• Francis P Henry, Daniel Côté, Mark A Randolph, Esther A Z Rust, Robert W Redmond, Irene E Kochevar, Charles P Lin, and Jonathan M Winograd.
• Plastic Surgery Research Laboratory, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
• Plast. Reconstr. Surg. 2009 Feb 1; 123 (2 Suppl): 123S-30S.

BackgroundCurrent analysis of nerve injury and repair relies largely on electrophysiologic and ex vivo histologic techniques. In vivo architectural assessment of a nerve without removal or destruction of the tissue would greatly assist in the grading of nerve injury and in the monitoring of nerve regeneration over time. Coherent anti-Stokes Raman scattering microscopy is an optical process with particular sensitivity for high-lipid-containing molecules such as myelin. This in vivo nonthermal technique offers high-resolution images that the authors aim to evaluate in both normal and injured nerves.MethodsA demyelinating crush injury was reproduced in the sciatic nerves of Sprague-Dawley rats (n = 12). Animals were randomized into groups, and coherent anti-Stokes Raman scattering microscopy was undertaken at day 1 and weekly up to 4 weeks after injury. Functional analysis was undertaken weekly and histomorphometry was completed after imaging.ResultsAll animals demonstrated loss of sciatic nerve function following injury. Recovery was documented, with functional data approaching normal at 3 and 4 weeks. Demyelination was confirmed in nerves up to 2 weeks after injury. Remyelination was observed in the 3-week group and beyond. Imaging of normal nerve revealed structured myelin bundles. These results were consistent with histologic findings that showed a statistically significant improvement in myelination over time.ConclusionsThe authors conclude that coherent anti-Stokes Raman scattering microscopy has the ability to image the peripheral nerve following demyelinating crush injury. This technology, which permits in vivo, real-time microscopy of nerves at a resolution of 5 mum, could provide invaluable diagnostic and prognostic information regarding intraneural preservation and recovery following injury.

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