Effects of Electrical Stimulation at Different Frequencies on Regeneration of Transected Peripheral Nerve

Background. Electrical stimulation of damaged peripheral nerve may aid regeneration. Objective. The purpose of this study was to determine whether 1 mA of percutaneous electrical stimulation at 1, 2, 20, or 200 Hz augments regeneration between the proximal and distal nerve stumps. Methods. A10-mm gap was made in rat sciatic nerve by suturing the stumps into silicone rubber tubes. A control group received no stimulation. Starting 1 week after transection, electrical stimulation was applied between the cathode placed at the distal stump and the anode at the proximal stump every other day for 6 weeks. Results. Higher frequency stimulation led to less regeneration compared to lower frequencies. Quantitative histology of the successfully regenerated nerves revealed that the groups receiving electrical treatment, especially at 2 Hz, had a more mature structure with a smaller cross-sectional area, more myelinated fibers, higher axon density, and higher ratio of blood vessel to total nerve area compared with the controls. Electrophysiology showed significantly shorter latency, longer duration, and faster conduction velocity. Conclusion. Electrical stimulation can have either a positive or negative impact on peripheral nerve regeneration. Clinical trials that combine stimulation with rehabilitation must determine the parameters that are most likely to be safe and effective.

[1]  M. Constantinescu,et al.  Effects of local continuous release of brain derived neurotrophic factor (BDNF) on peripheral nerve regeneration in a rat model , 2006, Experimental Neurology.

[2]  S. H. Yang,et al.  Effects of acupuncture on exercise-induced muscle soreness and serum creatine kinase activity. , 1999, The American journal of Chinese medicine.

[3]  Chou-Ching K Lin,et al.  The effects of different electrical stimulation protocols on nerve regeneration through silicone conduits. , 2004, The Journal of trauma.

[4]  Tessa Gordon,et al.  Electrical stimulation promotes sensory neuron regeneration and growth-associated gene expression , 2007, Experimental Neurology.

[5]  A. English,et al.  Electrical stimulation promotes peripheral axon regeneration by enhanced neuronal neurotrophin signaling , 2007, Developmental neurobiology.

[6]  Gianluca Ciardelli,et al.  Materials for peripheral nerve regeneration. , 2006, Macromolecular bioscience.

[7]  D. Currier,et al.  Effect of motor neuromuscular electrical stimulation on microvascular perfusion of stimulated rat skeletal muscle. , 1991, Physical therapy.

[8]  D B McCreery,et al.  Evolution and resolution of stimulation‐induced axonal injury in peripheral nerve , 1999, Muscle & nerve.

[9]  S. Egginton,et al.  Changes in capillary perfusion induced by different patterns of activity in rat skeletal muscle. , 1990, Microvascular research.

[10]  J. Balogun,et al.  The effects of acupuncture, electroneedling and transcutaneous electrical stimulation therapies on peripheral haemodynamic functioning. , 1998, Disability and rehabilitation.

[11]  A. Benabid,et al.  Alteration of hormone and neurotransmitter production in cultured cells by high and low frequency electrical stimulation , 2006, Acta Neurochirurgica.

[12]  K. Barron,et al.  Transcutaneous neuromuscular electrical stimulation effect on the degree of microvascular perfusion in autonomically denervated rat skeletal muscle. , 1996, Archives of physical medicine and rehabilitation.

[13]  S. Andersson,et al.  Long-lasting cardiovascular depression induced by acupuncture-like stimulation of the sciatic nerve in unanaesthetized spontaneously hypertensive rats , 1982, Brain Research.

[14]  Akihiko Takashima,et al.  Electrical Stimulation Modulates Fate Determination of Differentiating Embryonic Stem Cells , 2007, Stem cells.

[15]  Tessa Gordon,et al.  Electrical Stimulation Accelerates and Enhances Expression of Regeneration-Associated Genes in Regenerating Rat Femoral Motoneurons , 2004, Cellular and Molecular Neurobiology.

[16]  Ze Zhang,et al.  Electrically conductive biodegradable polymer composite for nerve regeneration: electricity-stimulated neurite outgrowth and axon regeneration. , 2007, Artificial organs.

[17]  J. Coote,et al.  Activity of muscle afferents and reflex circulatory responses to exercise. , 1972, American Journal of Physiology.

[18]  Kam W Leong,et al.  Peripheral nerve regeneration by microbraided poly(L-lactide-co-glycolide) biodegradable polymer fibers. , 2004, Journal of biomedical materials research. Part A.

[19]  A. Joseph Threlkeld,et al.  Effect of graded electrical stimulation on blood flow to healthy muscle. , 1986, Physical therapy.

[20]  Charles Tator,et al.  Growth factor enhancement of peripheral nerve regeneration through a novel synthetic hydrogel tube. , 2003, Journal of neurosurgery.

[21]  C. Yao,et al.  In vivo evaluation of a biodegradable EDC/NHS-cross-linked gelatin peripheral nerve guide conduit material. , 2007, Macromolecular bioscience.

[22]  C. Billante,et al.  Electrical stimulation of a denervated muscle promotes selective reinnervation by native over foreign motoneurons. , 2002, Journal of neurophysiology.

[23]  Michael A Glasby,et al.  Use of a static magnetic field to promote recovery after peripheral nerve injury. , 2006, Journal of neurosurgery.

[24]  K. Barron,et al.  The influence of muscle contraction on the degree of microvascular perfusion in rat skeletal muscle following transcutaneous neuromuscular electrical stimulation. , 1993, The Journal of orthopaedic and sports physical therapy.

[25]  Electrical field effects on crushed nerve regeneration , 1992, Experimental Neurology.

[26]  K. Fujimori,et al.  Long‐term effects of muscle‐derived protein with molecular mass of 77 kDa (MDP77) on nerve regeneration , 2005, Journal of neuroscience research.

[27]  Chun-Hsu Yao,et al.  An in vivo evaluation of a biodegradable genipin-cross-linked gelatin peripheral nerve guide conduit material. , 2005, Biomaterials.

[28]  O. Hudlická,et al.  A comparison of the microcirculation in rat fast glycolytic and slow oxidative muscles at rest and during contractions. , 1987, Microvascular research.