Evidence map›Paper›PMID 38998805›Full record

ArticleHealthcare (Basel, Switzerland)2024

Redesigned Electrodes for Improved Intraoperative Nerve Conduction Studies during the Treatment of Peripheral Nerve Injuries.

Nathaniel Riemann, Jack Coursen, Laura Elena Porras, Bryan Sabogal, Xin-Hua Liang, Christian Guaraca, Allan Belzberg, Matthias Ringkamp, Gang Wu, Lily Zhu and 2 more

Abstract read
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In one paragraph

Article in Healthcare (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Nathaniel RiemannDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.ORCID 0009-0009-3748-4583
Jack CoursenDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.
Laura Elena PorrasDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.
Bryan SabogalDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.
Xin-Hua LiangDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.
Christian GuaracaDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.ORCID 0000-0002-6414-2169
Allan BelzbergDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
Matthias RingkampDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
Gang WuDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
Lily ZhuDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.ORCID 0000-0002-8804-6630
Samantha WeedDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.
Constanza MirandaDepartment of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.ORCID 0000-0002-9110-2832

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Traumatic peripheral nerve injuries (PNI), present with symptoms ranging from pain to loss of motor and sensory function. Difficulties in intraoperative visual assessment of nerve functional status necessitate intraoperative nerve conduction studies (INCSs) by neurosurgeons and neurologists to determine the presence of functioning axons in the zone of a PNI. This process, also referred to as nerve "inching", uses a set of stimulating and recording electrode hooks to lift the injured nerve from the surrounding surgical field and to determine whether an electrical stimulus can travel through the zone of injury. However, confounding electrical signal artifacts can arise from the current workflow and electrode design, particularly from the mandatory lifting of the nerve, complicating the definitive assessment of nerve function and neurosurgical treatment decision-making. The objective of this study is to describe the design process and verification testing of our group's newly designed stimulating and recording electrodes that do not require the lifting or displacement of the injured nerve during INCSs. Ergonomic in vivo analysis of the device within a porcine model demonstrated successful intraoperative manipulation of the device, while quantitative nerve action potential (NAP) signal analysis with an ex vivo simulated "inching" procedure on healthy non-human primate nerve tissue demonstrated excellent reproducible recorded NAP fidelity and the absence of NAP signal artifacts at all points of recording. Lastly, electrode pullout force testing determined maximum forces of 0.43 N, 1.57 N, and 3.61 N required to remove the device from 2 mm, 5 mm, and 1 cm nerve models, respectively, which are well within established thresholds for nerve safety. These results suggest that these new electrodes can safely and successfully perform accurate PNI assessment without the presence of artifacts, with the potential to improve the INCS standard of care while remaining compatible with currently used neurosurgical technology, infrastructure, and clinical workflows.

Indexed as

action potentialclinical needdesign processelectrodeintraoperative neuromonitoringnerve conduction studynerve trauma injuryneurosurgical treatmentperipheral nervesignal artifact

Identifiers

PMID38998805
PMCPMC11241535

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.