Analysis Of Motor Hand Recovery In A Nonhuman Primate Following Median Nerve Repair As A Preclinical Model System For Conduit Implantation
Christine Radtke, MD, PHD1, Peter M. Vogt, MD, PhD1, Kerstin Reimers, PhD1, Christina Liebsch, B.Sc.1, Jeffery D. Kocsis, PhD2.
1Hannover Medical School, Hannover, Germany, 2Yale University, School of Medicine, New Haven, CT, USA.
PURPOSE: Surgical repair of peripheral nerve transection can result in nerve regeneration and functional recovery. However, the clinical outcome in nerve defect injuries is disappointing and research continues to develop nerve conduits for optimal enhancement of axonal regeneration. Model systems to evaluate nerve conduit implantation in a preclinical model are limited. Here, we describe the sequence of functional recovery of fine hand movements in combination with electrophysiological recordings following repair of a critical size median nerve defect.
METHODS: In the nonhuman primate, a 2.0 cm defect injury of the median nerve was induced and reconstructed by nerve conduit implantation or autologous nerve transplantation. Postoperatively, animals were tested monthly for fine motor dexterity. Noninvasive electrophysiological studies were carried out to determine conduction velocity.
RESULTS: Immediately after injury and nerve reconstruction, significant loss of fine hand movements was observed. With regard to conduit implantation, no adverse effects were observed. The sequence of functional recovery following conduit implantation was characterized in comparison to autologous nerve transplantation and comparable results were observed in both experimental groups. With increasing regeneration of the median nerve, recovery of fine motor dexterity of the hand could be observed. 12 months after median nerve repair, the behavioral outcome and muscle innervation indicated almost complete functional restoration.
CONCLUSION: The establishment of a nerve defect injury model and subsequent repair in a nonhuman primate combined with detailed analysis of functional recovery could serve as an important preclinical model system for conduit implantation studies providing data on the safety and efficacy.
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