The Role of the Proximal Segment in Peripheral Nerve Regeneration

The peripheral nervous system is designed to connect the orchestrations of brain and spinal cord to the rest of the body. In addition, it connects the outside world and that same brain, gathering information from numerous sensory organs in our skin and from our other “senses”. Injury to a nerve subsequently results in impairment of function as well as impairment of that information gathering system. In order to restore the damage, a series of complex changes is triggered in the cell body and the axon, all aimed at restoring motor and sensory function. However, different parts of the peripheral nervous system have different responses to injury. It is possible to distinguish three different parts: The cell body, the proximal segment and the distal segment. Proximal to the lesion, in the cell body and the proximal segment, the aim is to reconnect the axon to its effector organ as soon as possible. Distal to the lesion everything is aimed at creating an environment that allows reconnection of axons to happen. In order to accomplish this, the nerve proceeds through a number of morphological and electrophysiological changes. Although maybe not directly obvious, those morphological transformations after injury are reflected in electrophysiological changes. Previous research demonstrated changes in peak-peak amplitude of compound nerve action signals in the proximal segment after nerve transection and reconstruction45−48. However, the mechanisms involved however, are still unclear. The aim of this thesis is to explore the changes in the proximal segment and to clarify possible modifications to the proximal segment influencing repair.

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