# Intraoperative Nerve Damage Assessment Using Nerve-Specific Fluorescence Guided Surgery

> **NIH NIH R43** · INHERENT TARGETING, LLC · 2022 · $375,053

## Abstract

PROJECT SUMMARY
Acute peripheral nerve crush injuries frequently result from closed or open fractures, joint dislocations, and high-
energy collisions. Nerve crush, stretch, or transection can lead to functional deficits ranging from numbness to
complete motor and sensory function loss, affecting ~1.6M trauma patients annually. Assessment of the degree
of injury and the possibility for functional recovery after injury remains challenging and intraoperative nerve
stimulation, the only methodology to aid in decision-making during nerve repair surgery, often yields minimally
useful information. Thus, surgeons are left to make nerve damage assessments via gross visual examination,
which fails to capture the degree of axonal disruption, leaving ~50% of patients with poor functional recovery
outcomes. Surgeons and patients would benefit from a rapid intraoperative assessment of nerve damage to
make informed treatment decisions. We hypothesize that fluorescence imaging using a novel nerve-
specific fluorophore could provide an objective methodology to determine the degree and recoverability
of nerve injury, guiding surgical intervention in real-time to improve patient outcomes following
orthopaedic trauma surgery. We have developed a library of first-in-kind, targeted, near-infrared (NIR)
fluorophores that label nerve tissue with high affinity and are currently undergoing preclinical pharmacology and
toxicology testing to facilitate first-in-human (FIH) trials for improved intraoperative nerve visualization. These
fluorophores provide nerve visualization with high contrast at millimeter to centimeter tissue depths in mice, rats,
and swine and preliminary studies show clear identification between healthy and injured nerve tissues following
topical or systemic administration. Herein, we propose to fully characterize the fluorescent uptake profiles and
intensity differences between healthy and damaged nerve tissue using our NIR nerve-specific fluorophores to
provide an objective methodology for intraoperative nerve damage assessment. This study’s immediate
milestones will include (1) selection of an administration time point for the developed methodology, (2)
quantification of fluorescence intensity (FI) and uptake parameters in healthy, permanently damaged, and
recovering nerve tissue in mouse sciatic nerve injury models and (3) validation of the developed nerve damage
assessment methodology in a blinded rat sciatic nerve injury study for future clinical translation. Completion of
the proposed aims will result in the first objective nerve damage assessment methodology for trauma surgery
utilizing novel NIR nerve-specific fluorophores developed by Inherent Targeting. The proposed studies will
provide proof-of-concept for the expanded utility of our novel probe for future clinical translation, enabling a
robust diagnostic assessment for patients. This work will build upon work underway to obtain clinical approval
for these novel nerve-specific probes and pr...

## Key facts

- **NIH application ID:** 10482087
- **Project number:** 1R43NS127689-01
- **Recipient organization:** INHERENT TARGETING, LLC
- **Principal Investigator:** Connor William Barth
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $375,053
- **Award type:** 1
- **Project period:** 2022-09-20 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10482087

## Citation

> US National Institutes of Health, RePORTER application 10482087, Intraoperative Nerve Damage Assessment Using Nerve-Specific Fluorescence Guided Surgery (1R43NS127689-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10482087. Licensed CC0.

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