Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, South Korea.
Department of Medical Science, Chungnam National University School of Medicine, Daejeon, South Korea.
Adv Clin Exp Med. 2020 Jul;29(7):819-824. doi: 10.17219/acem/122177.
Conservative treatment, such as electrical stimulation and steroid injection, have been employed in an attempt to improve symptoms after peripheral nerve injury, without significant success. Although non-invasive and safe extracorporeal shockwave therapy (ESWT) can be a practical alternative, the therapeutic effects of ESWT on peripheral nerve remyelination has not been established.
To investigate the effects of ESWT on peripheral nerve remyelination and gait function for 5 weeks in a sciatic nerve crush model.
In total, we divided 97 rats into 5 groups: group 1 - a healthy negative control group; group 2 - 3 weeks after sciatic nerve crush and 3 sessions of ESWT; group 3 - 5 weeks after crush injury with 3 sessions of ESWT; group 4 - 3 weeks after crush injury with no ESWT; and group 5 - 5 weeks after crush injury with no ESWT. The focused ESWT was applied to the unilateral sciatic nerve injury site. One session consisted of 1,500 stimuli, and the session were performed at intervals of 1 week.
The degree of myelination and expression of myelin basic protein at the distal part of the injured sciatic nerve tended to increase in the ESWT groups compared with the no-ESWT groups 3 and 5 weeks after crush injury. Regarding the functional gait recovery, the print width and area of the injured leg in the ESWT groups was significantly larger than that in the no-ESWT groups 3 and 5 weeks after crush injury.
The ESWT may enhance peripheral nerve remyelination and gait function in a nerve crush model. Long-term follow-up after ESWT and investigation of molecular mechanisms will be needed to confirm these therapeutic effects.
在外周神经损伤后，曾尝试采用保守治疗，如电刺激和类固醇注射，以期改善症状，但收效甚微。虽然无创且安全的体外冲击波疗法（ESWT）可能是一种可行的替代方法，但 ESWT 对外周神经髓鞘再生的治疗效果尚未得到证实。
在坐骨神经挤压模型中，研究 ESWT 对周围神经髓鞘再生和步态功能的影响，为期 5 周。
共将 97 只大鼠分为 5 组：组 1 - 健康阴性对照组；组 2 - 坐骨神经挤压后 3 周，行 ESWT 治疗 3 次；组 3 - 挤压伤后 5 周，行 ESWT 治疗 3 次；组 4 - 挤压伤后 3 周，不行 ESWT 治疗；组 5 - 挤压伤后 5 周，不行 ESWT 治疗。聚焦式 ESWT 应用于单侧坐骨神经损伤部位。每次治疗包括 1500 次刺激，治疗间隔为 1 周。
与挤压伤后 3 周和 5 周的无 ESWT 组相比，ESWT 组损伤坐骨神经远端的髓鞘形成程度和髓鞘碱性蛋白表达均有增高趋势。在功能步态恢复方面，与挤压伤后 3 周和 5 周的无 ESWT 组相比，ESWT 组的损伤腿的脚印宽度和面积明显更大。
ESWT 可能增强挤压模型中周围神经的髓鞘再生和步态功能。需要进行 ESWT 后的长期随访和分子机制研究，以确认这些治疗效果。
