Periferik Sinir Hasarlanması ve Tedavisi

Yıl 2024, Cilt: 2 Sayı: 3, 345 - 361, 28.08.2024

Işınsu Alkan , Berrin Zuhal Altunkaynak

https://doi.org/10.58241/ksbd.28

https://izlik.org/JA88XF26NG

Öz

Periferik sinir sistemi merkezi sinir sistemi ile efektör organ arasında köprü kuran bir iletim sistemidir. Çevreden alınan uyarıları merkezi sinir sistemine taşırken, merkezi sinir sisteminden gelen uyarıları ise organlara iletmekle görevlidir. Periferik sinirler vücudun bir çok alanına yayılım göstermekte ve vücudun işleyişinin düzenlenmesinde önemli bir rol üstlenmektedir. Vücutta birçok alanda yer almaları sebebi ile travmalara bağlı olarak hasarlanması oldukça sık izlenmektedir. Hasarlanan periferik sinirlerin eski yapı ve fonksiyonuna dönmesi uzun ve zorlu bir süreçtir. Bu sürecin zorluğu ve süresi yaralanmaların boyutlarına göre farklılık göstermektedir. Tüm yaralanma tiplerinde rejenerasyonun tam ve hızlı olması adına literatürde bir çok farklı tedavi şekli yer almaktadır. Klasik sinir greftlerinin yanı sıra, son yıllarda sıklıkla elektriksel stimülasyonlar tedavi seçeneği olarak yerini almaya başlamıştır. Literatürde yer alan tüm çalışmaların ana amacı aksonal filizlenmeyi arttırmak ve efektif bir tedavi seçeneği oluşturmaktır. Bu derleme periferik sinir yaralanmalarında dejenrasyon sürecinin tanımlanması ve dejenerasyon alanlarında iyileşme sağlayan uygulamaların özetlenmesi amaçlanmaktadır.

Anahtar Kelimeler

Periferik sinir , Sinir Hasarı , Elektriksel stimulasyon , Dejenerasyon , Nöral greft

Kaynakça

• Alkan, I., Bekar, E., & Altunkaynak, Z. (2022). Periferik sinir yaralanmaları ve rejenerasyonu. Ahi Evran Medical Journal,6(2), 211-219.https://doi.org/10.46332/aemj.975395
• Al-Majed, A. A., Neumann, C. M., Brushart, T. M., & Gordon, T. (2000). Brief electrical stimulation promotes the speed and accuracy of motor axonal regeneration. J Neurosci,20(7), 2602-2608.https://doi.org/10.1523/JNEUROSCI.20-07-02602.2000
• Bademoğlu, G., Erdal, N., Uzun, C., & Taşdelen, B. (2021). The effects of pulsed electromagnetic field on experimentally induced sciatic nerve injury in rats. Electromagn Biol Med, 40(3), 408-419.
• Bosch-Queralt, M., Fledrich, R., & Stassart, R. M. (2023). Schwann cell functions in peripheral nerve development and repair. Neurobiol Dis,176, 105952.https://doi.org/10.1016/j.nbd.2022.105952
• Brandt, K.E, & Mackinnon, S.E. (1997). Microsurgical repair of peripheral nerves and nerve grafts. In: Grabb and Smith’s Plastic Surgery. Aston SJ, Beasley RW, Thorne CHM. (eds) Lippincott-Raven, Philadelphia. pp. 82.
• Burnett, M. G., & Zager, E. L. (2004). Pathophysiology of peripheral nerve injury: a brief review. Neurosurgical focus,16(5), 1-7. https://doi.org/10.3171/foc.2004.16.5.2
• Carvalho, C. R., Oliveira, J. M., & Reis, R. L. (2019). Modern trends for peripheral nerve repair and regeneration: beyond the hollow nerve guidance conduit. Front Bioeng Biotechnol, 7, 337.https://doi.org/10.3389/fbioe.2019.00337
• Cattin, A. L., & Lloyd, A. C. (2016). The multicellular complexity of peripheral nerve regeneration. Curr Opin Neurobiol, 39, 38-46.https://doi.org/10.1016/j.conb.2016.04.005
• Chhabra, A., Ahlawat, S., Belzberg, A., & Andreseik, G. (2014). Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications.Indian J Radiol Imaging,24(03), 217-224.
• Colen, K. L., Choi, M., & Chiu, D. T. (2009). Nerve grafts and conduits. Plast Reconstr Surg, 124(6), 386-394.
• Dahlin, L. B. (2004). The biology of nerve injury and repair. J Am Soc Surg Hand, 4(3), 143-155.
• Dvali, L., & Mackinnon, S. (2006). Peripheral nerve repair and transfers. In McCarthy, J. G., Galiano, R. D., & Boutros, S. G. (Eds.), Current therapy in plastic surgery(pp. 568-573). Saunders Elsevier.
• Fernandez, E., Pallini, R., Lauretti, L., & Scogna, A. (1997). Neurosurgery of the peripheral nervous system: Injuries, degeneration and regeneration of the peripheral nerves. Surg Neurol, 48(5), 446-447.
• Foecking, E. M., Fargo, K. N., Coughlin, L. M., et al. (2012). Single session of brief electrical stimulation immediately following crush injury enhances functional recovery of rat facial nerve. J Rehabil Res Dev, 49(4), 451-458.
• Gabella, G. (2004). The rat nervous system. In G. Paxinos (Ed.), Autonomic nervous system(pp. 77-109). Elsevier.Gordon, T. (2020). Peripheral nerve regeneration and muscle reinnervation. Int J Mol Sci, 21(22), 8652. https://doi.org/10.3390/ijms21228652
• Gordon, T., Amirjani, N., Edwards, D. C., & Chan, K. M. (2010). Brief post-surgical electrical stimulation accelerates axon regeneration and muscle reinnervation without affecting the functional measures in carpal tunnel syndrome patients. Exp Neurol,223(1), 192-202.https://doi.org/10.1016/j.expneurol.2009.09.020
• Grinsell, D., & Keating, C. P. (2014). Peripheral nerve reconstruction after injury: A review of clinical and experimental therapies. BioMed Research International, 2014, 698256. https://doi.org/10.1155/2014/698256
• Gupta, R., Rummler, L., & Steward, O. (2005). Understanding the biology of compressive neuropathies. Clin Orthop Relat Res,436, 251-260.
• Hei, W. H., Byun, S. H., Kim, J. S., et al. (2016). Effects of electromagnetic field (PEMF) exposure at different frequency and duration on the peripheral nerve regeneration: In vitro and in vivo study. Int J Neurosci, 126(8), 739-748.https://doi.org/10.3109/00207454.2015.1054032
• Hirata, K., & Kawabuchi, M. (2002). Myelin phagocytosis by macrophages and nonmacrophages during Wallerian degeneration. Microscopy Research and Technique, 57(6), 541-547. https://doi.org/10.1002/jemt.10108
• Hoffman, H. (1952). Acceleration and retardation of the process of axon-sprouting in partially denervated muscles. Aust J Exp Biol Med Sci, 30(6), 541-566.Hu, Y., Wu, Y., Gou, Z., et al. (2016). 3D-engineering of cellularized conduits for peripheral nerve regeneration. Scientific Reports, 6, 32184. https://doi.org/10.1038/srep32184
• Jones, L. L., Oidega, M., Bunge, M. B., & Tuszynski, M. H. (2001). Neurotrophic factors, cellular bridges and gene therapy for spinal cord injury. J Physiology, 533(1), 83-89. https://doi.org/10.1111/j.1469-7793.2001.0083b.x
• Juckett, L., Saffari, T. M., Ormseth, B., & Senger, J. L., Moore, A. M. (2022). The effect of electrical stimulation on nerve regeneration following peripheral nerve injury. Biomolecules, 12(12), 1856. https://doi.org/10.3390/biom12121856
• Kanje, M., Rusovan, A., Sisken, B., & Lundborg, G. (1993). Pretreatment of rats with pulsed electromagnetic fields enhances regeneration of the sciatic nerve. Bioelectromagnetics, 14(4), 353-359.
• Kaplan, A. A., Yurt, K. K., Deniz, Ö. G., & Altun, G. (2018). Peripheral nerve and diclofenac sodium: Molecular and clinical approaches. J Chem Neuroanat, 87, 2-11.https://doi.org/10.1016/j.jchemneu.2017.08.006
• Keyan, Z., Liqian, Z., Xinzhong, X., Juehua, J., & Chungui, X. (2023). Pulsed electromagnetic fields improved peripheral nerve regeneration after delayed repair of one month. Bioelectromagnetics, 44(7-8), 133-143. https://doi.org/10.1002/bem.22443
• Koppes, R. A., Park, S., Hood, T., et al. (2016). Thermally drawn fibers as nerve guidance scaffolds. Biomaterials, 81, 27-35.https://doi.org/10.1016/j.biomaterials.2015.11.063
• Liu, B., Xin, W., Tan, J. R., Zhu, R. P., Li, T., Wang, D., ... & He, T. C. (2019). Myelin sheath structure and regeneration in peripheral nerve injury repair. Proc Natl Acad Sci, 116(44), 22347-22352.https://doi.org/10.1073/pnas.1910292116
• Lopes, B., Sousa, P., Alvites, R., et al. (2022). Peripheral nerve injury treatments and advances: One health perspective. Int J Mol Sci, 23(2), 918. https://doi.org/10.3390/ijms23020918
• Lundborg, G. (1988). The nerve trunk. In Nerve injury and repair(pp. 32-63). Churchill Livingstone.pp.32-63Mackinnon, S. E. (1989). New directions in peripheral nerve surgery. Ann Plast Surg, 22, 257.
• Maggi, S. P., Lowe, J. B. III, & Mackinnon, S. E. (2003). Pathophysiology of nerve injury. Clinical Plastic Surgery, 30(2), 109-126.
• Markov, M. S., Muehsam, D. J., & Pilla, A. A. (1994). Modulation of cell-free myosin phosphorylation with pulsed radio frequency electromagnetic fields. In M. J. Allen, S. F. Cleary, & A. E. Sowers (Eds.), Charge and field effects in biosystems(Vol. 4, pp. 274-288). World Scientific Publishing.
• Menorca, R. M., Fussell, T. S., & Elfar, J. C. (2013). Nerve physiology: Mechanisms of injury and recovery. Hand Clin, 29(3), 317-330.https://doi.org/10.1016/j.hcl.2013.04.002
• Mert, T., Gunay, I., Gocmen, C., Kaya, M., & Polat, S. (2006). Regenerative effects of pulsed magnetic field on injured peripheral nerves. Altern Ther Health Med, 12(4), 42-49.Min, Q., Parkinson, D. B., & Dun, X. P. (2021). Migrating Schwann cells direct axon regeneration within the peripheral nerve bridge. Glia, 69(2), 235-254. https://doi.org/10.1002/glia.23892
• Minoo, S., Payman, T., & Rahim, M. (2017). Effects of pulsed electromagnetic fields on peripheral nerve regeneration using allografts in sciatic nerve: An animal model study. Biomedical Journal of Scientific & Technical Research, 1(6), 1667-1673.https://doi.org/10.26717/BJSTR.2017.01.000509
• Mirajullah, M., & Xinya, S. (2002). Schwann cells: Leader of nervenkitt. J Ayub Med Coll Abbottabad, 14(1), 30-33.Modrak, M., Talukder, M. A. H., Gurgenashvili, K., Noble, M., & Elfar, J. C. (2020). Peripheral nerve injury and myelination: Potential therapeutic strategies. J Neurosci Res, 98(5), 780-795. https://doi.org/10.1002/jnr.24538
• Neal, S. L., & Fields, K. B. (2010). Peripheral nerve entrapment and injury in the upper extremity. Am Fam Physician, 81(2), 147-155.
• Negredo, P., Castro, J., Lago, N., Navarro, X., & Avendano, C. (2004). Differential growth of axons from sensory and motor neurons through a regenerative electrode: A stereological, retrograde tracer, and functional study in the rat. Neuroscience, 128(3), 605-615.https://doi.org/10.1016/j.neuroscience.2004.07.017
• Önger, M. E., Altun, G., & Aydın, I., et al. (2014). Periferik sinir için stereolojik inceleme yöntemi. Türkiye Klinikleri J Neurol-Special Topics, 7(2), 56-60.
• Pagnotta, A., Tos, P., Fornaro, M., Gigante, A., Geuna, S., & Battiston, B. (2002). Neurotrophins and their receptors in early axonal regeneration along muscle‐vein‐combined grafts.Microsurgery: Official Journal of the International Microsurgical Society and the European Federation of Societies for Microsurgery,22(7), 300-303. https://doi.org/10.1002/micr.10053
• Pedrosa, S. S., Caseiro, A. R., Santos, J. D., & Maurício, A. C. (2017). Scaffolds for peripheral nerve regeneration, the importance of in vitro and in vivo studies for the development of cell-based therapies and biomaterials: state of the art.Scaffolds in Tissue Engineering Materials, Technologies and Clinical Applications,9(12), 179.
• Peltonen, S., Alanne, M., & Peltonen, J. (2013). Barriers of the peripheral nerve.Tissue barriers,1(3), e24956. https://doi.org/10.4161/tisb.24956
• Pestronk, A., Schmidt, R. E., Bucelli, R., & Sim, J. (2023). Schwann cells and myelin in human peripheral nerve: major protein components vary with age, axon size and pathology.Neuropathol Appl Neurobiol,49(2), e12898. https://doi.org/10.1111/nan.12898
• Pockett, S., & Gavin, R. M. (1985). Acceleration of peripheral nerve regeneration after crush injury in rat.Neurosci let,59(2), 221-224.https://doi.org/10.1016/0304-3940(85)90203-4
• Poongodi, R., Chen, Y. L., Yang, T. H., Huang, Y. H., Yang, K. D., Lin, H. C., & Cheng, J. K. (2021). Bio-scaffolds as cell or exosome carriers for nerve injury repair.International journal of molecular sciences,22(24), 13347.https://doi.org/10.3390/ijms222413347
• Quan, D., Bird, S. (1999). Nerve conduction studies and electromyography in the evaluation of peripheral nevre injuries. Orthopaedic Journal.12, 45-51.
• Robinson, LR. (2000). Traumatic injury to peripheral nerves. Muscle & Nerve. 23, 863-873.https://doi.org/10.1016/S1567-424X(09)70355-1
• Ross MH, Pawlina W. (2006). Histology: A text and atlas. Baltimore, Philadelphia, 5th ed, Lippincott Williams & Wilkins.Rusovan, A., Kanje, M., & Mild, K. H. (1992). The stimulatory effect of magnetic fields on regeneration of the rat sciatic nerve is frequency dependent.Experimental neurology,117(1), 81-84.https://doi.org/10.1016/0014-4886(92)90113-5
• Saito, F., Moore, S. A., Barresi, R., Henry, M. D., Messing, A., Ross-Barta, S. E., ... & Campbell, K. P. (2003). Unique role of dystroglycan in peripheral nerve myelination, nodal structure, and sodium channel stabilization.Neuron,38(5), 747-758.https://doi.org/10.1016/S0896-6273(03)00301-5
• Say, F., Altunkaynak, B. Z., Coşkun, S., Deniz, Ö. G., Yıldız, Ç., Altun, G., ... & Pişkin, A. (2016). Controversies related to electromagnetic field exposure on peripheral nerves.J Chem Neuroanat,75, 70-76.https://doi.org/10.1016/j.jchemneu.2015.12.008
• Seckel, B. R. (1990). Enhancement of peripheral nerve regeneration. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine,13(9), 785-800. https://doi.org/10.1002/mus.880130904
• Shenaq, S.M, Kim, J.Y.S. (2006). Repair and grafting of peripheral nevre. In: Mathes SJ. Plastic surgery. 2nd ed. Philadelphia: Saunders, Elsevier. 1,719-43.Snell, R.S. (1990). Clinical neuroanatomy for medical students. Second edition. Little Brown and Company, Boston pp. 47-75.
• Stewart, J. D. (2003). Peripheral nerve fascicles: anatomy and clinical relevance.Muscle & nerve,28(5), 525-541.https://doi.org/10.1002/mus.10454
• Stoll, G., & Müller, H. W. (1999). Nerve injury, axonal degeneration and neural regeneration: basic insights. Brain pathology,9(2), 313-325. https://doi.org/10.1111/j.1750-3639.1999.tb00229.x
• Stoll, G., Jander, S., & Myers, R. R. (2002). Degeneration and regeneration of the peripheral nervous system: from Augustus Waller's observations to neuroinflammation.J Peripher Nerv Syst,7(1), 13-27. https://doi.org/10.1046/j.1529-8027.2002.02002.x
• Strauch, B., Herman, C., Dabb, R., Ignarro, L. J., & Pilla, A. A. (2009). Evidence-based use of pulsed electromagnetic field therapy in clinical plastic surgery.Aesth Surg J,29(2), 135-143.https://doi.org/10.1016/j.asj.2009.02.001
• Suszyński, K., Marcol, W., & Górka, D. (2015). Physiotherapeutic techniques used in the management of patients with peripheral nerve injuries.Neural Regen Res,10(11), 1770-1772.https://doi.org/10.4103/1673-5374.170299
• Sütçü, M. (2010). Periferik sinir kesisinde farklı onarım zamanlarında melatoninin sinir iyileşmesine olan etkisinin incelenmesi. Vijayavenkataraman, S., Thaharah, S., Zhang, S., Lu, W. F., & Fuh, J. Y. H. (2019). 3D‐printed PCL/rGO conductive scaffolds for peripheral nerve injury repair.Artif Organs,43(5), 515-523.https://doi.org/10.1111/aor.13360
• Wachs, R. A., Wellman, S. M., Porvasnik, S. L., Lakes, E. H., Cornelison, R. C., Song, Y. H., ... & Schmidt, C. E. (2023). Apoptosis-Decellularized peripheral nerve scaffold allows regeneration across nerve gap.Cells Tissues Organs,212(6), 512-522.https://doi.org/10.1159/000525704
• Willand, M. P., Nguyen, M. A., Borschel, G. H., & Gordon, T. (2016). Electrical stimulation to promote peripheral nerve regeneration.Neurorehabil Neural Repair,30(5), 490-496.https://doi.org/10.1177/1545968315604399
• Wong, J. N., Olson, J. L., Morhart, M. J., & Chan, K. M. (2015). Electrical stimulation enhances sensory recovery: a randomized controlled trial.Ann Neurol, 77(6), 996-1006. https://doi.org/10.1002/ana.24397
• Yalaki, U. C., & Şekir, U. (2019). Periferik Sinir Yaralanmalarının Patofizyoloji, Tanı ve Tedavisi.Turkiye Klinikleri Sports Medicine-Special Topics,5(2), 16-22
• .Yi, S., Xu, L., & Gu, X. (2019). Scaffolds for peripheral nerve repair and reconstruction.Experimental neurology,319, 112761.https://doi.org/10.1016/j.expneurol.2018.05.016
• Zhang, P. X., Han, N., Kou, Y. H., Zhu, Q. T., Liu, X. L., Quan, D. P., ... & Jiang, B. G. (2019). Tissue engineering for the repair of peripheral nerve injury.Neural Regen Res,14(1), 51-58.https://doi.org/10.4103/1673-5374.243701
• Zhao, Y., Liu, Y., Kang, S., Sun, D., Liu, Y., Wang, X., & Lu, L. (2024). Peripheral nerve injury repair by electrical stimulation combined with graphene-based scaffolds. Front Bioeng Biotechnol,12, 1345163.https://doi.org/10.3389/fbioe.2024.1345163
• Zochodne, D. W. (2000). The microenvironment of injured and regenerating peripheral nerves.Muscle & nerve,23(S9), S33-S38.