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ObjectiveTo explore the effect of repetitive peripheral magnetic stimulation on upper limb motor function rehabilitation of stroke patients after contralateral seventh cervical nerve transfer (CC7). MethodsFrom May, 2020, to May, 2022, 34 stroke patients with hemiplegia underwent CC7 in Jing'an District Centre Hospital of Shanghai were randomly divided into control group (n = 17) and observation group (n = 17). Both groups received conventional rehabilitation. The observation group accepted repetitive peripheral magnetic stimulation, and the control group received sham stimulation, for eight weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Hua-Shan Grading of Upper Extremity (H-S grading) before and after treatment. ResultsTwo cases dropped down in each group. There was difference in gender between two groups (χ2 = 6.136, P < 0.05). After treatment, the scores of FMA-UE and H-S grading significantly improved in both groups (t > 4.000, P < 0.01), and the improvement was better in the observation group than in the control group (t > 2.362, P < 0.05). ConclusionRepetitive peripheral magnetic stimulation could improve the motor function of upper limb and hand of stroke patients with hemiplegia after CC7.
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Our previous investigation suggested that faster seventh cervical nerve (C7) regeneration occurs in patients with cerebral injury undergoing contralateral C7 transfer. This finding needed further verification, and the mechanism remained largely unknown. Here, Tinel’s test revealed faster C7 regeneration in patients with cerebral injury, which was further confirmed in mice by electrophysiological recordings and histological analysis. Furthermore, we identified an altered systemic inflammatory response that led to the transformation of macrophage polarization as a mechanism underlying the increased nerve regeneration in patients with cerebral injury. In mice, we showed that, as a contributing factor, serum amyloid protein A1 (SAA1) promoted C7 regeneration and interfered with macrophage polarization in vivo. Our results indicate that altered inflammation promotes the regenerative capacity of the C7 nerve by altering macrophage behavior. SAA1 may be a therapeutic target to improve the recovery of injured peripheral nerves.
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Our previous investigation suggested that faster seventh cervical nerve (C7) regeneration occurs in patients with cerebral injury undergoing contralateral C7 transfer. This finding needed further verification, and the mechanism remained largely unknown. Here, Tinel's test revealed faster C7 regeneration in patients with cerebral injury, which was further confirmed in mice by electrophysiological recordings and histological analysis. Furthermore, we identified an altered systemic inflammatory response that led to the transformation of macrophage polarization as a mechanism underlying the increased nerve regeneration in patients with cerebral injury. In mice, we showed that, as a contributing factor, serum amyloid protein A1 (SAA1) promoted C7 regeneration and interfered with macrophage polarization in vivo. Our results indicate that altered inflammation promotes the regenerative capacity of the C7 nerve by altering macrophage behavior. SAA1 may be a therapeutic target to improve the recovery of injured peripheral nerves.
Asunto(s)
Animales , Humanos , Ratones , Plexo Braquial , Neuropatías del Plexo Braquial/cirugía , Transferencia de Nervios , Nervios Periféricos , Nervios EspinalesRESUMEN
Objective To evaluate the long-term functional recovery after contralateral 7th cervical nerve(C7) transfer with brachial plexus root avulsion and the effect on the contralateral limbs after operation. Methods A total of 83 patients with injory of brachial plexus avulsion were underwent contralateral C7 transfer from September, 2004 to December, 2014.Among them, contralateral C7 were transferred to the median nerve in 33 cases, to radial nerve in 14 cases, to musculocutaneous nerve in 22 cases, and simultaneous transfer to median and musculocutaneous nerve in 14 cases.The followed-up contents included recovery of muscular strength and sensory innervated by the recipient nerve, bilateral limbs synergistic activity and the effect on the contralateral limbs after the surgery. Results All 83 cases were successfully followed-up for 3.2-6.2 years (average, 4.5 years), and found no significant effect on function of the contralateral limbs. In the group of C7 transferred to the median nerve group, 10 cases had muscle strength recov鄄ered≥M3, and 26 cases had sensory recovered≥S3; In the group of C7 transferred to the radial nerve, 6 cases had muscle strength recovered≥M3, and 9 cases had sensory recovered ≥S3; In the group of C7 transferred to the muscu鄄locutaneous nerve, 12 cases had muscle strength recovered≥M3, and 17 cases had sensory recovered≥S3.In the group of C7 simultaneous transferred to the median and musculocutaneous nerve, 6 cases had muscle strength of wrist and digital flexion recovered≥M3, 5 cases had elbow flexion recovered≥M3, 9 and 10 cases had sensory of innervated area and lateral forearm region recovered≥S3, respectively. Conclusion Contralateral C7 transfer is an ideal procedure for the treatment of total brachial plexus root avulsion with definitive clinical outcomes.
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Objective@#To evaluate the long-term functional recovery after contralateral 7th cervical nerve(C7) transfer with brachial plexus root avulsion and the effect on the contralateral limbs after operation.@*Methods@#A total of 83 patients with injory of brachial plexus avulsion were underwent contralateral C7 transfer from September, 2004 to December, 2014. Among them, contralateral C7 were transferred to the median nerve in 33 cases, to radial nerve in 14 cases, to musculocutaneous nerve in 22 cases, and simultaneous transfer to median and musculocutaneous nerve in 14 cases. The followed-up contents included recovery of muscular strength and sensory innervated by the recipient nerve, bilateral limbs synergistic activity and the effect on the contralateral limbs after the surgery.@*Results@#All 83 cases were successfully followed-up for 3.2-6.2 years (average, 4.5 years), and found no significant effect on function of the contralateral limbs. In the group of C7 transferred to the median nerve group, 10 cases had muscle strength recovered≥M3, and 26 cases had sensory recovered≥S3; In the group of C7 transferred to the radial nerve, 6 cases had muscle strength recovered≥M3, and 9 cases had sensory recovered ≥S3; In the group of C7 transferred to the musculocutaneous nerve, 12 cases had muscle strength recovered≥M3, and 17 cases had sensory recovered≥S3. In the group of C7 simultaneous transferred to the median and musculocutaneous nerve, 6 cases had muscle strength of wrist and digital flexion recovered≥M3, 5 cases had elbow flexion recovered≥M3, 9 and 10 cases had sensory of innervated area and lateral forearm region recovered≥S3, respectively.@*Conclusion@#Contralateral C7 transfer is an ideal procedure for the treatment of total brachial plexus root avulsion with definitive clinical outcomes.