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Stefano Geuna

Publications and source records attributed to Stefano Geuna.

29 records · Page 2Linked to original sources

Morphology of nerve fiber regeneration along a biodegradable poly (DLLA-epsilon-CL) nerve guide filled with fresh skeletal muscle.

Previous morphological and morphometrical studies showed that fresh-skeletal-muscle-enriched vein segments are good conduits for leading peripheral nerve regeneration. In the present study, we investigated the morphological features of peripheral nerve fibers regenerated along a 10-mm-long biodegradable poly (DLLA-epsilon-CL) nerve guide enriched with fresh skeletal muscle, comparing them to nerve fiber regeneration along 10-mm-long phosphate-buffered saline (PBS)-enriched poly (DLLA-epsilon-CL) tubes. Repaired nerves were analyzed at weeks 6 and 24 postoperatively. Structural and ultrastructural observation showed that good nerve fiber regeneration occurred in both PBS-enriched and fresh-skeletal-muscle-enriched nerve guides, and histomorphometrical analysis of regenerated myelinated fibers revealed no statistically significant differences between the two experimental groups at week 24 after surgery. The employment of fresh-muscle-enriched conduits for the repair of nerve defects is critically discussed in the light of these results.

Animals↗

Functional assessment of sciatic nerve recovery: biodegradable poly (DLLA-epsilon-CL) nerve guide filled with fresh skeletal muscle.

The aim of this study was to compare functional peripheral nerve recovery in the rat sciatic nerve model after reconstruction of a 10-mm gap with a biodegradable poly (DLLA-epsilon-CL) nerve guide, as filled with either fresh skeletal muscle or phosphate-buffered saline (PBS). During 24 weeks of recovery, motor and sensory functional evaluation was tested by extensor postural thrust (EPT) and withdrawal reflex latency (WRL), respectively. At the end of the experiment, anesthetized animals were prepared for motor nerve conduction velocity (MNCV) studies, followed by gastrocnemius and soleus muscle weight measurement. Motor functional recovery was greater in the muscle-grafted group, and reached a significant difference from weeks 8-12 (P < 0.05). The results of this investigation suggest that filling a nerve guide with fresh skeletal muscle induces faster maturation of regenerated nerve fibers in comparison with traditional tubular repair.

Absorbable Implants↗

Ankle kinematics to evaluate functional recovery in crushed rat sciatic nerve.

Peripheral nerve researchers frequently use the rat sciatic nerve crush model in order to test different therapeutic approaches. The purpose of this study was to determine the sequence of changes after an axonotmetic injury by means of a biomechanical model of the foot and ankle, and compare them with walking track analysis, over a fixed period of time. A kinematic analysis program was used to acquire ankle motion data for further analysis. Although repeated measures analysis of variance showed significant cumulative changes induced by the crush lesion for both ankle kinematic parameters and sciatic functional index, post-hoc multiple comparisons by the Student-Neuman-Keuls test revealed significant differences between week 0 and week 8 only for ankle kinematics. These results are of importance in showing the superiority of ankle kinematics in detecting small biomechanical deficits related to hyperexcitability of the plantarflexor muscles, in contrast with walking track analysis, which showed full motor functional recovery 8 weeks after the crush lesion.

Animals↗

Toe out angle: a functional index for the evaluation of sciatic nerve recovery in the rat model.

In experimental peripheral nerve studies, the rat sciatic nerve model is widely used to examine functional outcome following nerve injury and repair. A variety of evaluation methods exist in the literature, but an adequate selection continues to be a critical point for the researcher. Rats with sciatic nerve injury typically ambulate with an external rotation of the foot. A new functional assessment instrument, the toe out angle (TOA) is quantified using computerized gait analysis. We compared Sciatic Functional Index (SFI) with TOA parameter after peripheral nerve transection and entubulation repair. We found a good correlation between SFI and TOA measurements in terms of predicting functional recovery. Moreover, the TOA provides information on the biomechanical consequences of the external rotation of the foot in the stance phase of walking.

Animals↗

Morphologic and functional study of rat median nerve repair by terminolateral neurorrhaphy of the ulnar nerve.

While it has been shown that terminolateral (end-to-side) neurorrhaphy leads to successful functional motor reinnervation of the peripheral territories belonging to the severed nerve, data on the morphology of terminolateral sprouting and on the voluntary control of the motor function restored by terminolateral neurorrhaphy are still partial. In this study, the severed rat median nerve was sutured in an end-to-side fashion to the intact ulnar nerve. The progression of recovery of the flexion of the fingers was assessed by means of the grasping test. Seven months after surgery, the rats were sacrificed, and morphologic and morphometric analysis was performed on the regenerated median nerve and on the donor ulnar nerve. Results of the functional assessment showed that voluntary motor control of the muscles innervated by the median nerve was partially and progressively recovered by terminolateral neurorrhaphy, with a mean strength in the flexion of the fingers that reached about 20 percent of normal before sacrifice. Morphologic and morphometric analysis showed that nerve-fiber regeneration occurred in all repaired median nerves. Signs of nerve fiber atrophy were detected in the ulnar nerve distal to the point of suture, suggesting the possible occurrence of secondary damage to the donor nerve after terminolateral neurorrhaphy that should be taken into consideration in a clinical perspective.

Animals↗

Neurotrophins and their receptors in early axonal regeneration along muscle-vein-combined grafts.

Experimental and clinical studies have shown that a vein segment filled with skeletal muscle used to bridge a peripheral nerve defect (muscle-vein-combined graft) leads to good nerve repair. However, the molecular basis of the nerve fiber regeneration process along this type of graft still remains to be elucidated. The aim of this study was to verify the expression of two neurotrophins, nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), as well as their receptors, trkA and p75, in an early stage of axonal regeneration in muscle-vein-combined grafts. Severed rat sciatic nerves were repaired by means of 1-cm-long muscle-vein-combined grafts and withdrawn immediately after surgery (control grafts) and 5 days after surgery. Longitudinal sections of grafts were immunostained by means of the following antibodies: anti-NGF, anti-BDNF, anti-trkA, and anti-p75. An anti-glial fibrillar acid protein (anti-GFAP) antibody was used to recognize Schwann cells. Results showed the presence of a number of GFAP-positive Schwann cells inside the muscle-vein grafts. Many of these cells reacted for NGF, BDNF, and p75, but not trkA. In control grafts, i.e., immediately after surgery, no immunostaining was detected for any of the antibodies used in this study. These observations suggest that, very early after surgery, the muscle-vein-combined graft offers to growing axons an environment particularly favorable for regeneration, providing us with a possible explanation for the efficacy of this grafting technique for peripheral nerve repair.

Animals↗

Postnatal histogenesis in the peripheral nervous system.

The issue of postnatal neurogenesis has gained great importance over the last few years and the recent amazing scientific advancements, changing our viewpoint on the long-lasting "no new neurons" dogma, have opened promising new perspectives on the treatment of the damaged nervous system. While most of the researchers have focused on the central nervous system, the peripheral nervous system has received little attention so far with respect to postnatal histogenesis. To attract scientific attention on this issue, the present article was written with the aim of reviewing the body of literature on postnatal histogenesis in the various districts of the peripheral nervous system, from the historical roots to the most recent reports.

Afferent Pathways↗

Use of skeletal muscle tissue in peripheral nerve repair: review of the literature.

The management of peripheral nerve injury continues to be a major clinical challenge. The most widely used technique for bridging defects in peripheral nerves is the use of autologous nerve grafts. This technique, however, necessitates a donor nerve and corresponding deficit. Many alternative techniques have thus been developed. The use of skeletal muscle tissue as graft material for nerve repair is one example. The rationale regarding the use of the skeletal muscle tissue technique is the availability of a longitudinally oriented basal lamina and extracellular matrix components that direct and enhance regenerating nerve fibers. These factors provide superiority over other bridging methods as vein grafts or (non)degradable nerve conduits. The main disadvantages of this technique are the risk that nerve fibers can grow out of the muscle tissue during nerve regeneration, and that a donor site is necessary to harvest the muscle tissue. Despite publications on nerve conduits as an alternative for peripheral nerve repair, autologous nerve grafting is still the standard care for treatment of a nerve gap in the clinical situation; however, the use of the skeletal muscle tissue technique can be added to the surgeon's arsenal of peripheral nerve repair tools, especially for bridging short nerve defects or when traditional nerve autografts cannot be employed. This technique has been investigated both experimentally and clinically and, in this article, an overview of the literature on skeletal muscle grafts for bridging peripheral nerve defects is presented.

Animals↗

Satellite cells and myonuclei in neonatally denervated rat muscle.

While it is well know that the percentage of stellite cells in relation to myonuclei rapidly decreases in aneurally regenerating adult muscle, the fate of satellite cells in neonatally denervated muscles has received little attention so far. In the present study, rat tibialis anterior muscles were denervated at birth and analysed after 5, 7 and 10 weeks. At least 400 myonuclei in each muscle were assessed by electron microscopy and the percentage of satellite cell nuclei in relation to the number of myonuclei was calculated. The results indicated that the percentage of satellite cells steeply declines after neonatal denervation and, after 10 weeks, satellite cells were practically lacking in the muscles under analysis. This process of exhaustion of the satellite cell pool appears to be more rapid in developing than in adult muscles.

Animals↗

Nerve regeneration inside fresh skeletal muscle-enriched synthetic tubes: a laser confocal microscope study in the rat sciatic nerve model.

The search for good conduits for bridging nerve defects is a major challenge of today's tissue engineering research. In this paper we report on a laser confocal microscope study on early nerve regeneration inside a tissue engineered graft made by a poly(DLLA-epsilon-CL) conduit enriched with fresh skeletal muscle. The same biodegradable tubes filled with PBS solution were used as controls. The conduits were placed to bridge unilateral 1-cm-long rat sciatic nerve defects and analysed 10 days after surgery. Results showed that inside the muscle-enriched tubes axon regeneration, labelled by means of anti-neurofilament antibody, was already begun, whilst no axon regeneration was detectable along control tubes. In addition, a-GFAP (glial fibrillar acid protein) immuno-labelling of Schwann cells showed that progression inside muscle-enriched tubes, especially from the distal nerve stump, was much more evident than in control conduits. These results suggest that enrichment of synthetic tubes with fresh skeletal muscle promotes axon regeneration and Schwann cell migration in early nerve repair stages.

Absorbable Implants↗