Low-energy extracorporeal shockwave therapy improves locomotor functions, tissue regeneration, and modulating the inflammation induced FGF1 and FGF2 signaling to protect damaged tissue in spinal cord injury of rat model: an experimental animal study

Chieh-Cheng Hsu, Kay LH Wu, Jei-Ming Peng, Yi-No Wu, Hou-Tsung Chen, Meng-Shiou Lee, Jai-Hong Cheng • Unknown (PMCID specified but journal not clearly indicated) • 2023 • Focused ESWT

Summary

This experimental animal study investigated the effects of low-energy extracorporeal shockwave therapy (ESWT) on spinal cord injury (SCI) in rats. The study found that multiple ESWT sessions (ESWT3) significantly improved motor functions, promoted tissue regeneration, reduced inflammation, and enhanced mitochondrial function compared to a single session (ESWT). The therapy modulated FGF1, FGF2, FGFR1, and pERK signaling, suggesting it may protect damaged tissue in SCI.

Key Findings

"Low-energy ESWT had a dose-dependent effect, with three treatment sessions (ESWT3) showing superior outcomes compared to a single session"

"ESWT3 significantly improved motor functions [run patterns, run average speed, and maximum variation, as well as the Basso, Beattie, and Bresnahan score] and promoted tissue regeneration while reducing inflammation"

"ESWT3 significantly decreased levels of IL-1β, IL6, and macrophages (CD68) while increasing leukocyte (CD45) infiltration"

"ESWT3 upregulated NueN and mitofusin 2 (MFN2), suggesting enhanced neuronal health and mitochondrial function"

"ESWT3 modulated the expression of fibroblast growth factor 1 (FGF1), FGF2, their receptor FGFR1 and phosphorylation of ERK, aiding tissue repair, and regeneration in SCI"

Treatment Categories

Spinal Cord Injury

moderate effectiveness

Low-energy ESWT demonstrated dose-dependent effects in a rat SCI model, with three treatment sessions (ESWT3) showing superior outcomes compared to a single session. ESWT3 significantly improved motor function, reduced inflammation, enhanced neuronal health, and protected mitochondrial function.

Specific Findings

Multiple sessions of low-energy ESWT (ESWT3) significantly improved motor function, tissue regeneration, and reduced inflammation in rats with spinal cord injury

Experimental animal study with BBB scores and CatWalk gait analysis showing improved locomotor function; histopathological examination showing tissue regeneration; reduced inflammatory markers (IL-1β, IL-6, CD68)

Patient Type

Animal model (Sprague-Dawley rats)

Shockwave Type

Focused ESWT

Protocol

sessions: Three sessions (1, 2, and 3 weeks post-surgery) vs single session (1 week post-surgery)

energyFluxDensity: 0.13 mJ/mm²

impulses: 500 impulses

frequency: 4 Hz

Outcomes

Pain Reduction: Not assessed

Functional Improvement: Significant improvement in BBB scores and gait parameters (run average speed, maximum variation)

Tissue Healing: Enhanced tissue regeneration in gray and white matter; increased NeuN and MFN2 expression; modulated FGF1, FGF2, FGFR1, and pERK signaling

Return to Activity: Improved locomotor function at 7 weeks post-injury

Compared To: Untreated SCI control group and single-session ESWT

Limitations

Rat model may not fully replicate human SCI complexity; optimal treatment parameters still undetermined; 6-week observation period doesn't address long-term effects

Study Limitations

Rat model may not fully replicate the complexity of human SCI, limiting direct translational potential
Optimal ESWT treatment regimen (frequency, intensity, duration) remains undetermined
6-week observation period does not address long-term effects
Molecular mechanisms by which ESWT modulates FGF1, FGF2, FGFR1, and pERK signaling require further investigation

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