Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Peripheral nerve injuries are common, identified in 3% of patients presenting to major emergency centers. Despite advances in surgical care, recovery following peripheral nerve injury is often poor, with movement and sensory losses that have lifelong personal and societal costs. Poor clinical outcomes are due to the slow rate of nerve regrowth after injury. A method to accelerate this process therefore is of great clinical importance. One promising technique that increases rates of nerve growth is the conditioning lesion. A conditioning lesion refers to crushing a nerve one week before repairing the nerve. Despite over thirty years of research establishing its ability to improving animal recovery, this technique cannot be applied to clinical practice as we cannot crush human nerves. The search for a non-injurious means to condition a nerve is the holy grail of peripheral nerve research. My PhD research project has shown that conditioning electrical stimulation (CES) has a similar effect as the traditional conditioning crush lesion. Unlike a crush, however, CES does not injure the nerve. Rather, one hour of electrical current is delivered to the nerve by inserting a needle through the skin. CES is therefore minimally invasive and can be performed in the clinic. In my thesis work, I will explore how CES influences nerve regeneration, identify its mechanisms of action and determine how it allows for recovery of muscle control and skin sensation following a nerve injury. Finally, to lay the groundwork for clinical translation, I will study the effects of CES on regeneration following a series of common peripheral nerve surgeries. If our human studies compare with the animal model, in which CES increases nerve regeneration up to four-fold, CES will change the field of peripheral nerve repair surgery. Our results may reduce health care system costs by changing the standard treatment of traumatic nerve injuries, and reducing long term rehabilitative and disability costs.