Permanent LMN denervation of human skeletal muscle and recovery by h-b FES: management and monitoring

Denervation of a defined skeletal muscle is due to lower motor neuron (LMN) or peripheral nerve lesions that have major consequences on the muscle tissue. After early atrophy, the mid- and late-phases presents two very contrasting myofibers populations: beside those severely atrophic with internaliz...

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Main Authors: Helmut Kern, Roberto Stramare, Leonora Martino, Riccardo Zanato, Paolo Gargiulo, Ugo Carraro
Format: Article
Language:English
Published: PAGEPress Publications 2010-09-01
Series:European Journal of Translational Myology
Subjects:
Online Access:http://pagepressjournals.org/index.php/bam/article/view/1806
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author Helmut Kern
Roberto Stramare
Leonora Martino
Riccardo Zanato
Paolo Gargiulo
Ugo Carraro
author_facet Helmut Kern
Roberto Stramare
Leonora Martino
Riccardo Zanato
Paolo Gargiulo
Ugo Carraro
author_sort Helmut Kern
collection DOAJ
description Denervation of a defined skeletal muscle is due to lower motor neuron (LMN) or peripheral nerve lesions that have major consequences on the muscle tissue. After early atrophy, the mid- and late-phases presents two very contrasting myofibers populations: beside those severely atrophic with internalized groups of myonuclei, large fast-type muscle fibers continue to be present 4 to 6 years after Spinal Cord Injury (SCI). Recent results of rat experiments provides the rational basis for understanding the residual functional characteristics of the long-term denervated muscle and the molecular explanation of its ability to respond to home-base functional electrical stimulation (h-b FES) using custom-designed electrodes and stimulators. Further outcomes of the Vienna-Padova ten-year collaboration are: 1. a world-unique Myo- Bank of muscle biopsies and 2. improved imaging procedures (Color Computer Tomography (CT) scan and Functional Echomyography), all demonstrating that h-b FES induces improvements in muscle contractility, tissue composition and mass, despite permanent LMN denervation. The benefits of h-b FES could be extended from patents suffering with complete Conus-Cauda Syndrome to the numerous patients with incomplete LMN denervation of skeletal muscles to determine whether h-b FES reduces secondary complications related to disuse and impaired blood perfusion (reduction in bone density, risk of bone fracture, decubitus ulcers, and pulmonary thromboembolism). We are confident that translation of the results of a clinical experiment, the EU Project RISE, to the larger cohort of incomplete LMN denervated muscles will provide the wanted results.
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spelling doaj.art-1d666ccfe88c4b57a065ee45fe7b7d842022-12-22T03:23:22ZengPAGEPress PublicationsEuropean Journal of Translational Myology2037-74522037-74602010-09-012039110410.4081/ejtm.2010.18061181Permanent LMN denervation of human skeletal muscle and recovery by h-b FES: management and monitoringHelmut Kern0Roberto Stramare1Leonora Martino2Riccardo Zanato3Paolo Gargiulo4Ugo Carraro5Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Department of Physical Medicine and Rehabilitation, Wilhelminenspital WienDepartment of Diagnostics and Special Therapy, University of PadovaDepartment of Diagnostics and Special Therapy, University of PadovaDepartment of Diagnostics and Special Therapy, University of PadovaClinical Engineering and Information Technology, Landspitali - University Hospital, ReykjavikLaboratory of Translational Myology, Department of Biomedical Sciences, Interdepartmental Research Center of Myology, University of PadovaDenervation of a defined skeletal muscle is due to lower motor neuron (LMN) or peripheral nerve lesions that have major consequences on the muscle tissue. After early atrophy, the mid- and late-phases presents two very contrasting myofibers populations: beside those severely atrophic with internalized groups of myonuclei, large fast-type muscle fibers continue to be present 4 to 6 years after Spinal Cord Injury (SCI). Recent results of rat experiments provides the rational basis for understanding the residual functional characteristics of the long-term denervated muscle and the molecular explanation of its ability to respond to home-base functional electrical stimulation (h-b FES) using custom-designed electrodes and stimulators. Further outcomes of the Vienna-Padova ten-year collaboration are: 1. a world-unique Myo- Bank of muscle biopsies and 2. improved imaging procedures (Color Computer Tomography (CT) scan and Functional Echomyography), all demonstrating that h-b FES induces improvements in muscle contractility, tissue composition and mass, despite permanent LMN denervation. The benefits of h-b FES could be extended from patents suffering with complete Conus-Cauda Syndrome to the numerous patients with incomplete LMN denervation of skeletal muscles to determine whether h-b FES reduces secondary complications related to disuse and impaired blood perfusion (reduction in bone density, risk of bone fracture, decubitus ulcers, and pulmonary thromboembolism). We are confident that translation of the results of a clinical experiment, the EU Project RISE, to the larger cohort of incomplete LMN denervated muscles will provide the wanted results.http://pagepressjournals.org/index.php/bam/article/view/1806LMN denervation, human skeletal muscle, managements, monitorings, h-b FES, Color CT scan, ultra sonography, Functional Echomyography
spellingShingle Helmut Kern
Roberto Stramare
Leonora Martino
Riccardo Zanato
Paolo Gargiulo
Ugo Carraro
Permanent LMN denervation of human skeletal muscle and recovery by h-b FES: management and monitoring
European Journal of Translational Myology
LMN denervation, human skeletal muscle, managements, monitorings, h-b FES, Color CT scan, ultra sonography, Functional Echomyography
title Permanent LMN denervation of human skeletal muscle and recovery by h-b FES: management and monitoring
title_full Permanent LMN denervation of human skeletal muscle and recovery by h-b FES: management and monitoring
title_fullStr Permanent LMN denervation of human skeletal muscle and recovery by h-b FES: management and monitoring
title_full_unstemmed Permanent LMN denervation of human skeletal muscle and recovery by h-b FES: management and monitoring
title_short Permanent LMN denervation of human skeletal muscle and recovery by h-b FES: management and monitoring
title_sort permanent lmn denervation of human skeletal muscle and recovery by h b fes management and monitoring
topic LMN denervation, human skeletal muscle, managements, monitorings, h-b FES, Color CT scan, ultra sonography, Functional Echomyography
url http://pagepressjournals.org/index.php/bam/article/view/1806
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