Electrical stimulation accelerates axonal and functional peripheral nerve regeneration across long gaps.

Area of Science:

• Neuroscience
• Regenerative Medicine
• Biomaterials Science

Background:

• Peripheral nerve injuries often result in significant functional deficits.
• Bridging nerve gaps exceeding spontaneous regeneration capacity remains a clinical challenge.
• Electrical stimulation (ESTIM) has shown promise in promoting nerve repair.

Purpose of the Study:

• To investigate the efficacy of short-term electrical stimulation (ESTIM) in enhancing peripheral nerve regeneration across significant gaps.
• To evaluate the combined effects of ESTIM with different nerve reconstruction strategies.

Main Methods:

• Rat sciatic nerve gaps (13 mm) were bridged using nerve autotransplantation, silicone tubes, or gene-therapy-loaded tubular grafts (FGF-2 overexpressing Schwann cells).
• Experimental groups received short-term low-frequency electrical stimulation (ESTIM) prior to or during nerve reconstruction.
• Regeneration was assessed functionally (electrodiagnostics) and histomorphometrically up to 8 weeks post-surgery.

Main Results:

• ESTIM combined with nerve autotransplantation significantly increased nerve fiber density and functional motor recovery.
• ESTIM with naïve Schwann cell transplantation enhanced gap-bridging nerve tissue regeneration.
• ESTIM with FGF-2 gene therapy resulted in a high rate of functionally reconnected nerves, despite no macroscopic improvement.

Conclusions:

• Brief electrical stimulation (ESTIM) is a promising strategy to accelerate axonal regeneration and functional recovery in peripheral nerve gap reconstruction.
• Combining ESTIM with various nerve grafting techniques, including cell-based therapies, can further improve clinical outcomes for nerve repair.