Kaluskar Priya, Bharadwaj Dhruv, Iyer K Swaminathan, Dy Christopher, Zheng Minghao, Brogan David M
Centre for Orthopaedic Research, Medical School, The University of Western Australia, Nedlands, WA, Australia.
Perron Institute for Neurological and Translational Science, Perth, Australia.
J Hand Surg Glob Online. 2024 Jun 29;6(5):722-739. doi: 10.1016/j.jhsg.2024.03.005. eCollection 2024 Sep.
The purpose of this systematic review was to assess the currently available evidence for the use of external stimulation to modulate neural activity and promote peripheral nerve regeneration. The most common external stimulations are electrical stimulation (ES), optogenetic stimulation (OS), and magnetic stimulation (MS). Understanding the comparative effectiveness of these stimulation methods is pivotal in advancing therapeutic interventions for peripheral nerve injuries. This systematic review focused on these three external stimulation modalities as potential strategies to enhance peripheral nerve repair (PNR). We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework to systematically evaluate and compare the efficiency of ES, OS, and MS in PNR. The review included studies published between 2018 and 2023 using ES, OS, or MS for PNR focused on enhancing recovery of peripheral nerve injuries in rodent models identified through PubMed and Google Scholar. The search strategies and inclusion criteria identified 19 studies (13 ES, 4 OS, and 2 MS) for detailed analysis, focusing on critical parameters such as functional recovery, histological outcomes, and electrophysiological data. Although ES demonstrated a consistent improvement in all the analyses, high-frequency repetitive MS (HFr-MS) emerged as a promising modality. HFr-MS demonstrated accelerated PNR, as histological and electrophysiological evidence indicated. In contrast, OS exhibited superior functional recovery outcomes. Notable limitations include constrained MS and OS data sets and the challenge of comparing relative improvements because of methodological diversity in evaluation techniques. Our findings underscore the potential of HFr-MS and OS in PNR while emphasizing the critical need for standardized testing protocols to facilitate meaningful cross-study comparisons. External stimulations have the potential to improve functional recovery in patients with nerve injury.
本系统评价的目的是评估目前关于使用外部刺激来调节神经活动和促进周围神经再生的现有证据。最常见的外部刺激是电刺激（ES）、光遗传学刺激（OS）和磁刺激（MS）。了解这些刺激方法的相对有效性对于推进周围神经损伤的治疗干预至关重要。本系统评价聚焦于这三种外部刺激方式，将其作为增强周围神经修复（PNR）的潜在策略。我们使用系统评价和Meta分析的首选报告项目框架，系统地评估和比较ES、OS和MS在PNR中的效率。该评价纳入了2018年至2023年发表的研究，这些研究使用ES、OS或MS进行PNR，重点是通过PubMed和谷歌学术搜索确定的啮齿动物模型中周围神经损伤恢复的增强。搜索策略和纳入标准确定了19项研究（13项ES、4项OS和2项MS）进行详细分析，重点关注功能恢复、组织学结果和电生理数据等关键参数。尽管ES在所有分析中都显示出持续的改善，但高频重复磁刺激（HFr-MS）成为一种有前景的方式。组织学和电生理证据表明，HFr-MS显示出加速的PNR。相比之下，OS表现出更好的功能恢复结果。显著的局限性包括MS和OS数据集有限，以及由于评估技术的方法多样性而难以比较相对改善情况。我们的研究结果强调了HFr-MS和OS在PNR中的潜力，同时强调了标准化测试方案对于促进有意义的跨研究比较至关重要。外部刺激有可能改善神经损伤患者的功能恢复。
