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CC BY 4.0 · J Brachial Plex Peripher Nerve Inj 2022; 17(01): e1-e9
DOI: 10.1055/s-0042-1743132
Original Contribution

Effects of Prestretch on Neonatal Peripheral Nerve: An In Vitro Study

Anita Singh 
1   Department of Biomedical Engineering, Widener University School of Engineering, Chester, Pennsylvania, United States
,
Tanmay Majmudar
2   Drexel University School of Biomedical Engineering, Science, and Health Systems, Philadelphia, Pennsylvania, United States
3   Drexel University College of Medicine, Philadelphia, Pennsylvania, United States
,
Rachel Magee
2   Drexel University School of Biomedical Engineering, Science, and Health Systems, Philadelphia, Pennsylvania, United States
,
Bernard Gonik
4   Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States
,
Sriram Balasubramanian
2   Drexel University School of Biomedical Engineering, Science, and Health Systems, Philadelphia, Pennsylvania, United States
› Author Affiliations Funding This project was supported by funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award no.: R15HD093024, and National Science Foundation (NSF) Faculty Early Career Development (CAREER) grant Award no.: 1752513.
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Abstract

Background Characterizing the biomechanical failure responses of neonatal peripheral nerves is critical in understanding stretch-related peripheral nerve injury mechanisms in neonates.

Objective This in vitro study investigated the effects of prestretch magnitude and duration on the biomechanical failure behavior of neonatal piglet brachial plexus (BP) and tibial nerves.

Methods BP and tibial nerves from 32 neonatal piglets were harvested and prestretched to 0, 10, or 20% strain for 90 or 300 seconds. These prestretched samples were then subjected to tensile loading until failure. Failure stress and strain were calculated from the obtained load-displacement data.

Results Prestretch magnitude significantly affected failure stress but not the failure strain. BP nerves prestretched to 10 or 20% strain, exhibiting significantly lower failure stress than those prestretched to 0% strain for both prestretch durations (90 and 300 seconds). Likewise, tibial nerves prestretched to 10 or 20% strain for 300 seconds, exhibiting significantly lower failure stress than the 0% prestretch group. An effect of prestretch duration on failure stress was also observed in the BP nerves when subjected to 20% prestretch strain such that the failure stress was significantly lower for 300 seconds group than 90 seconds group. No significant differences in the failure strains were observed. When comparing BP and tibial nerve failure responses, significantly higher failure stress was reported in tibial nerve prestretched to 20% strain for 300 seconds than BP nerve.

Conclusion These data suggest that neonatal peripheral nerves exhibit lower injury thresholds with increasing prestretch magnitude and duration while exhibiting regional differences.

Keywords

neonates - brachial plexus - prestretch - tibial nerve - stretch - injury


Publication History

Received: 03 April 2021

Accepted: 08 June 2021

Article published online:
08 April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Rydevik BL, Kwan MK, Myers RR. et al. An in vitro mechanical and histological study of acute stretching on rabbit tibial nerve. J Orthop Res 1990; 8 (05) 694-701
    CrossrefPubMedGoogle Scholar
  • 2 Kwan MK, Wall EJ, Weiss JA, Rydevik BL, Garfin SR, Woo S-Y. Analysis of rabbit peripheral nerve: in situ stresses and strains. Biomech Symp ASME/AMD 1989; 98: 109-112
    PubMedGoogle Scholar
  • 3 Li J, Shi R. Stretch-induced nerve conduction deficits in guinea pig ex vivo nerve. J Biomech 2007; 40 (03) 569-578
    CrossrefPubMedGoogle Scholar
  • 4 Bain AC, Raghupathi R, Meaney DF. Dynamic stretch correlates to both morphological abnormalities and electrophysiological impairment in a model of traumatic axonal injury. J Neurotrauma 2001; 18 (05) 499-511
    CrossrefPubMedGoogle Scholar
  • 5 Sunderland S. The anatomy and physiology of nerve injury. Muscle Nerve 1990; 13 (09) 771-784
    CrossrefPubMedGoogle Scholar
  • 6 Campbell WW. Evaluation and management of peripheral nerve injury. Clin Neurophysiol 2008; 119 (09) 1951-1965
    CrossrefPubMedGoogle Scholar
  • 7 Jou IM, Lai KA, Shen CL, Yamano Y. Changes in conduction, blood flow, histology, and neurological status following acute nerve-stretch injury induced by femoral lengthening. J Orthop Res 2000; 18 (01) 149-155
    CrossrefPubMedGoogle Scholar
  • 8 Li J, Shi R. A device for the electrophysiological recording of peripheral nerves in response to stretch. J Neurosci Methods 2006; 154 (1,2): 102-108
    CrossrefPubMedGoogle Scholar
  • 9 Abe I, Tsujino A, Hara Y, Ochiai N. Effect of the rate of prestretching a peripheral nerve on regeneration potential after transection and repair. J Orthop Sci 2003; 8 (05) 693-699
    CrossrefPubMedGoogle Scholar
  • 10 Destandau J, Micallef JP, Rabischong P. An experimental study of traction on the cervical spinal nerves. Surg Radiol Anat 1986; 8 (03) 197-204
    CrossrefPubMedGoogle Scholar
  • 11 Marani E, van Leeuwen JL, Spoor CW. The tensile testing machine applied in the study of human nerve rupture: a preliminary study. Clin Neurol Neurosurg 1993; 95 (suppl): S33-S35
    CrossrefPubMedGoogle Scholar
  • 12 Zapałowicz K, Radek M. The distribution of brachial plexus lesions after experimental traction: a cadaveric study. J Neurosurg Spine 2018; 29 (06) 704-710
    CrossrefPubMedGoogle Scholar
  • 13 Zapałowicz K, Radek A. Experimental investigations of traction injury of the brachial plexus. Model and results. Ann Acad Med Stetin 2005; 51 (02) 11-14
    PubMedGoogle Scholar
  • 14 Zapałowicz K, Radek A. Mechanical properties of the human brachial plexus. Neurol Neurochir Pol 2000; 34 (6, suppl): 89-93
    PubMedGoogle Scholar
  • 15 Ma Z, Hu S, Tan JS, Myer C, Njus NM, Xia Z. In vitro and in vivo mechanical properties of human ulnar and median nerves. J Biomed Mater Res A 2013; 101 (09) 2718-2725
    CrossrefPubMedGoogle Scholar
  • 16 Kawai H, Ohta I, Masatomi T, Kawabata H, Masada K, Ono K. Stretching of the brachial plexus in rabbits. Acta Orthop Scand 1989; 60 (06) 635-638
    CrossrefPubMedGoogle Scholar
  • 17 Takai S, Dohno H, Watanabe Y, Yoshino N, Ogura T, Hirasawa Y. In situ strain and stress of nerve conduction blocking in the brachial plexus. J Orthop Res 2002; 20 (06) 1311-1314
    CrossrefPubMedGoogle Scholar
  • 18 Singh A, Shaji S, Delivoria-Papadopoulos M, Balasubramanian S. Biomechanical responses of neonatal brachial plexus to mechanical stretch. J Brachial Plex Peripher Nerve Inj 2018; 13 (01) e8-e14
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Singh A, Magee R, Balasubramanian S. In vivo biomechanical testing of brachial plexus in neonatal piglets. J Vis Exp 2019;(154):10.3791/59860
    PubMedGoogle Scholar
  • 20 Balasubramanian S, Peters JR, Robinson LF, Singh A, Kent RW. Thoracic spine morphology of a pseudo-biped animal model (kangaroo) and comparisons with human and quadruped animals. Eur Spine J 2016; 25 (12) 4140-4154
    CrossrefPubMedGoogle Scholar
  • 21 Chauhan SP, Blackwell SB, Ananth CV. Neonatal brachial plexus palsy: incidence, prevalence, and temporal trends. Semin Perinatol 2014; 38 (04) 210-218
    CrossrefPubMedGoogle Scholar
  • 22 Singh A, Lu Y, Chen C, Cavanaugh JM. Mechanical properties of spinal nerve roots subjected to tension at different strain rates. J Biomech 2006; 39 (09) 1669-1676
    CrossrefPubMedGoogle Scholar
  • 23 Roberts D, West T, Schenk M, Schnall D, O'Brien M, Groome M, Knarr B, Higginson J, Singh A. Smartboot: An Instrumented Clinical Walking Boot for Partial Weight Bearing Training. Summer Biomechanics, Bioengineering and Biotransport Conference (SB3C) June 17-20, Snowbird, Utah 2015;Poster # 328
    PubMedGoogle Scholar
  • 24 Singh A, Balasubramanian S. Recent Patents on Body Weight Support Training Devices for Spinal Cord Injury. Recent Patents on Biomedical Engineering, Bentham Science Publishers 2009; 2 (02) 133-140
    CrossrefPubMedGoogle Scholar
  • 25 Noble J, Munro CA, Prasad VS, Midha R. Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries. J Trauma 1998; 45 (01) 116-122
    CrossrefPubMedGoogle Scholar
  • 26 Missios S, Bekelis K, Spinner RJ. Traumatic peripheral nerve injuries in children: epidemiology and socioeconomics. J Neurosurg Pediatr 2014; 14 (06) 688-694
    CrossrefPubMedGoogle Scholar
  • 27 Wall EJ, Kwan MK, Rydevik BL, Woo SLY, Garfin SR. Stress relaxation of a peripheral nerve. J Hand Surg Am 1991; 16 (05) 859-863
    CrossrefPubMedGoogle Scholar
  • 28 Driscoll PJ, Glasby MA, Lawson GM. An in vivo study of peripheral nerves in continuity: biomechanical and physiological responses to elongation. J Orthop Res 2002; 20 (02) 370-375
    CrossrefPubMedGoogle Scholar
  • 29 Xu D, Zhao C, Ma H, Wei J, Li D. Comparison of viscoelasticity between normal human sciatic nerve and amniotic membrane. Neural Regen Res 2013; 8 (14) 1269-1275
    CrossrefPubMedGoogle Scholar
  • 30 Kendall JP, Stokes IAF, O'Hara JP, Dickson RA. Tension and creep phenomena in peripheral nerve. Acta Orthop Scand 1979; 50 (6 pt 2): 721-725
    CrossrefPubMedGoogle Scholar
  • 31 Kwan MK, Wall EJ, Massie J, Garfin SR. Strain, stress and stretch of peripheral nerve. Rabbit experiments in vitro and in vivo. Acta Orthop Scand 1992; 63 (03) 267-272
    CrossrefPubMedGoogle Scholar
  • 32 Toby EB, Rotramel J, Jayaraman G, Struthers A. Changes in the stress relaxation properties of peripheral nerves after transection. J Hand Surg Am 1999; 24 (04) 694-699
    CrossrefPubMedGoogle Scholar
  • 33 Spong CY, Beall M, Rodrigues D, Ross MG. An objective definition of shoulder dystocia: prolonged head-to-body delivery intervals and/or the use of ancillary obstetric maneuvers. Obstet Gynecol 1995; 86 (03) 433-436
    CrossrefPubMedGoogle Scholar
  • 34 Gherman RB, Ouzounian JG, Goodwin TM. Obstetric maneuvers for shoulder dystocia and associated fetal morbidity. Am J Obstet Gynecol 1998; 178 (06) 1126-1130
    CrossrefPubMedGoogle Scholar
  • 35 Lerner H, Durlacher K, Smith S, Hamilton E. Relationship between head-to-body delivery interval in shoulder dystocia and neonatal depression. Obstet Gynecol 2011; 118 (2 pt 1): 318-322
    CrossrefPubMedGoogle Scholar
  • 36 Beall MH, Spong C, McKay J, Ross MG. Objective definition of shoulder dystocia: a prospective evaluation. Am J Obstet Gynecol 1998; 179 (04) 934-937
    CrossrefPubMedGoogle Scholar
  • 37 Hope P, Breslin S, Lamont L. et al. Fatal shoulder dystocia: a review of 56 cases reported to the confidential enquiry into stillbirths and deaths in infancy. Br J Obstet Gynaecol 1998; 105 (12) 1256-1261
    CrossrefPubMedGoogle Scholar
  • 38 Haftek J. Stretch injury of peripheral nerve. Acute effects of stretching on rabbit nerve. J Bone Joint Surg Br 1970; 52 (02) 354-365
    CrossrefPubMedGoogle Scholar
  • 39 Kerns J, Piponov H, Helder C, Amirouche F, Solitro G, Gonzalez M. Mechanical properties of the human tibial and peroneal nerves following stretch with histological correlations. Anat Rec (Hoboken) 2019; 302 (11) 2030-2039
    CrossrefPubMedGoogle Scholar
  • 40 Singh A. Extent of impaired axoplasmic transport and neurofilament compaction in traumatically injured axon at various strains and strain rates. Brain Injury 2017; 31 (10) 1-9
    CrossrefPubMedGoogle Scholar
  • 41 Dyer K, King B, Witko J, Herman A, Shaji S, Singh A. A New Body Weight Supported Treadmill Device to Measure Kinetic Response from Spinal Cord Injury Animals”. 41st Annual Northeast Bioengineering Conference (NEBEC) April 17-19, Troy, NY 2015; Poster # P2-54
    PubMedGoogle Scholar
  • 42 Singh A. A new approach to teaching biomechanics through active, adaptive, and experiential learning. ASME. J Biomech Eng 2017; 139 (07) 071001-071001-7
    CrossrefPubMedGoogle Scholar
  • 43 Singh A, Ferry D, Mills S. Learning Biomedical Engineering While Advancing Nursing Education. World Congress of Biomechanics, July 8-12, Ireland, Dublin. 2018#2704
    PubMedGoogle Scholar
  • 44 Singh A, Ferry D. Identifying Unmet Needs in Biomedical Engineering Through Bridging the Gap Between Classroom and Clinic. Paper presented at: American Society for Engineering Education (ASEE) April 10-11, PA 2015
    PubMedGoogle Scholar
  • 45 Singh A, Ferry D, Mills S. Improving Biomedical Engineering Education Through Continuity in Adaptive, Experiential and Interdisciplinary Learning Environments. ASME J Biomech Eng 2018; 140 (08) 081009 . Paper No: BIO-18-1165
    CrossrefPubMedGoogle Scholar
  • 46 Singh A, Ferry D, Balasubramanian S. Efficacy of clinical simulation based training in biomedical engineering education. J Biomech Eng 2019; 141 (12) 121011-121011-7
    CrossrefPubMedGoogle Scholar
  • 47 Singh A, Ferry D, Balasubramanian S. Using virtual reality in biomedical engineering education. J Biomech Eng 2020;142(11):
    PubMedGoogle Scholar
  • 48 D'Andrea C, Singh A, Balasubramanian S. Finite Element Model of Neonatal Brachial Plexus and Spinal Cord. Summer Biomechanics, Bioengineering and Biotransport Conference (SB3C) Seven Springs, PA 2019;P208
    PubMedGoogle Scholar
  • 49 Tom B, Witko J, Lemay M, Singh A. Effects of bioengineered scaffold loaded with neurotrophins and locomotor training in restoring H-Reflex responses after spinal cord injury. Experimental Brain Research 2018; 236 (11) 3077-3084
    CrossrefPubMedGoogle Scholar