title: Chapter 23: Manual stimulation of target muscles has different impact on functional recovery after injury of pure motor or mixed nerves.
abstract: Direct coaptation and interpositional nerve grafting (IPNG) of an injured peripheral nerve is still associated with poor functional recovery. Main reasons for that are thought to be an extensive collateral axonal branching at the site of transection and the polyinnervation of motor endplates due to terminal axonal and intramuscular sprouting. Moreover, severe changes occurring within the muscle after long-term denervation, like loss of muscle bulk and circulation as well as progressive fibrosis, have a negative effect on the quality of functional recovery after reinnervation. We have recently shown that manual stimulation (MS) of paralyzed vibrissal muscles in rat promotes full recovery after facial nerve coaptation. Furthermore, MS improved functional recovery after hypoglossal nerve repair, hypoglossal-facial IPNG of the facial nerve in rat. In contrary, MS did not improve recovery after injury of the median nerve in rat, which is however a mixed peripheral nerve comparing to the facial nerve. It is speculated that manually stimulated recovery of motor function requires an intact sensory input, which is affected in case of mixed peripheral nerves but not in case of pure motor nerves. In this article, we summarize our results of MS in several peripheral nerve injury models in order to illustrate the application potential of this method and to give insights into further investigations on that field.
authors.affiliation: Department of Hand, Plastic, Reconstructive Surgery and Burn Unit, Eberhard-Karls-University of Tuebingen, BG Trauma Center Tuebingen, Germany.
authors.forename: Nektarios
authors.initials: N
authors.lastname: Sinis
authors.forename: Thodora
authors.initials: T
authors.lastname: Manoli
authors.forename: Frank
authors.initials: F
authors.lastname: Werdin
authors.forename: Armin
authors.initials: A
authors.lastname: Kraus
authors.forename: Hans E
authors.initials: HE
authors.lastname: Schaller
authors.forename: Orlando
authors.initials: O
authors.lastname: Guntinas-Lichius
authors.forename: Maria
authors.initials: M
authors.lastname: Grosheva
authors.forename: Andrey
authors.initials: A
authors.lastname: Irintchev
authors.forename: Emanouil
authors.initials: E
authors.lastname: Skouras
authors.forename: Sarah
authors.initials: S
authors.lastname: Dunlop
authors.forename: Doychin N
authors.initials: DN
authors.lastname: Angelov
mesh_terms: D000818:Animals; D005154:Facial Nerve / Q000502:physiology; D020220:Facial Nerve Injuries / Q000503:physiopathology; D007002:Hypoglossal Nerve / Q000502:physiology; D061228:Hypoglossal Nerve Injuries; D009046:Motor Neurons / Q000502:physiology*; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology*; D009416:Nerve Regeneration / Q000502:physiology; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000502:physiology* / Q000503:physiopathology; D010812:Physical Stimulation; D051381:Rats; D020127:Recovery of Function