O'Gara Tadhg, Urban William, Polishchuk Daniil, Pierre-Louis Alain, Stewart Mark
Department of Orthopaedic Surgery, SUNY at Downstate, Brooklyn, New York 11203, USA.
Clin Orthop Relat Res. 2006 Jun;447:209-13. doi: 10.1097/01.blo.0000203481.11797.0f.
Wallerian degeneration of the distal portion of a cut nerve is considered irreversible. A possible reason for degeneration is lack of axon stimulation in the distal, cut nerves. We hypothesized greater rates of stimulation of distal nerve stumps would prolong time to action potential propagation failure, and uncut nerves would not be damaged by implanted nerve stimulators. We also hypothesized that action potentials measured from the body of the sciatic nerve would show similar response as motor-evoked potentials measured in the muscles innervated by branches of the sciatic nerve. We implanted a nerve stimulator onto distal cut sciatic nerves of rats and recorded motor-evoked potentials. Three groups were stimulated at 1 Hz (once per second), 0.1 Hz (once per 10 seconds), and 0.01 Hz (once per 100 seconds) respectively. Motor-evoked potentials progressively declined after nerve transection, failing faster at 1 Hz (26.8 hours +/- 108 minutes) and 0.1 Hz (22 hours +/- 66 minutes) compared with stimulation at 0.01 Hz (36.75 hours +/- 83 minutes). Intact axons were not damaged by implanted nerve stimulators. Action potentials recorded directly from nerves were equivalent to motor- evoked potentials. Failure of motor-evoked potential transmission in a transected nerve is accelerated by a greater rate of continuous stimulation of the distal stump.
切断神经远侧部分的华勒氏变性被认为是不可逆的。变性的一个可能原因是切断的远侧神经缺乏轴突刺激。我们假设,对远侧神经残端进行更高频率的刺激会延长动作电位传导失败的时间,并且未切断的神经不会因植入的神经刺激器而受损。我们还假设,从坐骨神经主体记录的动作电位将显示出与在坐骨神经分支所支配肌肉中测量的运动诱发电位相似的反应。我们将神经刺激器植入大鼠切断的坐骨神经远侧端,并记录运动诱发电位。三组分别以1赫兹(每秒一次)、0.1赫兹(每10秒一次)和0.01赫兹(每100秒一次)进行刺激。神经横断后运动诱发电位逐渐下降,与0.01赫兹刺激(36.75小时±83分钟)相比,在1赫兹(26.8小时±108分钟)和0.1赫兹(22小时±66分钟)时下降更快。完整的轴突未因植入的神经刺激器而受损。直接从神经记录的动作电位与运动诱发电位相当。对远侧残端进行更高频率的持续刺激会加速横断神经中运动诱发电位的传导失败。