Effect of Nimodipine and Botulinum Toxin A on Peripheral Nerve Regeneration in Rats: A Pilot Study.

Autor: Odorico SK; University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin., Shulzhenko NO; University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin., Zeng W; University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin., Dingle AM; University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin., Francis DO; University of Wisconsin School of Medicine and Public Health, Division of Otolaryngology, Department of Surgery, Madison, Wisconsin; University of Wisconsin School of Medicine and Public Health, Wisconsin Surgical Outcomes Research Program, Department of Surgery, Madison, Wisconsin., Poore SO; University of Wisconsin School of Medicine and Public Health, Division of Plastic Surgery, Department of Surgery, Madison, Wisconsin. Electronic address: poore@surgery.wisc.edu.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2021 Aug; Vol. 264, pp. 208-221. Date of Electronic Publication: 2021 Apr 07.
DOI: 10.1016/j.jss.2021.02.016
Abstrakt: Background: Peripheral nerve damage is a frequent problem, with an estimated 2.8%-5.0% of trauma admissions involving peripheral nerve injury. End-to-end, tension-free microsurgical repair (neurorrhaphy) is the current gold standard treatment for complete transection (neurotmesis). While neurorrhaphy reapproximates the nerve, it does not address the complex molecular regenerative process. Evidence suggests that botulinum toxin A (BTX) and nimodipine (NDP) may improve functional recovery, but mechanisms of action remain unknown.
Methods: This research investigates BTX and NDP for their novel capacity to improve neural regeneration in the setting of neurorrhaphy using a Lewis rat tibial nerve neurotmesis model. In a triple-masked, placebo-controlled, randomized study design, we compared functional (rotarod, horizontal ladder walk), electrophysiological (conduction velocity, duration), and stereological (axon count, density) outcomes of rats treated with: NDP+saline injection, BTX+NDP, Saline+placebo, and BTX+placebo. Additional controls included sham surgery +/- BTX.
Results: NDP+saline outperformed other treatment groups in the ladder walk. This group had the fewest deep slips (15.07% versus 30.77% in BTX+NDP, P = 0.122), and the most correct steps (70.53% versus 55.58% in BTX+NDP, P = 0.149) in functional testing. NDP+saline also had the fastest nerve conduction velocity (0.811m/s versus 0.598m/s in BTX+NDP, P = 0.126) among treatment groups. BTX+NDP had the highest axon count (10,012.36 versus 7,738.18 in NDP+Saline, P = 0.009).
Conclusion: This study is the first to test NDP with BTX in a multimodal assessment of nerve recovery following neurotmesis and neurorrhaphy. NDP outperformed BTX+NDP functionally. Future work will focus on nimodipine in an effort to improve nerve recovery in trauma patients.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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