Faculty members at the Center for Nerve Injury and Paralysis are active in a wide range of research projects with a common goal of improving outcomes for patients with peripheral nerve injuries:
The Tal Peripheral Nerve Research Lab focuses on studies that improve the surgical management of otherwise irreparable nerve injuries requiring reconstruction with a nerve allograft. The lab carries out its research under the direction of Susan Mackinnon, MD, chief of the Division of Plastic and Reconstructive Surgery, and other faculty members in the division.
Some of the specific studies are investigating:
Tammie Benzinger: Tammie Benzinger, MD, PhD, is investigating the use of diffusion tensor imaging MRI to pinpoint the location of a peripheral nerve injury and whether the injury is primarily to the nerve itself (axon) or to the myelin sheath around the nerve. Diffusion tensor imaging MRI currently is used with evaluation of brain tumors to visualize and identify fiber tracks in the brain associated with movement or speech skills. The technique measures the movement of water in tissue to produce neural tract images.
The goal of using diffusion tensor imaging MRI to evaluate peripheral nerve injuries is to reduce the amount
of time before surgery can be performed. The standard treatment for patients is to wait three to six months
after injury to see if function returns before operating on the injury. With the use of this technique, it may
be possible to evaluate injuries and perform surgery within one month, which may produce better results.
Research Opportunities in the MRI Lab.
Jack Engsberg, PhD, associate professor of occupational therapy, and William Janes, doctoral student in occupational therapy, run a movement science laboratory that seeks to standardize the method for measuring movement in the extremities after nerve repair. To date, efforts to assess function after nerve repair have been subjective, making it difficult to compare results from center to center. With the use of video motion-capture analysis, a set of cameras captures the three-dimensional movement of the repaired limb. The data are analyzed and calculated. In addition, there is an electromyography (EMG) component that uses surface electrodes to determine which muscles are performing work.
A second project seeks to evaluate and correct problematic postures in patients who have had nerve compression neuropathies such as carpal tunnel syndrome and cubital tunnel syndrome. The goal is to help these patients avoid surgery. Research Opportunities in the Movement Science Lab.
Ida Fox, MD, received seed money from the Henry F. Jackson Foundation for the Advancement of Military Medicine to develop a multimedia web site that guides military physicians in the treatment of peripheral nerve injuries.
Traumatic nerve injuries are a prominent component of many improvised explosive device (IED)-inflicted and other conflict-related upper and lower extremity injuries. Although great gains have been made in salvaging limbs, sensation and motor function must be restored for optimal results.
The web site provides a step-by-step tutorial in the approach to the diagnosis and treatment of peripheral nerve injuries and will include the most up-to-date surgical techniques and post-treatment rehabilitation. The ultimate goal is to improve neurological outcomes of military personnel.