The Plastic Surgery Foundation
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Grants We Funded

In 2019, The Plastic Surgery Foundation (The PSF) awarded 33 investigator-initiated projects and allocated $891,274 to support the newest, clinically relevant research in plastic surgery.

The American Society of Plastic Surgeons/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.

Revealing how vibration injures peripheral nerves and methods of prevention

Principal Investigator
Chaowen Wu MD

Year
2016

Institution
The Medical College of Wisconsin

Funding Mechanism
ASPN/PSF Research Grant

Focus Area
Peripheral Nerve, Hand or Upper Extremity

Abstract
Millions of Americans are exposed to hand transmitted vibration and risk developing hand-arm vibration syndrome (HAVS). HAVS manifests in debilitating and irreversible numbness and later painful vasospasm of the fingers (Raynaud's phenomenon). The diagnosis is frustrating to both patients and upper extremity surgeons as there is currently no effective intervention. The pathogenesis remains unclear, therefore, it is critical to reveal the mechanism of injury in order to successfully prevent HAVS.

To study the mechanism of injury, a rat-tail model of HAVS will be used to simulate the effect of vibration on the nerves and arteries of the fingers. Aim 1 will determine whether the mechanical movements of vibration alone can lead to nerve injury if we remove the sensation of vibration. We will test this by examining signs of myelin damage in rat tails nerves vibrated with or without local tail anesthesia. Aim 2 will test whether vibration causes an increase in nerve energy usage and build of of harmful reactive oxygen species (ROS). We will quantify and compare levels of ATP (adenosine triphosphate), NAD+ (nicotinamide adenine dinucleotide; a molecules important in ATP generation), and ROS using tissue assays. We will also test whether supplementing the nerve with additional energy using nicotinamide riboside (a precursor to NAD+) can prevent vibration damage. Aim 3 will determine whether vibration injures sensory nerves, motor nerves, or both indiscriminately. We will examine nerve staining for sensory neurons using carbonic anhydrase and motor neurons using cholinesterase to determine how myelin damage colocalizes with sensory or motor nerve staining.

We hypothesize that vibration overactivates sensory nerve firing which uses energy. Energy deficit leads to ROS build up and sensory nerve injury. Consequently, damaged sensory nerves cannot provide accurate feedback to the sympathetic nervous system which controls when blood vessel should dilate or constrict. This leads to the development of vasospasm (Raynaud's Phenomenon). We predict that vibrational nerve injury can be prevented by either anesthetizing the sensory perception of vibration to prevent sensory nerve overactivation, or by supplementing the energy needed to support high frequency nerve firing induced by vibration. These studies will increase our understanding about how vibration causes nerve injury and potentially provide effective therapies to prevent HAVS.

Biography
Chaowen Wu, MD/PhD, is a plastic surgery resident at the Medical College of Wisconsin. Her research interests include examining peripheral nerve biology, nerve degeneration, and restoration of nerve function after injury or disease. Chaowen received her Bachelor of Science degree in neuroscience with a minor in philosophy from the University of Michigan. She went on to obtain a dual MD/PhD degree at Wayne State University School of Medicine. During her PhD, she studied the architecture of retinal neurons and vision restoration. Her work uncovered a novel neuronal structure in a key cell population in the retina, the AII amacrine cell, which explained how these interneurons were able to generate action potentials without an axon. In her work on restoring vision after photoreceptor degeneration, Chaowen used protein targeting techniques to deliver light sensitive proteins to retinal ganglion cells and successfully recreated the center-surround inhibitory receptive field in these neurons which brings more accuracy to artificial vision restoration. Currently at the Medical College of Wisconsin, Chaowen continues to pursue her passion in peripheral nerve research on topics including vibrational nerve injury (hand-arm vibration syndrome), stretch injuries, and nerve compression injuries.