Irintchev A, Angelov D N, Guntinas-Lichius O
Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Friedrich-Schiller-Universität, 07740, Jena, Deutschland.
HNO. 2010 May;58(5):426-32. doi: 10.1007/s00106-010-2100-3.
Despite increasing knowledge of cellular and molecular mechanisms determining the success or failure of peripheral nerve regeneration, no effective treatments for peripheral nerve injury exist. Newly developed and validated approaches for precise numerical assessment of motor deficits have recently allowed testing of novel strategies in experimental animals. One of these approaches is the daily manual stimulation of the denervated musculature. This treatment is effective in cases of cranial nerve lesions with preservation of the sensory input (facial or hypoglossal nerve) and has the potential of direct translation in clinical settings. However, manual stimulation appears to be ineffective for the treatment of mixed peripheral nerve injuries. Generally, no long-term improvement of functional recovery is achieved by electrical stimulation in rodents. While short-term post-traumatic stimulation of the proximal nerve stump has no negative effects, direct electrical stimulation of the muscle during the period of de- and reinnervation appears to hinder muscle fibre reinnervation. Finally, experimental evidence suggests that application of peptides known as glycomimetics, which mimic functional properties of carbohydrate molecules, may provide significant benefits after injuries of mixed peripheral nerves.
尽管人们对决定周围神经再生成败的细胞和分子机制的了解不断增加，但目前尚无针对周围神经损伤的有效治疗方法。最近新开发并经过验证的精确数字评估运动功能障碍的方法，使得在实验动物中测试新策略成为可能。其中一种方法是每天对手部失神经支配的肌肉组织进行刺激。这种治疗方法在保留感觉输入的颅神经损伤（面神经或舌下神经）病例中有效，并且有可能直接转化应用于临床。然而，手动刺激似乎对混合性周围神经损伤的治疗无效。一般来说，在啮齿动物中，电刺激并不能实现功能恢复的长期改善。虽然创伤后对近端神经残端进行短期刺激没有负面影响，但在去神经支配和重新神经支配期间直接对肌肉进行电刺激似乎会阻碍肌纤维的重新神经支配。最后，实验证据表明，应用被称为糖模拟物的肽（其模拟碳水化合物分子的功能特性）可能会在混合性周围神经损伤后带来显著益处。
