• Yuval Shapira, Vanessa Sammons, Joanne Forden, Gui Fang Guo, Alexander Kipp, Jill Girgulis, Tanmay Mishra, Jacob Daniel de Villers Alant, and Rajiv Midha.
• Department of Neurosurgery, Tel Aviv University, Tel Aviv, Israel.
• Neurosurgery. 2019 Jul 1; 85 (1): 156-163.

BackgroundBrief electrical stimulation (ES) therapy to the nerve may improve outcome in lacerated, repaired nerves. However, most human nerve injuries leave the nerve in continuity with variable and often poor functional recovery from incomplete axon regeneration and reinnervation.ObjectiveTo evaluate the effect of brief ES in an experimental model for neuroma-in-continuity (NIC) injuries in rodents.MethodsLewis rats were randomly assigned to 1 of 4 groups: NIC injury immediately followed by brief (1 h) ES; NIC injury without ES; sham-operated controls; sciatic nerve transection without repair. Outcome measures included serial behavioral evaluation and electrophysiology together with terminal retrograde spinal cord motor neuron labeling and histomorphological analysis for axonal regeneration.ResultsApplying brief ES immediately after in-continuity nerve injury resulted in earlier recovery and significantly improved locomotion function at 4 and 6 wk. At 8 wk, brief ES resulted in higher compound action potential amplitude. By 12 wk there was no significant difference between the 2 groups in behavior or electrophysiology. Histomorphological analysis demonstrated a significantly higher percentage of neural tissue in the brief ES group. Spinal cord motor neuron pool cell counts revealed a preference for regeneration into a motor over a sensory nerve, for the group receiving ES.ConclusionThe application of brief ES for in-continuity nerve injury promotes faster recovery, although in a rat model where regeneration distances are short the control group ultimately recovers to a similar degree. Brief EF requires further evaluation as a promising therapy for in-continuity nerve injuries in humans.Copyright © 2018 by the Congress of Neurological Surgeons.

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