Rayner, MLD;
Brown, HL;
Wilcox, M;
Phillips, JB;
Quick, TJ;
(2020)
Quantifying regeneration in patients following peripheral nerve injury.
Journal of Plastic, Reconstructive & Aesthetic Surgery
, 73
(2)
pp. 201-208.
10.1016/j.bjps.2019.10.007.
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Abstract
Healthy nerve function provides humans with the control of movement, sensation (such as pain, touch and temperature) and the quality of skin, hair and nails. Injury to this complex system creates a deficit in function which is slow to recover and rarely, if ever, returns to what patients consider to be normal. Despite promising preclinical experiments in animals, a significant limitation in the translation of emerging therapies is the lack of effective measures with which to quantify nerve regeneration in patients and to relate this to clinical recovery. In animal models, tissue can be obtained interventionally following treatment to quantify muscle mass and structure and the number of axons in nerve. This would incur a significant functional deficit if undertaken in humans, and furthermore, quantification of such biological features does not necessarily reflect patient experience of functional recovery. This article presents a combined commentary of current practice from a specialist clinical unit and research team in regard to laboratory and clinic quantification of nerve regeneration. We highlight how electrophysiological diagnostic methods (which are used with significant recognised limitations in assessment of clinical medicine) can potentially be used with more validity to interpret and assess the processes of neural regeneration in the clinical context. Thus throwing light on the factors at play in translating lab advances into the clinic.
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