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Jeanpaul Marie - One of the best experts on this subject based on the ideXlab platform.
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syngeneic transplantation of rat olfactory stem cells in a vein conduit improves facial movements and reduces Synkinesis after facial nerve injury
Plastic and Reconstructive Surgery, 2020Co-Authors: Fanny Bense, M Montava, Celia Duclos, Aurelie Bisson, Quentin Delarue, Nicolas Bon Mardion, Olivier Boyer, Francois Feron, Nicolas Guerout, Jeanpaul MarieAbstract:Background Posttraumatic facial paralysis is a disabling condition. Current surgical management by faciofacial nerve suture provides limited recovery. To improve the outcome, the authors evaluated an add-on strategy based on a syngeneic transplantation of nasal olfactory stem cells in a rat model of facial nerve injury. The main readouts of the study were the recording of whisking function and buccal Synkinesis. Methods Sixty rats were allocated to three groups. Animals with a 2-mm facial nerve loss were repaired with a femoral vein, filled or not with olfactory stem cells. These two groups were compared to similarly injured rats but with a faciofacial nerve suture. Olfactory stem cells were purified from rat olfactory mucosa. Three months after surgery, facial motor performance was evaluated using video-based motion analysis and electromyography. Synkinesis was assessed by electromyography, using measure of buccal involuntary movements during blink reflex, and double retrograde labeling of regenerating motoneurons. Results The authors' study reveals that olfactory stem cell transplantation induces functional recovery in comparison to nontransplanted and faciofacial nerve suture groups. They significantly increase (1) maximal amplitude of vibrissae protraction and retraction cycles and (2) angular velocity during protraction of vibrissae. They also reduce buccal Synkinesis, according to the two techniques used. However, olfactory stem cell transplantation did not improve axonal regrowth of the facial nerve, 3 months after surgery. Conclusions The authors show here that the adjuvant strategy of syngeneic transplantation of olfactory stem cells improves functional recovery. These promising results open the way for a phase I clinical trial based on the autologous engraftment of olfactory stem cells in patients with a facial nerve paralysis.
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Co-transplantation of olfactory ensheathing cells from mucosa and bulb origin enhances functional recovery after peripheral nerve lesion. PLoS One 2011
2016Co-Authors: Re Paviot, Olivier Boyer, Damien Genty, Laetitia Jean, Nicolas Bon-mardion, Jeanpaul MarieAbstract:Olfactory ensheathing cells (OECs) represent an interesting candidate for cell therapy and could be obtained from olfactory mucosa (OM-OECs) or olfactory bulbs (OB-OECs). Recent reports suggest that, depending on their origin, OECs display different functional properties. We show here the complementary and additive effects of co-transplanting OM-OECs and OB-OECs after lesion of a peripheral nerve. For this, a selective motor denervation of the laryngeal muscles was performed by a section/anastomosis of the recurrent laryngeal nerve (RLN). Two months after surgery, recovery of the laryngeal movements and Synkinesis phenonema were analyzed by videolaryngoscopy. To complete these assessments, measure of latency and potential duration were determined by electrophysiological recordings and myelinated nerve fiber profiles were defined based on toluidine blue staining. To explain some of the mechanisms involved, tracking of GFP positive OECs was performed. It appears that transplantation of OM-OECs or OB-OECs displayed opposite abilities to improve functional recovery. Indeed, OM-OECs increased recuperation of laryngeal muscles activities without appropriate functional recovery. In contrast, OB-OECs induced some functional recovery by enhancing axonal regrowth. Importantly, co-transplantation of OM-OECs and OB-OECs supported a major functional recovery, with reduction of Synkinesis phenomena. This study is the first which clearly demonstrates the complementary and additive properties of OEC
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co transplantation of olfactory ensheathing cells from mucosa and bulb origin enhances functional recovery after peripheral nerve lesion
PLOS ONE, 2011Co-Authors: Nicolas Guerout, Celia Duclos, Olivier Boyer, Alexandre Paviot, Nicolas Bonmardion, Damien Genty, Laetitia Jean, Jeanpaul MarieAbstract:Olfactory ensheathing cells (OECs) represent an interesting candidate for cell therapy and could be obtained from olfactory mucosa (OM-OECs) or olfactory bulbs (OB-OECs). Recent reports suggest that, depending on their origin, OECs display different functional properties. We show here the complementary and additive effects of co-transplanting OM-OECs and OB-OECs after lesion of a peripheral nerve. For this, a selective motor denervation of the laryngeal muscles was performed by a section/anastomosis of the recurrent laryngeal nerve (RLN). Two months after surgery, recovery of the laryngeal movements and Synkinesis phenonema were analyzed by videolaryngoscopy. To complete these assessments, measure of latency and potential duration were determined by electrophysiological recordings and myelinated nerve fiber profiles were defined based on toluidine blue staining. To explain some of the mechanisms involved, tracking of GFP positive OECs was performed. It appears that transplantation of OM-OECs or OB-OECs displayed opposite abilities to improve functional recovery. Indeed, OM-OECs increased recuperation of laryngeal muscles activities without appropriate functional recovery. In contrast, OB-OECs induced some functional recovery by enhancing axonal regrowth. Importantly, co-transplantation of OM-OECs and OB-OECs supported a major functional recovery, with reduction of Synkinesis phenomena. This study is the first which clearly demonstrates the complementary and additive properties of OECs obtained from olfactory mucosa and olfactory bulb to improve functional recovery after transplantation in a nerve lesion model.
Cagdas Topcu - One of the best experts on this subject based on the ideXlab platform.
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recovery of facial expressions using functional electrical stimulation after full face transplantation
Journal of Neuroengineering and Rehabilitation, 2018Co-Authors: Cagdas Topcu, Hilmi Uysal, Omer Ozkan, Ozlenen Ozkan, Ovunc Polat, Merve Bedeloglu, Arzu Akgul, Ela Naz Doger, Refik SeverAbstract:We assessed the recovery of 2 face transplantation patients with measures of complexity during neuromuscular rehabilitation. Cognitive rehabilitation methods and functional electrical stimulation were used to improve facial emotional expressions of full-face transplantation patients for 5 months. Rehabilitation and analyses were conducted at approximately 3 years after full facial transplantation in the patient group. We report complexity analysis of surface electromyography signals of these two patients in comparison to the results of 10 healthy individuals. Facial surface electromyography data were collected during 6 basic emotional expressions and 4 primary facial movements from 2 full-face transplantation patients and 10 healthy individuals to determine a strategy of functional electrical stimulation and understand the mechanisms of rehabilitation. A new personalized rehabilitation technique was developed using the wavelet packet method. Rehabilitation sessions were applied twice a month for 5 months. Subsequently, motor and functional progress was assessed by comparing the fuzzy entropy of surface electromyography data against the results obtained from patients before rehabilitation and the mean results obtained from 10 healthy subjects. At the end of personalized rehabilitation, the patient group showed improvements in their facial symmetry and their ability to perform basic facial expressions and primary facial movements. Similarity in the pattern of fuzzy entropy for facial expressions between the patient group and healthy individuals increased. Synkinesis was detected during primary facial movements in the patient group, and one patient showed Synkinesis during the happiness expression. Synkinesis in the lower face region of one of the patients was eliminated for the lid tightening movement. The recovery of emotional expressions after personalized rehabilitation was satisfactory to the patients. The assessment with complexity analysis of sEMG data can be used for developing new neurorehabilitation techniques and detecting Synkinesis after full-face transplantation.
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Recovery of facial expressions using functional electrical stimulation after full-face transplantation
Journal of NeuroEngineering and Rehabilitation, 2018Co-Authors: Cagdas Topcu, Hilmi Uysal, Omer Ozkan, Ozlenen Ozkan, Ovunc Polat, Merve Bedeloglu, Arzu Akgul, Ela Naz Doger, Refik Sever, Ömer Halil ÇolakAbstract:Background We assessed the recovery of 2 face transplantation patients with measures of complexity during neuromuscular rehabilitation. Cognitive rehabilitation methods and functional electrical stimulation were used to improve facial emotional expressions of full-face transplantation patients for 5 months. Rehabilitation and analyses were conducted at approximately 3 years after full facial transplantation in the patient group. We report complexity analysis of surface electromyography signals of these two patients in comparison to the results of 10 healthy individuals. Methods Facial surface electromyography data were collected during 6 basic emotional expressions and 4 primary facial movements from 2 full-face transplantation patients and 10 healthy individuals to determine a strategy of functional electrical stimulation and understand the mechanisms of rehabilitation. A new personalized rehabilitation technique was developed using the wavelet packet method. Rehabilitation sessions were applied twice a month for 5 months. Subsequently, motor and functional progress was assessed by comparing the fuzzy entropy of surface electromyography data against the results obtained from patients before rehabilitation and the mean results obtained from 10 healthy subjects. Results At the end of personalized rehabilitation, the patient group showed improvements in their facial symmetry and their ability to perform basic facial expressions and primary facial movements. Similarity in the pattern of fuzzy entropy for facial expressions between the patient group and healthy individuals increased. Synkinesis was detected during primary facial movements in the patient group, and one patient showed Synkinesis during the happiness expression. Synkinesis in the lower face region of one of the patients was eliminated for the lid tightening movement. Conclusions The recovery of emotional expressions after personalized rehabilitation was satisfactory to the patients. The assessment with complexity analysis of sEMG data can be used for developing new neurorehabilitation techniques and detecting Synkinesis after full-face transplantation.
Raman Malhotra - One of the best experts on this subject based on the ideXlab platform.
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direct brow lift and skin contraction in facial nerve palsy a switch technique
Ophthalmic Plastic and Reconstructive Surgery, 2021Co-Authors: Sonali Nagendran, Daniel Butler, Raman MalhotraAbstract:The authors present a case series of 4 patients with facial nerve palsy who underwent a direct brow lift to correct brow ptosis, using the excised brow skin as a full-thickness skin graft to correct lower eyelid skin contracture, ectropion, and retraction. Functional outcomes were measured using the validated cornea, static asymmetry, dynamic function, Synkinesis (CADS) grading system and by photographic assessment of lower eyelid height via margin reflex distance. Aesthetic outcomes were measured using a published grading scale specific to eyelid skin grafts.
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validation of cads grading scale an ophthalmic specific grading instrument for facial nerve palsy
Ophthalmic Plastic and Reconstructive Surgery, 2017Co-Authors: Petrina Tan, We Fong Siah, Johnny Wong, Raman MalhotraAbstract:To evaluate the inter- and intraobserver reliability of the CADS score, a previously described facial nerve grading instrument for ophthalmic grading of facial nerve palsy. This is a cross-sectional validation study. Two clinicians independently assessed and graded each patient on the same day, masked to each other’s grading. Four parameters are assessed in the CADS scale: Cornea (0–3, ±a), static Asymmetry (0–2), Dynamic function (0–3), and Synkinesis (0–2). One clinician reassessed the patients and performed the grading again at a minimum time interval of 1 hour later. A weighted κ analysis was performed to determine inter- and intraobserver reliability using 95% bootstrapped bias-corrected and accelerated (BCa) confidence intervals (CIs). Thirty-three patients (27 women, mean age 51.7, range 23–80 years) with unilateral facial nerve palsy were graded. The overall interobserver reliability was 0.80 (95% BCa CI: 0.68–0.91) for cornea, 0.93 for resting asymmetry (95% BCa CI: 0.55–1.00), 0.80 for dynamic function (95% BCa CI: 0.50–0.96), and 0.88 (95% BCa CI: 0.71–0.96) for Synkinesis. The overall intraobserver reliability was 0.93 for cornea (95% BCa CI: 0.83–0.98), 0.82 for resting asymmetry (95% BCa CI: 0.53–0.96), 0.92 for dynamic function (95% BCa CI: 0.72–1.00), and 0.98 for Synkinesis (95% BCa CI: 0.84–1.00). The CADS grading scale demonstrates good interobserver reliability and very good intraobserver reliability. It incorporates all ophthalmic complications for facial nerve palsy and remains easy to use and refer to.
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cads grading scale towards better grading of ophthalmic involvement in facial nerve paralysis
British Journal of Ophthalmology, 2016Co-Authors: Raman Malhotra, Kimia Ziahosseini, Andre S Litwin, Charles Nduka, Nora ElshammahAbstract:Introduction Ophthalmologists lack a facial nerve grading instrument (FNGI) that comprehensively encompasses the ophthalmic sequelae of facial nerve paralysis (FNP). Assessment and management of ophthalmic sequelae remains inconsistent, and outcomes of clinical studies are incomparable. We have developed and successfully adopted an FNGI based on four aspects of periorbital involvement: cornea, asymmetry, dynamic function and Synkinesis. This CADS classification is specific for periorbital involvement, with objective and subjective parameters, to standardise grading. We present this classification and the results of a validation study in clinical practice. Methods A cross-sectional, validation study. Two clinicians independently assessed and graded each patient on the same day, blinded to each other9s grading. Each grader assigned a score to each of four parameters: C (0–3, ±a), A (0–2), D (0–3), S (0–2). Results Thirty patients (19 females, mean age 60, range 30–84 years) with unilateral facial paralysis were graded. A total of 60 assessments were conducted. CADS scores ranged from C 0 A 0 D 1 S 1 to C 3 aA 2 D 3 S 0 . In the first 30 assessments (of the first 15 patients), the two assessors disagreed over the corneal grading in four patients. The last 30 assessments of 15 patients showed complete agreement in all four parameters of the grading scale. The overall inter-observer agreement was 86.7% for cornea, 93.3% for resting asymmetry, 93.3% for dynamic function and 86.7% for Synkinesis. After the first six patients, Cohen9s κ reached 1 for all but Synkinesis that ranged between 0.9 and 1. Conclusions We present a validation study of an FNGI specifically designed for ophthalmic involvement of FNP. Objective and subjective parameters helped standardise grading and management planning.
Refik Sever - One of the best experts on this subject based on the ideXlab platform.
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recovery of facial expressions using functional electrical stimulation after full face transplantation
Journal of Neuroengineering and Rehabilitation, 2018Co-Authors: Cagdas Topcu, Hilmi Uysal, Omer Ozkan, Ozlenen Ozkan, Ovunc Polat, Merve Bedeloglu, Arzu Akgul, Ela Naz Doger, Refik SeverAbstract:We assessed the recovery of 2 face transplantation patients with measures of complexity during neuromuscular rehabilitation. Cognitive rehabilitation methods and functional electrical stimulation were used to improve facial emotional expressions of full-face transplantation patients for 5 months. Rehabilitation and analyses were conducted at approximately 3 years after full facial transplantation in the patient group. We report complexity analysis of surface electromyography signals of these two patients in comparison to the results of 10 healthy individuals. Facial surface electromyography data were collected during 6 basic emotional expressions and 4 primary facial movements from 2 full-face transplantation patients and 10 healthy individuals to determine a strategy of functional electrical stimulation and understand the mechanisms of rehabilitation. A new personalized rehabilitation technique was developed using the wavelet packet method. Rehabilitation sessions were applied twice a month for 5 months. Subsequently, motor and functional progress was assessed by comparing the fuzzy entropy of surface electromyography data against the results obtained from patients before rehabilitation and the mean results obtained from 10 healthy subjects. At the end of personalized rehabilitation, the patient group showed improvements in their facial symmetry and their ability to perform basic facial expressions and primary facial movements. Similarity in the pattern of fuzzy entropy for facial expressions between the patient group and healthy individuals increased. Synkinesis was detected during primary facial movements in the patient group, and one patient showed Synkinesis during the happiness expression. Synkinesis in the lower face region of one of the patients was eliminated for the lid tightening movement. The recovery of emotional expressions after personalized rehabilitation was satisfactory to the patients. The assessment with complexity analysis of sEMG data can be used for developing new neurorehabilitation techniques and detecting Synkinesis after full-face transplantation.
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Recovery of facial expressions using functional electrical stimulation after full-face transplantation
Journal of NeuroEngineering and Rehabilitation, 2018Co-Authors: Cagdas Topcu, Hilmi Uysal, Omer Ozkan, Ozlenen Ozkan, Ovunc Polat, Merve Bedeloglu, Arzu Akgul, Ela Naz Doger, Refik Sever, Ömer Halil ÇolakAbstract:Background We assessed the recovery of 2 face transplantation patients with measures of complexity during neuromuscular rehabilitation. Cognitive rehabilitation methods and functional electrical stimulation were used to improve facial emotional expressions of full-face transplantation patients for 5 months. Rehabilitation and analyses were conducted at approximately 3 years after full facial transplantation in the patient group. We report complexity analysis of surface electromyography signals of these two patients in comparison to the results of 10 healthy individuals. Methods Facial surface electromyography data were collected during 6 basic emotional expressions and 4 primary facial movements from 2 full-face transplantation patients and 10 healthy individuals to determine a strategy of functional electrical stimulation and understand the mechanisms of rehabilitation. A new personalized rehabilitation technique was developed using the wavelet packet method. Rehabilitation sessions were applied twice a month for 5 months. Subsequently, motor and functional progress was assessed by comparing the fuzzy entropy of surface electromyography data against the results obtained from patients before rehabilitation and the mean results obtained from 10 healthy subjects. Results At the end of personalized rehabilitation, the patient group showed improvements in their facial symmetry and their ability to perform basic facial expressions and primary facial movements. Similarity in the pattern of fuzzy entropy for facial expressions between the patient group and healthy individuals increased. Synkinesis was detected during primary facial movements in the patient group, and one patient showed Synkinesis during the happiness expression. Synkinesis in the lower face region of one of the patients was eliminated for the lid tightening movement. Conclusions The recovery of emotional expressions after personalized rehabilitation was satisfactory to the patients. The assessment with complexity analysis of sEMG data can be used for developing new neurorehabilitation techniques and detecting Synkinesis after full-face transplantation.
Adrian Mendez - One of the best experts on this subject based on the ideXlab platform.
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brief electrical stimulation and Synkinesis after facial nerve crush injury a randomized prospective animal study
Journal of Otolaryngology-head & Neck Surgery, 2018Co-Authors: Adrian Mendez, Alex Hopkins, Vincent L Biron, Hadi Seikaly, Lin Fu Zhu, David W J CoteAbstract:Recent studies have examined the effects of brief electrical stimulation (BES) on nerve regeneration, with some suggesting that BES accelerates facial nerve recovery. However, the facial nerve outcome measurement in these studies has not been precise or accurate. Furthermore, no previous studies have been able to demonstrate the effect of BES on Synkinesis. The objective of this study is to examine the effect of brief electrical stimulation (BES) on facial nerve function and Synkinesis in a rat model. Four groups of six rats underwent a facial nerve injury procedure. Group 1 and 2 underwent a crush injury at the main trunk of the nerve, with group 2 additionally receiving BES for 1 h. Group 3 and 4 underwent a transection injury at the main trunk, with group 4 additionally receiving BES for 1 h. A laser curtain model was used to measure amplitude of whisking at 2, 4, and 6 weeks. Fluorogold and fluororuby neurotracers were additionally injected into each facial nerve to measure Synkinesis. Buccal and marginal mandibular branches of the facial nerve were each injected with different neurotracers at 3 months following injury. Based on facial nucleus motoneuron labelling of untreated rats, comparison was made to post-treatment animals to deduce whether Synkinesis had taken place. All animals underwent trans-cardiac perfusion with subsequent neural tissue sectioning. At week two, the amplitude observed for group 1 and 2 was 14.4 and 24.0 degrees, respectively (p = 0.0004). Group 4 also demonstrated improved whisking compared to group 3. Fluorescent neuroimaging labelling appear to confirm improved pathway specific regeneration with BES following facial nerve injury. This is the first study to use an implantable stimulator for serial BES following a crush injury in a validated animal model. Results suggest performing BES after facial nerve injury is associated with accelerated facial nerve function and improved facial nerve specific pathway regeneration in a rat model.
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Brief electrical stimulation and Synkinesis after facial nerve crush injury: a randomized prospective animal study
BMC, 2018Co-Authors: Adrian Mendez, Alex Hopkins, Vincent L Biron, Hadi Seikaly, Lin Fu Zhu, David W J CoteAbstract:Abstract Background Recent studies have examined the effects of brief electrical stimulation (BES) on nerve regeneration, with some suggesting that BES accelerates facial nerve recovery. However, the facial nerve outcome measurement in these studies has not been precise or accurate. Furthermore, no previous studies have been able to demonstrate the effect of BES on Synkinesis. The objective of this study is to examine the effect of brief electrical stimulation (BES) on facial nerve function and Synkinesis in a rat model. Methods Four groups of six rats underwent a facial nerve injury procedure. Group 1 and 2 underwent a crush injury at the main trunk of the nerve, with group 2 additionally receiving BES for 1 h. Group 3 and 4 underwent a transection injury at the main trunk, with group 4 additionally receiving BES for 1 h. A laser curtain model was used to measure amplitude of whisking at 2, 4, and 6 weeks. Fluorogold and fluororuby neurotracers were additionally injected into each facial nerve to measure Synkinesis. Buccal and marginal mandibular branches of the facial nerve were each injected with different neurotracers at 3 months following injury. Based on facial nucleus motoneuron labelling of untreated rats, comparison was made to post-treatment animals to deduce whether Synkinesis had taken place. All animals underwent trans-cardiac perfusion with subsequent neural tissue sectioning. Results At week two, the amplitude observed for group 1 and 2 was 14.4 and 24.0 degrees, respectively (p = 0.0004). Group 4 also demonstrated improved whisking compared to group 3. Fluorescent neuroimaging labelling appear to confirm improved pathway specific regeneration with BES following facial nerve injury. Conclusions This is the first study to use an implantable stimulator for serial BES following a crush injury in a validated animal model. Results suggest performing BES after facial nerve injury is associated with accelerated facial nerve function and improved facial nerve specific pathway regeneration in a rat model
