Motor Nerve Function Research Articles

Advancements and mechanisms of stem cell-based therapies for spinal cord injury in animals.

Spinal cord injury (SCI) is a neurodegenerative disorder of the central nervous system (CNS) that can lead to permanent loss of sensation and voluntary movement beyond the affected area. Extensive preclinical and clinical trials have been conducted to evaluate the safety and effectiveness of stem cells for the treatment of various CNS diseases or disorders, including SCI. However, several challenges hinder nerve cell regeneration in the injured spinal cord, such as extensive cell loss, limited neural cell regeneration capacity, axonal disruption, and the presence of growth-inhibiting molecules, particularly astroglial scarring or glial scars at the injury site in chronic cases. These obstacles pose significant challenges for physicians in restoring normal motor and sensory nerve function in both humans and animals following SCI. This review focuses on SCI pathogenesis, the mechanisms underlying the therapeutic potential of Mesenchymal Stem Cells (MSCs) in SCI, and the potential of stem cell-based therapies as promising avenues for treatment. This review article also included relevant preclinical and clinical data from animal studies.

Effects of transcranial magnetic stimulation on axonal regeneration in the corticospinal tract of female rats with spinal cord injury

BackgroundThis study investigates the potential of transcranial magnetic stimulation (TMS) to enhance spinal cord axon regeneration by modulating corticospinal pathways and improving motor nerve function recovery in rats with spinal cord injury (SCI). New methodTMS is a non-invasive neuromodulation technique that generates a magnetic field to activate neurons in the brain, leading to depolarization and modulation of cortical activity. Initially utilized for brain physiology research, TMS has evolved into a diagnostic and prognostic tool in clinical settings, with increasing interest in its therapeutic applications. However, its potential for treating motor dysfunction in SCI has been underexplored. ResultsThe TMS intervention group exhibited significant improvements compared to the control group across behavioral assessments, neurophysiological measurements, pathological analysis, and immunological markers. Comparison with existing methodsUnlike most studies that focus on localized spinal cord injury or muscle treatments, this study leverages the non-invasive, painless, and highly penetrating nature of TMS to focus on the corticospinal tracts, exploring its therapeutic potential for SCI. ConclusionsTMS enhances motor function recovery in rats with SCI by restoring corticospinal pathway integrity and promoting axonal regeneration. These findings highlight TMS as a promising therapeutic option for SCI patients with currently limited treatment alternatives.

Biomimetic multi-channel nerve conduits with micro/nanostructures for rapid nerve repair

Peripheral nervous system (PNS) injuries often lead to significant sensory and motor impairments. Traditional artificial nerve conduits, lacking anisotropic structures, have been associated with prolonged repair time and failures in nerve regeneration. This study aimed to address these challenges by developing a novel approach for rapid repair of peripheral nerve injuries (PNI). A 3D oriented fibers scaffold featuring distinct radial (RFs) and longitudinal (LFs) fibers orientations was engineered using coaxial electrospinning and gas directional foaming techniques. This scaffold was then integrated with a shape memory conduit to form a directional multi-channel nerve conduit with micro/nanostructures. The results revealed that the grooved surface of the fibers significantly improved cellular directional guidance, effectively facilitating the migration of SCs from the periphery towards the center and from the base to the apex of the scaffold. In a rat model with a 10 mm nerve defect, the ND-PLATMC/LF ND-PCL scaffold significantly enhanced nerve regeneration and motor function recovery within 4 weeks. These results suggest the potential of this innovative scaffold for efficient repair of the nerve injuries.

Repetitive magnetic stimulation prevents dorsal root ganglion neuron death and enhances nerve regeneration in a sciatic nerve injury rat model

Peripheral nerve injury (PNI) often leads to retrograde cell death in the spinal cord and dorsal root ganglia (DRG), hindering nerve regeneration and functional recovery. Repetitive magnetic stimulation (rMS) promotes nerve regeneration following PNI. Therefore, this study aimed to investigate the effects of rMS on post-injury neuronal death and nerve regeneration. Seventy-two rats underwent autologous sciatic nerve grafting and were divided into two groups: the rMS group, which received rMS and the control (CON) group, which received no treatment. Motor neuron, DRG neuron, and caspase-3 positive DRG neuron counts, as well as DRG mRNA expression analyses, were conducted at 1-, 4-, and 8-weeks post-injury. Functional and axon regeneration analyses were performed at 8-weeks post-injury. The CON group demonstrated a decreased DRG neuron count starting from 1 week post-injury, whereas the rMS group exhibited significantly higher DRG neuron counts at 1- and 4-weeks post-injury. At 8-weeks post-injury, the rMS group demonstrated a significantly greater myelinated nerve fiber density in autografted nerves. Furthermore, functional analysis showed significant improvements in latency and toe angle in the rMS group. Overall, these results suggest that rMS can prevent DRG neuron death and enhance nerve regeneration and motor function recovery after PNI.

Fully biodegradable and self-powered nerve guidance conduit based on zinc-molybdenum batteries for peripheral nerve repair

Peripheral nerve injury (PNI) poses a significant public health issue, often leading to muscle atrophy and persistent neuropathic pain, which can drastically impact the quality of life for patients. Electrical stimulation represents an effective and non-pharmacological treatment to promote nerve regeneration. Yet, the postoperative application of electrical stimulation remains a challenge. Here, we propose a fully biodegradable, self-powered nerve guidance conduit (NGC) based on dissolvable zinc-molybdenum batteries. The conduit can offer topographic guidance for nerve regeneration and deliver sustained electrical cues between both ends of a transected nerve stump, extending beyond the surgical window. Schwann cell proliferation and adenosine triphosphate (ATP) production are enhanced by the introduction of the zinc-molybdenum batteries. In rodent models with 10-mm sciatic nerve damage, the device effectively enhances nerve regeneration and motor function recovery. This study offers innovative strategies for creating biodegradable and electroactive devices that hold important promise to optimize therapeutic outcomes for nerve regeneration.

Biological characteristics of tissue engineered-nerve grafts enhancing peripheral nerve regeneration

BackgroundA favorable regenerative microenvironment is essential for peripheral nerve regeneration. Neural tissue-specific extracellular matrix (ECM) is a natural material that helps direct cell behavior and promote axon regeneration. Both bone marrow-derived mesenchymal stem cells (BMSCs) and adipose-derived mesenchymal stem cells (ADSCs) transplantation are effective in repairing peripheral nerve injury (PNI). However, there is no study that characterizes the in vivo microenvironmental characteristics of these two MSCs for the early repair of PNI when combined with neural tissue-derived ECM materials, i.e., acellular nerve allograft (ANA).MethodsIn order to investigate biological characteristics, molecular mechanisms of early stage, and effectiveness of ADSCs- or BMSCs-injected into ANA for repairing PNI in vivo, a rat 10 mm long sciatic nerve defect model was used. We isolated primary BMSCs and ADSCs from bone marrow and adipose tissue, respectively. First, to investigate the in vivo response characteristics and underlying molecular mechanisms of ANA combined with BMSCs or ADSCs, eighty-four rats were randomly divided into three groups: ANA group, ANA+BMSC group, and ANA+ADSC group. We performed flow cytometry, RT-PCR, and immunofluorescence staining up to 4 weeks postoperatively. To further elucidate the underlying molecular mechanisms, changes in long noncoding RNAs (lncRNAs), circular RNAs (circRNAs), microRNAs (miRNAs), and messenger RNAs (mRNAs) were systematically investigated using whole transcriptome sequencing. We then constructed protein–protein interaction networks to find 10 top ranked hub genes among differentially expressed mRNAs. Second, in order to explore the effectiveness of BMSCs and ADSCs on neural tissue-derived ECM materials for repairing PNI, sixty-eight rats were randomized into four groups: ANA group, ANA+BMSC group, ANA+ADSC group, and AUTO group. In the ANA+BMSC and ANA+ADSC groups, ADSCs/BMSCs were equally injected along the long axis of the 10-mm ANA. Then, we performed histological and functional assessments up to 12 weeks postoperatively.ResultsThe results of flow cytometry and RT-PCR showed that ANA combined with BMSCs exhibited more significant immunomodulatory effects, as evidenced by the up-regulation of interleukin (IL)-10, down-regulation of IL-1β and tumor necrosis factor-alpha (TNF-α) expression, promotion of M1-type macrophage polarization to M2-type, and a significant increase in the number of regulatory T cells (Tregs). ANA combined with ADSCs exhibited more pronounced features of pro-myelination and angiogenesis, as evidenced by the up-regulation of myelin-associated protein gene (MBP and MPZ) and angiogenesis-related factors (TGF-β, VEGF). Moreover, differentially expressed genes from whole transcriptome sequencing results further indicated that ANA loaded with BMSCs exhibited notable immunomodulatory effects and ANA loaded with ADSCs was more associated with angiogenesis, axonal growth, and myelin formation. Notably, ANA infused with BMSCs or ADSCs enhanced peripheral nerve regeneration and motor function recovery with no statistically significant differences.ConclusionsThis study revealed that both ANA combined with BMSCs and ADSCs enhance peripheral nerve regeneration and motor function recovery, but their biological characteristics (mainly including immunomodulatory effects, pro-vascular regenerative effects, and pro-myelin regenerative effects) and underlying molecular mechanisms in the process of repairing PNI in vivo are different, providing new insights into MSC therapy for peripheral nerve injury and its clinical translation.

CLINICAL-EXPERIMENTAL JUSTIFICATION OF PATHOGENETIC TREATMENT OF DIABETIC DAMAGE OF THE PERIPHERAL NERVOUS SYSTEM

Background. Diabetes mellitus is a chronic endocrinological disease that, in addition to the somatic sphere, affects all departments and levels of the nervous system. At the same time, its prevalence is increasing every year. Most often, neurological manifestations concern the peripheral nervous system in the form of sensory-motor polyneuropathies. Aim: To clinically and experimentally study the effectiveness of the complex scheme of prevention and treatment of diabetic polyneuropathy, which is composed taking into account the pathogenetic mechanisms of the studied pathology. To find out the clinical features of the course of the disease and electrophysiological patterns. Under experimental conditions, to study the dynamics of changes in the indicators of sensitivity (nociception) and motor function of peripheral nerves in case of diabetic nerve damage. Materials and methods. In the work, streptozotocin-induced diabetic polyneuropathy was reproduced in rats in a chronic experiment. The formation of the latter was confirmed by a morphological study of the sciatic and tail nerves with the determination of edema and degeneration of Schwann cells, as well as segmental demyelination and spasm of precapillary arterioles. Nicergoline, alpha-lipoic acid, group B vitamins, NG-nitro-L-arginine were used for therapeutic or preventive purposes in groups of animals. The speed of conduction of excitation along the tail nerve was studied. In addition, the "hot plate" test was used. In the clinical part of the work, 43 patients with diabetic polyneuropathy were examined. In addition to the clinical and neurological examination; assessed the severity of polyneuropathies according to the scale of neuropathy symptoms, as well as stimulation electroneuromyography.The patients were divided into groups: the first received a developed treatment complex, the second received conventional treatment. Results. The obtained data indicate the feasibility of using direct (NG-nitro-L-arginine) and indirect (nicergoline - "Sermion" and LC - "Alpha-lipon") inhibitors of nitric oxide synthesis, as well as the complex of vitamin preparations "Neovitam", taking into account their reparative and antioxidant properties, in the clinic in patients with diabetic polyneuropathy with a therapeutic, and possibly preventive purpose. The positive experimental and clinical effects of the developed DPP prevention and treatment scheme are associated with the development of antioxidant and reparative effects, as well as the restoration of the myelin sheath of peripheral nerves, since demyelination contributes to the development of the clinic of polyneuropathy. Conclusion. Patients with diabetic polyneuropathy who received a complex treatment scheme achieved probable clinical, neurological and neurophysiological improvement. On the basis of experimental research, the probable mechanisms of this kind of improvement due to the restoration of myelin, blood circulation, antioxidant and reparative effects have been proven.

High-Porosity Sieve-Type Neural Electrodes for Motor Function Recovery and Nerve Signal Acquisition.

In this study, the effects of electrode porosity on nerve regeneration and functional recovery after sciatic nerve transection in rats was investigated. A sieve-type neural electrode with 70% porosity was designed and compared with an electrode with 30% porosity. Electrodes were fabricated from photosensitive polyimide and implanted into the transected sciatic nerves. Motor function recovery was evaluated using the Sciatic Function Index. The number of active channels and their signal quality were recorded and analyzed to assess the sensory neural signal acquisition. Electrical impedance spectroscopy was used to evaluate the electrode performance. The group implanted with the 70% porosity electrode demonstrated significantly enhanced nerve regeneration and motor function recovery, approaching control group levels by the fifth week. In contrast, the group with the 30% porosity electrode exhibited limited improvement. Immunohistochemical analysis confirmed extensive nerve fiber growth within the 70% porous structure. Moreover, the 70% porosity electrode consistently acquired neural signals from more channels compared to the 30% porosity electrode, demonstrating its superior performance in sensory signal detection. These findings emphasize the importance of optimizing electrode porosity in the development of advanced neural interfaces, with the potential to enhance clinical outcomes in peripheral nerve repair and neuroprosthetic applications.

Orientin Promotes Antioxidant Capacity, Mitochondrial Biogenesis, and Fiber Transformation in Skeletal Muscles through the AMPK Pathway.

The sleep-breathing condition obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse, which can exacerbate oxidative stress and free radical generation, thereby detrimentally impacting both motor and sensory nerve function and inducing muscular damage. OSA development is promoted by increasing proportions of fast-twitch muscle fibers in the genioglossus. Orientin, a water-soluble dietary C-glycosyl flavonoid with antioxidant properties, increased the expression of slow myosin heavy chain (MyHC) and signaling factors associated with AMP-activated protein kinase (AMPK) activation both in vivo and in vitro. Inhibiting AMPK signaling diminished the effects of orientin on slow MyHC, fast MyHC, and Sirt1 expression. Overall, orientin enhanced type I muscle fibers in the genioglossus, enhanced antioxidant capacity, increased mitochondrial biogenesis through AMPK signaling, and ultimately improved fatigue resistance in C2C12 myotubes and mouse genioglossus. These findings suggest that orientin may contribute to upper airway stability in patients with OSA, potentially preventing airway collapse.

Efektivitas Pemberian Terapi Latihan Terhadap Aktivitas Fungsional Pada Pasien Claw Hand E.C. Morbus Hansen

Leprosy is a chronic infectious disease caused by Mycobacterium leprae that affects the skin, peripheral nerves, mucosal surfaces of the respiratory tract, muscles and bones. Most leprosy patients experience paralysis of the ulnar nerve which causes partial disruption of the fingers or called clawhand where the finger is like a bird's claw. Purpose: this study is to determine the benefits of exercise therapy on functional activity in patients with Claw Hand e.c Morbus Hansen. Method: This study uses a case report method conducted at Kelet Donorejo Hospital by taking a sample of one of the leprosy patients by providing exercise therapy for 3 therapy sessions. Furthermore, measuring the first therapy and the third therapy. Results: In this study, the results of physiotherapy interventions were obtained, namely showing an increase in muscle strength even though it was not significant, showing a decrease in pain, in measuring nerve thickening there was no change, motor nerve function and functional measurements of the hand there was an increase even though it was not significant. Conclusion: Physiotherapy management in patients with claw hand e.c. multi-bacillary morbus hansen in the form of active exercise therapy, strengthening exercise and functional exercise obtained the results of increased muscle strength even though it was not significant, showed a decrease in pain, in the measurement of nerve thickening there was no change, motor nerve function and functional hand measurements there was an increase even though it was not significant.

Role of conventional ultrasound and shear wave elastography of median nerve in diagnosis and differentiation of carpal tunnel syndrome severity in correlation with electrodiagnostic studies

BackgroundThe gold standard for CTS diagnosis is abnormalities on electrophysiologic testing in conjunction with specified symptoms. Electrophysiologic testing can also identify the severity of nerve injury.Aim of workAimed to investigate how effective various ultrasonography and elastography parameters at diagnosing and grading the severity of carpal tunnel syndrome in correlation with the electrophysiological evaluation of the median nerve.MethodsThe study included 62 wrists, 31 CTS cases and 25 females. Thirty-one healthy adults served as control group. Eleven males (35.5%) and 20 females (64.5%) were included. All US examinations were done with the subjects sitting with their upper limbs relaxed on a pillow with forearm in supine position, and the fingers are semi-flexed. Ultrasound and elastography parameters were recorded. NCS was done by recording median nerve motor and sensory functions and then comparing median nerve versus radial and ulnar nerves if the previous recordings were normal to detect early starting cases.ResultsUS and elastography can significantly diagnose CTS and detecting its severity (mild/moderate versus severe CTS).ConclusionsIt is noninvasive to examine the median nerve using ultrasound and shear wave elastography, highly sensitive diagnostic modality. It can significantly diagnose CTS and severity of CTS (in contrast to mild, moderate, and severe instances). Mixing high-resolution conventional B-mode US with shear wave ultrasound elastography of the median nerve may increase the diagnostic precision of CTS.

Engineered PVDF/PLCL/PEDOT Dual Electroactive Nerve Conduit to Mediate Peripheral Nerve Regeneration by Modulating the Immune Microenvironment

AbstractElectroactive materials are increasingly recognized for their efficacy in promoting the repair of peripheral nerve injury. However, the mechanism by which electroactive materials promote peripheral nerve regeneration by modulating the immune microenvironment remains incompletely explored. In this study, a PVDF/PLCL/PEDOT artificial peripheral nerve conduit with dual electroactivity by integrating piezoelectric properties and electrical conductivity is constructed. The electroactive conduit exhibited excellent spontaneous electrical and conductive properties, superior suture resistance and anti‐twisting properties. Detailed in vitro cell experiments and in vivo animal experiments are conducted, revealing that the electroactive nerve conduit can effectively promote rat sciatic nerve regeneration while facilitating reconstruction of both nerve conduction function and motor function. Furthermore, the underlying mechanism in depth is investigated and found that the electroactive material can regulate the immune microenvironment by activating the PI3K/AKT‐Nrf2 signaling pathway, thereby promoting macrophage polarization toward M2 anti‐inflammatory phenotype. This subsequently facilitated Schwann cell recruitment and myelin formation through mediation of the macrophage paracrine system. Importantly, blocking immune signaling pathways diminished the effectiveness of the electroactive nerve conduit in promoting nerve repair. The work elucidated how electroactive materials modulate immune microenvironment to positively impact peripheral nerve repair, highlighting the critical role of immune modulation in peripheral nerve repair.

Diagnostic efficacy of tract-specific diffusion tensor imaging in cervical spondylotic myelopathy with electrophysiological examination validation.

This study aimed to investigate the effectiveness of tract-specific diffusion tensor imaging (DTI) metrics in identifying the responsible segments for neurological dysfunction in cervical spondylotic myelopathy (CSM). The study encompassed nineteen participants diagnosed with CSM, including 10 males and 9 females. Additionally, a control group consisting of ten healthy caregivers (5 males and 5 females) were recruited with no symptoms and no compressions on magnetic resonance imaging (MRI). All participants underwent a comprehensive physical examination, MRI assessment, and DTI examination conducted by a senior chief physician. Several parameters were collected from the MR images, including the aspect ratio (defined as the anteroposterior diameter / the transverse diameter of the corresponding segment's spinal cord), transverse ratio (defined as the transverse diameter of the corresponding segment's spinal cord / the transverse diameter of the spinal cord at C2/3), and T2 high signal of the spinal cord. Furthermore, quantitative DTI metrics, such as axial diffusivity (AD), mean diffusivity (MD), radial diffusivity (RD), and fractional anisotropy (FA), were calculated using automatic region-of-interest (ROI) analysis for both whole spinal cord column and dorsal column. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic efficacy of the aspect ratio, transverse ratio, and DTI parameters. The area under the curve (AUC), sensitivity, and specificity were calculated. Intraoperative spinal cord electrophysiological examination was performed as the objective measure of spinal cord function during surgery. As determined by electrophysiological examination, neurological dysfunction was found in 2 patients due to C3/4 compression, in 10 patients due to C4/5 compression, in 6 patients due to C5/6 compression, and in 1 patient due to C6/7 compression. The modified Japanese Orthopedic Association scale (mJOA) was 12.71 ± 1.55 in the CSM group, with 4.87 ± 0.72 for sensory nerve function and 5.05 ± 1.35 for motor nerve function. For the control group, none of the volunteers had neurological dysfunction. T2 high signal was found at the most stenotic segment in 13 patients of the CSM group. Considering all the cervical segments, the aspect ratio (AUC = 0.823, P = 0.001, Sensitivity = 68.42%, Specificity = 82.47%) was more capable of determining the responsible segment than transverse ratio (AUC = 0.661, P = 0.027, Sensitivity = 68.42%, Specificity = 67.01%). AD, MD, and RD were significantly higher while FA was significantly lower in the responsible segment than in the irresponsible segment (P < 0.05). The AUC of DTI-Dorsal column parameters (AD, MD, RD, FA) was larger than the corresponding parameters of the DTI (Whole spinal cord). AD of DTI-Dorsal Column possessed the greatest efficacy (AUC = 0.823, sensitivity = 84.21%, specificity = 77.32%) to determine the responsible segment, larger than AD of DTI-Whole spinal cord (AUC = 0.822, P = 0.001, Sensitivity = 89.47%, Specificity = 77.32%), aspect ratio (AUC = 0.823, P = 0.001, Sensitivity = 68.42%, Specificity = 82.47%) and transverse ratio (AUC = 0.661, P = 0.027, Sensitivity = 68.42%, Specificity = 67.01%). Subgroup analysis revealed that the diagnostic efficacy of DTI and MRI parameters was influenced by cervical spine segment. When considering all cervical segments, AD from the DTI-Dorsal Column exhibited the most significant potential in identifying responsible segments. This potential was found to be superior to that of DTI-Whole spinal cord, aspect ratio, the most stenotic segment, T2 high signals, transverse ratio, motor nerve dysfunction, and sensory nerve dysfunction. The diagnostic effectiveness of both DTI and MRI parameters was notably influenced by the specific cervical spine segment.

High-fat diet exacerbated motor dysfunction via necroptosis and neuroinflammation in acrylamide-induced neurotoxicity in mice

Health risks associated with acrylamide (ACR) or high-fat diet (HFD) exposure alone have been widely concerned in recent years. In a realistic situation, ACR and HFD are generally co-existence, and both are risk factors for the development of neurological diseases. The purpose of the present study was to investigate the combined effects of ACR and HFD on the motor nerve function. As a result, neurobehavioral tests and Nissl staining disclosed that long-term HFD exacerbated motor dysfunction and the damage of spinal cord motor neurons in ACR-exposed mice. Co-exposure of ACR and HFD resulted in morphological changes in neuronal mitochondria of the spinal cord, a significantly reduced mitochondrial subunits NDUFS1, UQCRC2, and MTCO1, released the mitochondrial DNA (mtDNA) into the cytoplasm, and promoted the production of reactive oxygen species (ROS). Combined exposure of HFD and ACR activated the calpain/CDK5/Drp1 axis and caused the mitochondrial excessive division, ultimately increasing MLKL-mediated necroptosis in spinal cord motor neurons. Meanwhile, HFD significantly exacerbated ACR-induced activation of NFkB, NLRP3 inflammasome, and cGAS-STING pathway. Taken together, our findings demonstrated that combined exposure of ACR and HFD aggravated the damage of spinal cord motor neurons via neuroinflammation and necroptosis signaling pathway, pointing to additive effects in mice than the individual stress effects.

Physical training and activity in people with diabetic peripheral neuropathy: A case report

Background: Diabetes mellitus (DM) is the most common endocrine disorder affecting more than 100 million people worldwide, around 6% of the population. This matter characterized by hyperglycemia (high glucose levels in blood) caused by a lack or ineffective production of insulin by the pancreas which results in an increase or decrease in the concentration of glucose in the blood. Diabetic peripheral neuropathy (DPN) or what is called diabetic peripheral neuropathy is the most common complication in cases of diabetes mellitus. DPN is a disease of loss of motor, sensory and autonomic nerve function, which can affect the peripheral nervous system. Sensorimotor training is considered a technique that can improve balance. This emphasizes the function of the sensorimotor system as a unit that works to increase sensory input and motor recruitment patterns in maintaining joint stability and regulating movement through the central nervous system (CNS). Aerobic exercise is a type of physical activity that can prevent and reduce DPN. Aerobic exercise such as treadmill can train balance. Balance training shows a high positive effect on improving motor and sensory symptoms in peripheral neuropathyPurpose: To examine the effects of sensorimotor training and lower limb muscle activity in DPN patients using treadmill.Method: The research uses a case study design, namely a research method that uses various data sources that can be used as research material, describing and explaining comprehensively various aspects of an individual, group, program, organization or event systematically. Participants in this study were patients aged 64 years, female, diagnosed diabetes mellitus type 2 (T2DM) for 10 years by a doctor. This research uses an aspect identification questionnaire instrument. DPN is screened using Michigan Neuropathy Screening Instrument (MNSI). Static balance is determined by romberg test and for dynamic balance it is measured by timed up and go test. Functional lower limb muscle strength is checked using tests Five Time Sit to Stand (5xSST).Results: The data for the respondent is a housewife aged 64 years, last education is junior high school with status as a housewife. The patient suffered from T2DM for 10 years with a hemoglobin 1AC level of 6.8 mg/dl, was overweight as indicated by the patient's BMI of 26 kg/m2. Often feels pain in both legs, when the patient walks and does strenuous activities with a score of 9, and the pain decreases when resting with a score of 3. Apart from that, the patient also has vision problems with a score of 20/40, meaning the patient can only see letters. at a distance of 20 feet. Even though normally letters can be seen clearly, namely 40 feet, this visual disturbance can cause the patient's balance to be disturbed. Providing treatment for 6 weeks can significantly improve the patient's quality of life as seen from the initial WHO QoL score of 58 to 86.Conclusion: Providing treadmill training for 6 weeks carried out 3 times a week showed significant results in reducing hemoglobin levels and DPN scores in T2DM patients.

Lycium barbarum glycopeptide alleviates neuroinflammation in spinal cord injury via modulating docosahexaenoic acid to inhibiting MAPKs/NF-kB and pyroptosis pathways

BackgroundLycium barbarum polysaccharide (LBP) is an active ingredient extracted from Lycium barbarum that inhibits neuroinflammation, and Lycium barbarum glycopeptide (LbGp) is a glycoprotein with immunological activity that was purified and isolated from LBP. Previous studies have shown that LbGp can regulate the immune microenvironment, but its specific mechanism of action remains unclear.AimsIn this study, we aimed to explore the mechanism of action of LbGp in the treatment of spinal cord injury through metabolomics and molecular experiments.MethodsSD male rats were randomly assigned to three experimental groups, and after establishing the spinal cord hemisection model, LbGp was administered orally. Spinal cord tissue was sampled on the seventh day after surgery for molecular and metabolomic experiments. In vitro, LbGp was administered to mimic the inflammatory microenvironment by activating microglia, and its mechanism of action in suppressing neuroinflammation was further elaborated using metabolomics and molecular biology techniques such as western blotting and q-PCR.ResultsIn vivo and in vitro experiments found that LbGp can improve the inflammatory microenvironment by inhibiting the NF-kB and pyroptosis pathways. Furthermore, LbGp induced the secretion of docosahexaenoic acid (DHA) by microglia, and DHA inhibited neuroinflammation through the MAPK/NF-κB and pyroptosis pathways.ConclusionsIn summary, we hypothesize that LbGp improves the inflammatory microenvironment by regulating the secretion of DHA by microglia and thereby inhibiting the MAPK/NF-κB and pyroptosis pathways and promoting nerve repair and motor function recovery. This study provides a new direction for the treatment of spinal cord injury and elucidates the potential mechanism of action of LbGp.

Evaluation of the effect of pitavastatin on motor deficit and functional recovery in sciatic nerve injury: A CatWalk study.

This study aims to investigate the electrophysiological, scintigraphic, and histopathological effects of pitavastatin and its impact on functional status in rats with sciatic nerve injury. A total of 30 Wistar albino rats were divided into three equal groups including 10 rats in each group: sham group (no injury), control group (nerve injury induced), and pitavastatin group (nerve injury induced and 2 mg/kg of pitavastatin administered orally once a day for 21 days). Before and at the end of intervention, quantitative gait analysis with the CatWalk system and sciatic nerve conduction studies were performed. After the intervention, the gastrocnemius muscle was scintigraphically evaluated, and the sciatic nerve was histopathologically examined. There was no significant difference in the sciatic nerve conduction before the intervention and Day 21 among the groups (p>0.05). According to the quantitative gait analysis, there were significant differences in the control group in terms of the individual, static, dynamic, and coordination parameters (p<0.05). The histopathological examination revealed a significant difference in the total myelinated axon count and mean axon diameter among the groups (p<0.001). Pitavastatin is effective in nerve regeneration and motor function recovery in rats with sciatic nerve injury.

Association between spill-related exposure to fine particulate matter and peripheral motor and sensory nerve function among oil spill response and cleanup workers following the Deepwater Horizon oil spill.

Burning/flaring of oil/gas during the Deepwater Horizon oil spill response and cleanup (OSRC) generated high concentrations of fine particulate matter (PM2.5). Personnel working on the water during these activities may have inhaled combustion products. Neurologic effects of PM2.5 have been reported previously but few studies have examined lasting effects following disaster exposures. The association of brief, high exposures and adverse effects on sensory and motor nerve function in the years following exposure have not been examined for OSRC workers. We assessed the relationship between exposure to burning/flaring-related PM2.5 and measures of sensory and motor nerve function among OSRC workers. PM2.5 concentrations were estimated from Gaussian plume dispersion models and linked to self-reported work histories. Quantitative measures of sensory and motor nerve function were obtained 4-6 years after the disaster during a clinical exam restricted to those living close to two clinics in Mobile, AL or New Orleans, LA (n = 3401). We obtained covariate data from a baseline enrollment survey and a home visit, both in 2011-2013. The analytic sample included 1186 participants. We did not find strong evidence of associations between exposure to PM2.5 and sensory or motor nerve function, although there was a suggestion of impairment based on single leg stance among individuals with high exposure to PM2.5. Results were generally consistent whether we examined average or cumulative maximum exposures or removed individuals with the highest crude oil exposures to account for co-pollutant confounding. There was no evidence of exposure-response trends. Remediating environmental disasters is essential for long-term human and environmental health. During the Deepwater Horizon oil spill disaster, burning and flaring of oil and gas were used to remove these pollutants from the environment, but led to potentially high fine particulate matter exposures for spill response workers working on the water. We investigate the potential adverse effects of these exposures on peripheral nerve function; understanding the potential health harm of remediation tactics is necessary to inform future clean up approaches and protect human health.

A mouse model of sensory neuropathy induced by a long course of monomethyl-auristatin E treatment

Antibody-drug conjugates (ADCs) are anticancer drugs consisting of a monoclonal antibody, targeting selective tumor antigens, to which has been frequently associated a highly potent cytotoxic agent, the monomethyl auristatin E (MMAE) using a chemical linker. MMAE is a tubulin polymerization inhibitor derived from dolastin-10. These MMAE-ADCs are responsible for peripheral nerve toxicities. Our objective was to develop and characterize a mouse model of MMAE-induced peripheral neuropathy induced by free MMAE injections.MMAE was injected in Swiss mice at 50 μg/kg i.p. every other day for 7 weeks. Assessments of motor and sensory nerve functions were performed once a week on MMAE and Vehicle-treated mice. Sciatic nerve and paw skin were removed at the end of experiment for subsequent immunofluorescence and morphological analysis.MMAE did not affect motor coordination, muscular strength and heat nociception, but significantly induced tactile allodynia in MMAE-treated mice compared with Vehicle-treated mice from day 35 to day 49. MMAE significantly reduced myelinated and unmyelinated axon densities in sciatic nerves and led to a loss of intraepidermal nerve fiber in paw skin.In summary, long course of low dose of MMAE induced a peripheral sensory neuropathy associated with nerve degeneration, without general state alteration. This model may represent a ready accessible tool to screen neuroprotective strategies in the context of peripheral neuropathies induced by MMAE-ADCs.

CHARACTERISTICS OF REHABILITATION OF PEOPLE WITH SPINAL CORD INJURY

The article shows the results of the study concerning the rehabilitation peculiarities of young people with cervical spinal cord injuries. The aim of the study is to develop the optimal rehabilitation program, motor development and motor compensation, physical characteristics, mental health, nerve and muscle function, and the formation of positive motivation during special training programs. It will help young people adapt to their new situation, and to integrate them into society. The results of the experiment have shown quite a low level of development of motor skills, manual motor skills, daily living skills, and little regulation of the visceral motor system. The aim of the present work is to present correctional rehabilitation during three phases (early, late, and residual). 150 students, including 90 boys and 60 girls aged 16 to 18 with incomplete cervical spinal cord injuries participated in the study. It has been proven that the main psychological and pedagogical conditions, which fully ensure the effectiveness of psychophysical and social rehabilitation of elder students with incomplete cervical spinal cord injuries are: staged approach to rehabilitation that takes into account the complexity of this disease and personal characteristics, creating comfortable conditions and situations that form optimistic expectations about students’ capabilities, and positive didactic rehabilitation motivation; a comprehensive approach to the correction using psychological and social factors, specific motor training, methods of control, motor skills formation, physical development, correction, and motor compensation; control of the level of fundamental motor skills; a comprehensive approach to social adaptation; and finally high physical activity level of each person with disabilities in official and independent types of physical therapy. Specially organized training according to all the criteria and indicators, positively influenced the students from the experimental group in contrast to the control group, where the indicators remained quite low.