Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 7, July, p. 819–824

doi: 10.17219/acem/122177

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Extracorporeal shockwave therapy enhances peripheral nerve remyelination and gait function in a crush model

Hyun Jung Park1,B,C, Jinpyo Hong1,B, Yibo Piao1,B, Hyo Jung Shin1,2,B, Se Jeong Lee3,B, Im Joo Rhyu3,B, Min-Hee Yi4,A,B, Jinhyun Kim5,A, Dong Woon Kim1,2,A,E, Jaewon Beom6,A,C,D,F

1 Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, South Korea

2 Department of Medical Science, Chungnam National University School of Medicine, Daejeon, South Korea

3 Department of Anatomy, Korea University College of Medicine, Seoul, South Korea

4 Department of Neurology, Mayo Clinic, Rochester, USA

5 Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea

6 Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea


Background. Conservative treatment, such as electrical stimulation and steroid injection, have been employed in an attempt to improve symptoms after peripheral nerve injury, without significant success. Although non-invasive and safe extracorporeal shockwave therapy (ESWT) can be a practical alternative, the therapeutic effects of ESWT on peripheral nerve remyelination has not been established.
Objectives. To investigate the effects of ESWT on peripheral nerve remyelination and gait function for 5 weeks in a sciatic nerve crush model.
Material and Methods. In total, we divided 97 rats into 5 groups: group 1 – a healthy negative control group; group 2 – 3 weeks after sciatic nerve crush and 3 sessions of ESWT; group 3 – 5 weeks after crush injury with 3 sessions of ESWT; group 4 – 3 weeks after crush injury with no ESWT; and group 5 – 5 weeks after crush injury with no ESWT. The focused ESWT was applied to the unilateral sciatic nerve injury site. One session consisted of 1,500 stimuli, and the session were performed at intervals of 1 week.
Results. The degree of myelination and expression of myelin basic protein at the distal part of the injured sciatic nerve tended to increase in the ESWT groups compared with the no-ESWT groups 3 and 5 weeks after crush injury. Regarding the functional gait recovery, the print width and area of the injured leg in the ESWT groups was significantly larger than that in the no-ESWT groups 3 and 5 weeks after crush injury.
Conclusion. The ESWT may enhance peripheral nerve remyelination and gait function in a nerve crush model. Long-term follow-up after ESWT and investigation of molecular mechanisms will be needed to confirm these therapeutic effects.

Key words

peripheral nerve injuries, extracorporeal shockwave therapy, myelin basic protein, remyelination, gait

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