J Reconstr Microsurg 2016; 32(06): 491-497
DOI: 10.1055/s-0036-1579540
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Electrical Nerve Stimulation Enhances Perilesional Branching after Nerve Grafting but Fails to Increase Regeneration Speed in a Murine Model

Christian Witzel
1   Plastic and Reconstructive Surgery, Charité-Universitätsmedizin Berlin, Germany
,
Thomas M. Brushart
2   Department of Orthopaedic Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
,
Georgios Koulaxouzidis*
3   Department of Plastic and Hand Surgery, University of Freiburg Medical Centre, Freiburg, Germany
,
Manfred Infanger*
4   Department of Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Magdeburg, Germany
› Author Affiliations
Further Information

Publication History

23 June 2015

09 January 2016

Publication Date:
14 March 2016 (online)

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Abstract

Background Electrical stimulation immediately following nerve lesion helps regenerating axons cross the subsequently grafted nerve repair site. However, the results and the mechanisms remain open to debate. Some findings show that stimulation after crush injury increases axonal crossing of the repair site without affecting regeneration speed. Others show that stimulation after transection and fibrin glue repair doubles regeneration distance.

Methods Using a sciatic-nerve-transection-graft in vivo model, we investigated the morphological behavior of regenerating axons around the repair site after unilateral nerve stimulation (20 Hz, 1 hour). With mice expressing axonal fluorescent proteins (thy1-YFP), we were able to calculate the following at 5 and 7 days: percentage of regenerating axons and arborizing axons, branches per axon, and regeneration distance and speed.

Results Brief stimulation significantly increases the percentage of regenerating axons (5 days: 35.5 vs. 27.3% nonstimulated, p < 0.05; 7 days: 43.3 vs. 33.9% nonstimulated, p < 0.05), mainly by increasing arborizing axons (5 days: 49.3 [4.4] vs. 33.9 [4.1]% [p < 0.001]; 7 days: 42.2 [5.6] vs. 33.2 [3.1]% [p < 0.001]). Neither branches per arborizing axon nor regeneration speed were affected.

Conclusion Our morphological data analysis revealed that electrical stimulation in this model increases axonal crossing of the repair site and promotes homogeneous perilesional branching, but does not affect regeneration speed.

* Both the authors contributed equally to the study.