Effect of the neurodynamic mobilization technique combined with electroacupuncture on functional recovery and GAP-43 expression after sciatic nerve injury in rabbits

Abstract Background While the peripheral nervous system has remarkable regenerative capacities following injury and disease, its regeneration is often incomplete and slow, and full functional recovery from spontaneous peripheral nerve repair is rare. Hence, there is intense interest in developing a novel strategy for improving functional recovery after peripheral nerve injury (PNI). Objective We aimed to determine whether the application of the neurodynamic mobilization technique (NMT) combined with electroacupuncture (EA) can upregulate the expression of proteins relevant to nerve regeneration, such as the GAP-43 protein, as well as enhance functional recovery after sciatic nerve crush injury in rabbits. Methods This study establishes a model of a single unilateral crush injury to the sciatic nerve in rabbits. A total of 90 male and female New Zealand rabbits were randomly divided into five groups: the sham injury control group, sciatic nerve crush control (SNCr) group, NMT group, EA group, and NMT + EA group. The function of the injured side of the sciatic nerve was evaluated with the toe-spreading reflex and the modified Tarlov score at the 1-, 2-, and 4-week time points after surgery. We used immunohistochemical analysis and toluidine blue staining to detect changes in the injured sciatic nerve samples. Results We found that combination therapy with NMT and EA enhanced locomotor function. Additionally, light microscopy showed that the number of myelinated axons was significantly higher in rabbits treated with a combination of NMT and EA than in rabbits treated with NMT or EA alone. Furthermore, cotreatment with NMT and EA promoted GAP-43 expression in injured neural tissue. Conclusions We propose that combination treatment with NMT and EA promotes axon regeneration and functional recovery via the upregulation of GAP-43 expression at the lesion site. Therefore, cotreatment with NMT and EA might be a very promising therapeutic strategy to improve the clinical outcomes of sciatic nerve injury.