment 1: 12 rats were divided into two groups of 6 each. Groups: (1) Sham control group: a crush injury of the sciatic nerve with no treatment and (2) Calcitonin pump group: a crush injury of the sciatic nerve with a calcitonin micro-osmotic pump. These rats were evaluated at 4 weeks of recovery with the following assessments: 1. CMAP taking readings from the extensor digitorum longus (EDL); 2. NXA measurement; 3. NFC Results: NXA correlated with CMAP for both treatment groups; NFC did not correlate with CMAP for both groups. Experiment 2: 16 rats were divided into two groups of 8 each. Groups: (1) Sham control group: a transection injury of the sciatic nerve with no treatment and (2) Calcitonin pump group: a transection injury of the sciatic nerve with a calcitonin micro-osmotic pump. These were evaluated at 12 weeks of recovery with the following assessments: 1. CMAP; 2. Tetanic Muscle Force (TMF); 3. NFC Results: NFC correlated with CMAP and TMF. The outcomes of this study validated the results in experiment 1.
Conclusion: 1. NFC is not a reliable method for predicting muscular recovery in the early stages. NXA is a dependable assessment for muscular recovery in the early stages of nerve regeneration. 2. Using nerve axon area measurement can predict later electrophysiological and functional recovery. 3. Using NXA with CMAP measurement for nerve injury, repair, and treatment in the animal study can save cost and time.
All research on these experiments were completed at the Medical College of Wisconsin.
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