FMRI in Peripheral Nerve Injury

Determining the role of brain reorganization in sensory and motor recovery following peripheral nerve injury and repair

Full Project Name:FMRI in Peripheral Nerve InjuryPrincipal Investigator:Christopher Pawela, PhD, Plastic SurgeryAward Amount:383,000
Award Date
July2011
Project Duration:48 months

Project Description Narrative:


Peripheral nerve injuries result in more than 50,000 surgeries annually in the United States, and occur in the upper extremities most often as the result of traumatic accidents. Wisconsin suffers disproportionately from these injuries compared to other states due to a large number of manufacturing jobs, high number of traffic accidents involving motorcycles, the popularity of outdoor activities including hunting and all-terrain vehicles, and violence.

It is well understood that successful recovery following nerve surgery first requires proper nerve regeneration and accurate axonal reconnection of the nerves to the skeletal muscles. However, surgical treatments for these injuries are not uniform and recovery is often incomplete with some patients displaying suboptimal functional outcomes following surgical nerve repair procedures even with a seemingly successful repair and functioning nerves post-repair. The wide variation in treatments and incomplete outcomes implies that medicine has not yet reached an intervention for peripheral nerve damage with an acceptable clinical outcome.

Through this award, investigators aim to better understand these complications by studying how the brain responds to injury, and documenting over time the functional structure of the brain post-nerve injury and repair in order to improve treatment protocols, functional recovery, and quality of life for Wisconsin residents suffering from peripheral nerve injury.

Outcomes & Lessons Learned:


• Developed a central finding that there are significant reorganizational changes in the brain after peripheral nerve injury and repair, identifying key discoveries that in both humans and animals the brain is permanently altered after injury, that the use of functional magnetic resonance imaging (fMRI) allows tracking reorganization longitudinally in time, and that these changes may be interpreted as a biomarker for recovery

• Began testing of pharmacological methods to enhance brain plasticity after nerve repair, acquiring data for ongoing analysis

• Obtained preliminary data to support further work in the field

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