# Quantitative Assessment of Peripheral Nerve Injury and Repair via Multi-Parametric MRI

> **NIH NIH R01** · ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER · 2020 · $365,385

## Abstract

PROJECT SUMMARY 
The overall goal of this proposal is to develop and evaluate a multi-parametric set of quantitative MRI (qMRI) 
tools for monitoring the microstructural changes associated with traumatic peripheral nerve injury (TPNI) and 
subsequent surgical repair. Up to 5% of all admissions to level I trauma centers have a TPNI; and a significant 
increase in the incidence of TPNI has been noted in recent military missions. Common etiologies include 
trauma to limbs from penetrating injury, crush, stretch, and ischemia. Clinical management of TPNI faces two 
limitations: i) the inability to acutely identify injuries that require surgery (e.g., nerve lacerations) and ii) the 
inability to detect failed nerve surgeries prior to muscle re-innervation—may take months or years depending on the 
injury site. Due to these limitations, physicians are required to a “wait and watch” using qualitative measures 
obtained from patient history and physical exam. This results in delayed management and increased instances 
of permanent motor/sensory loss. Quantitative MRI (qMRI) techniques may provide a non-invasive, 
quantitative  characterization  of  nerve  microstructure  in  vivo  following  trauma  and  throughout  the  recovery  process 
(i.e., prior to muscle re-innervation). We propose to develop and evaluate qMRI techniques for this purpose. If 
successful, these strategies could improve outcomes by i) identifying patients that require surgery and ii) 
identifying surgical failures earlier than current techniques, even guiding re-operation. The proposed qMRI 
methods will be developed and evaluated as potential biomarkers of nerve recovery via human studies in the 
median/ulnar nerves of the forearm and wrist. We will first develop and optimize qMRI methods of these nerves 
(Aim  1).  MRI of peripheral nerves is challenging due a number of factors, including the need for fast,  
high-resolution imaging and the influence of fat. The PI has previously shown success in developing and 
optimizing qMRI methods to evaluate inherited neuropathies. Here, we will build upon these previous developments 
and  employ  quantitative  magnetization transfer and diffusion imaging to assay  Wallerian  degeneration and 
axonal  outgrowth  following  injury/repair,  respectively.  We have shown that inflammation confounds  
diffusion-based assessments of nerve recovery in a rat model of trauma. As a result, we will also evaluate models 
the account for the influence of inflammation. Once optimized, we will perform cross-sectional studies (Aim 2) 
in patients with nerve injuries of varying severity to evaluate the ability of qMRI to identify injuries that  
require surgery.  We will also perform longitudinal studies  (Aim  3) following surgery to evaluate the ability of 
qMRI  to monitor nerve regeneration, with results compared to EMG/NCS  and  function  (e.g.,  grip strength). 
Finally,  we will explore MRI methods to monitor the downstream effects of TPNI on skeleta...

## Key facts

- **NIH application ID:** 9930132
- **Project number:** 5R01NS097821-06
- **Recipient organization:** ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER
- **Principal Investigator:** Richard Dortch
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $365,385
- **Award type:** 5
- **Project period:** 2016-08-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9930132

## Citation

> US National Institutes of Health, RePORTER application 9930132, Quantitative Assessment of Peripheral Nerve Injury and Repair via Multi-Parametric MRI (5R01NS097821-06). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9930132. Licensed CC0.

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