4-Aminopyridine as a single agent diagnostic and treatment for severe nerve crush injury

Mark Noble, Kuang Ching Tseng, Haiyan Li, John Elfar

Research output: Contribution to journalArticle

Abstract

Background Traumatic peripheral nerve injury (TPI) is a major medical problem without effective treatment options. There is no way to diagnose or treat an incomplete injury and delays contribute to morbidity. We examined 4-aminopyridine (4-AP), a potassium-channel blocker as a possible treatment for TPI. Methods We used standard mouse models of TPI with functional outcomes including sciatic-functional-index, sensory indices, and electrodiagnostics; in addition to standard immunohistochemical, and electron microscopic correlates of axon and myelin morphology. Results Sustained early 4-AP administration increased the speed and extent of behavioral recovery too rapidly to be explained by axonal regeneration. 4-AP also enhanced recovery of nerve conduction velocity, promoted remyelination, and increased axonal area post-injury. 4-AP treatment also enabled the rapid distinction between incomplete and complete nerve lesions. Conclusion 4-AP singularly provides both a new potential therapy to promote durable recovery and remyelination in acute peripheral nerve injury and a means of identifying lesions in which this therapy would be most likely to be of value. The ability to distinguish injuries that may respond to extended therapy without intervention can offer benefit to wounded soldiers.

Original languageEnglish (US)
Pages (from-to)379-385
Number of pages7
JournalMilitary medicine
Volume184
DOIs
StatePublished - Mar 1 2019

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Nerve Crush
4-Aminopyridine
Peripheral Nerve Injuries
Wounds and Injuries
Therapeutics
Potassium Channel Blockers
Neural Conduction
Military Personnel
Myelin Sheath
Axons
Crush Injuries
Regeneration
Electrons
Morbidity

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Noble, Mark ; Tseng, Kuang Ching ; Li, Haiyan ; Elfar, John. / 4-Aminopyridine as a single agent diagnostic and treatment for severe nerve crush injury. In: Military medicine. 2019 ; Vol. 184. pp. 379-385.
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4-Aminopyridine as a single agent diagnostic and treatment for severe nerve crush injury. / Noble, Mark; Tseng, Kuang Ching; Li, Haiyan; Elfar, John.

In: Military medicine, Vol. 184, 01.03.2019, p. 379-385.

Research output: Contribution to journalArticle

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