Grants Funded
ASPS/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.
Research Abstracts
Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area or PSF funding mechanism.
Targeted muscle reinnervation in a neuropathic pain model
Principal Investigator
Gwendolyn Hoben MD, PhD
Gwendolyn Hoben MD, PhD
Year
2019
2019
Institution
The Medical College of Wisconsin
The Medical College of Wisconsin
Funding Mechanism
AAHS/PSF Research Grant
AAHS/PSF Research Grant
Focus Area
Hand or Upper Extremity, Peripheral Nerve
Hand or Upper Extremity, Peripheral Nerve
Abstract
Major limb amputation affects 185,000 Americans each year. Chronic pain associated with amputations is debilitating, severely compromises amputee quality of life, can prevent the use of prostheses, and is associated with chronic opioid use. A new technique in the management of upper extremity amputation is targeted muscle reinnervation (TMR). This surgical procedure re-routes amputated motor nerves to intact branches in order to create a strong electrical signal for a prosthesis. However, clinical work has shown that this procedure also reduces pain development associated with the amputation. However, the efficacy seems to be reduced with more chronic amputations and this may be related to central sensitization. In this project we are analyzing the effect of chronicity on the efficacy of TMR and exploring possible mechanistic components like selective sensory neuron regeneration, sensory neuron sensitization, and Schwann cell senescence. These analyses will help inform clinical decision making and increase our understanding of the mechanisms behind neuropathic pain.
Major limb amputation affects 185,000 Americans each year. Chronic pain associated with amputations is debilitating, severely compromises amputee quality of life, can prevent the use of prostheses, and is associated with chronic opioid use. A new technique in the management of upper extremity amputation is targeted muscle reinnervation (TMR). This surgical procedure re-routes amputated motor nerves to intact branches in order to create a strong electrical signal for a prosthesis. However, clinical work has shown that this procedure also reduces pain development associated with the amputation. However, the efficacy seems to be reduced with more chronic amputations and this may be related to central sensitization. In this project we are analyzing the effect of chronicity on the efficacy of TMR and exploring possible mechanistic components like selective sensory neuron regeneration, sensory neuron sensitization, and Schwann cell senescence. These analyses will help inform clinical decision making and increase our understanding of the mechanisms behind neuropathic pain.
Biography
My research career began with cartilage but through my post graduate training I developed a growing affection for nerves. Compounding this, I found nerve surgery incredibly satisfying and I spent two years doing nerve research in Dr. Susan Mackinnon’s laboratory. I then pursued a fellowship in hand surgery and now as a plastic surgeon my practice is a mix of 100% hand and nerve surgery and 100% peripheral nerve research. The percentages do not add, but that is the beauty of an academic practice, there really are no boundaries between clinical work and research- I learn from both my human and rodent patients. Since 2018 I have been building my laboratory group and my original focus was nerve regeneration. However, the growing use of nerve transfers to treat pain combined with the incredible pain research community at Medical College of Wisconsin has allowed me to grow the laboratory in the direction of the interplay of nerve regeneration and pain. Nerve transfers for pain provide an unusual and surgically accessible insight to pain pathways while at the same time shedding new light on what we know about how nerve coaptations affect regeneration. It is my goal that these efforts expand the tools available to mitigate pain related to any nerve injury from amputation to diabetic neuropathy.
My research career began with cartilage but through my post graduate training I developed a growing affection for nerves. Compounding this, I found nerve surgery incredibly satisfying and I spent two years doing nerve research in Dr. Susan Mackinnon’s laboratory. I then pursued a fellowship in hand surgery and now as a plastic surgeon my practice is a mix of 100% hand and nerve surgery and 100% peripheral nerve research. The percentages do not add, but that is the beauty of an academic practice, there really are no boundaries between clinical work and research- I learn from both my human and rodent patients. Since 2018 I have been building my laboratory group and my original focus was nerve regeneration. However, the growing use of nerve transfers to treat pain combined with the incredible pain research community at Medical College of Wisconsin has allowed me to grow the laboratory in the direction of the interplay of nerve regeneration and pain. Nerve transfers for pain provide an unusual and surgically accessible insight to pain pathways while at the same time shedding new light on what we know about how nerve coaptations affect regeneration. It is my goal that these efforts expand the tools available to mitigate pain related to any nerve injury from amputation to diabetic neuropathy.