{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:04:09Z","timestamp":1785773049345,"version":"3.56.0"},"reference-count":41,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Pathologies associated with neural blood disturbance have been reported in patients with chronic nerve compression (CNC) neuropathy. Fluorescein angiography (FAG) and laser Doppler flowmetry (LDF) are effective for real-time peripheral nerve blood flow assessment. However, their reliability in severe neuropathy models in large animals or clinical conditions remains unclear. Initially, we aim to apply FAG to two different CNC animal models and evaluate their characteristics in comparison with those of LDF. In FAG, we quantified the peak luminance at the compression site following fluorescein injection. Then, we positioned the LDF probe at the center of the compression site and recorded the blood flow. Subsequently, we analyzed whether the FAG characteristics obtained in this animal experiment were consistent with those of clinical studies in patients with severe carpal tunnel syndrome (CTS). In the CNC rat model, FAG and LDF effectively monitored reduced neural blood flow over time. We observed significant blood flow reduction using both techniques in a newly developed severe CNC rabbit model. Notably, FAG correlated strongly with the compound muscle action potential (CMAP) amplitude in electrodiagnostic findings, unlike LDF. As a next step, we performed FAG after open carpal tunnel release in clinical cases of CTS. FAG correlated significantly with preoperative CMAP amplitude. This indicates FAG\u2019s importance for assessing nerve blood flow during surgery, potentially improving diagnostic accuracy and surgical outcomes.<\/jats:p>","DOI":"10.3390\/neurolint16050074","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T11:23:19Z","timestamp":1725535399000},"page":"976-991","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fluorescein Angiography for Monitoring Neural Blood Flow in Chronic Nerve Compression Neuropathy: Experimental Animal Models and Preliminary Clinical Observations"],"prefix":"10.3390","volume":"16","author":[{"given":"Kosuke","family":"Saito","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Osaka City University, 1-4-3, Asahimachi, Abenoku, Osaka 545-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Osaka City University, 1-4-3, Asahimachi, Abenoku, Osaka 545-8585, Japan"},{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahimachi, Abenoku, Osaka 545-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Yokoi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Seikeikai Hospital, 1-1-1, Minami-Yasui-cho, Sakaiku, Sakai, Osaka 590-0064, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7438-5052","authenticated-orcid":false,"given":"Shunpei","family":"Hama","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Yodogawa Christian Hospital, 1-7-50, Kunijima, Higashi Yodogawaku, Osaka 533-0024, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Osaka City University, 1-4-3, Asahimachi, Abenoku, Osaka 545-8585, Japan"},{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahimachi, Abenoku, Osaka 545-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1097\/00001648-199805000-00021","article-title":"Incidence of diagnosed carpal tunnel syndrome in a general population","volume":"9","author":"Nordstrom","year":"1998","journal-title":"Epidemiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jns.2005.02.010","article-title":"Incidence of ulnar neuropathy at the elbow in the province of Siena (Italy)","volume":"234","author":"Mondelli","year":"2005","journal-title":"J. Neurol. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"107437","DOI":"10.1016\/j.clineuro.2022.107437","article-title":"A prospective randomized study comparing retractor-endoscopic vs. open release of carpal tunnel and cubital tunnel syndromes","volume":"222","author":"Schwarm","year":"2022","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6","DOI":"10.5312\/wjo.v14.i1.6","article-title":"Update on surgical procedures for carpal tunnel syndrome: What is the current evidence and practice? What are the future research directions?","volume":"14","author":"Pace","year":"2023","journal-title":"World J. Orthop."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/S0363-5023(86)80052-1","article-title":"Histopathology of compression of the superficial radial nerve in the forearm","volume":"11","author":"Mackinnon","year":"1986","journal-title":"J. Hand Surg. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1097\/00000637-198408000-00004","article-title":"Chronic Nerve Compression\u2014An Experimental Model in the Rat","volume":"13","author":"Mackinnon","year":"1984","journal-title":"Ann. Plast. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"897","DOI":"10.2106\/JBJS.M.01116","article-title":"Early Surgical Decompression Restores Neurovascular Blood Flow and Ischemic Parameters in an in Vivo Animal Model of Nerve Compression Injury","volume":"96","author":"Jung","year":"2014","journal-title":"J. Bone Jt. Surg."},{"key":"ref_8","first-page":"993","article-title":"Carpal Tunnel Syndrome: Diagnosis and Management","volume":"94","author":"Wipperman","year":"2016","journal-title":"Am. Fam. Physician"},{"key":"ref_9","first-page":"4","article-title":"Pathophysiology of carpal tunnel syndrome","volume":"20","author":"Aboonq","year":"2015","journal-title":"Neurosciences"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"116694","DOI":"10.1016\/j.jns.2020.116694","article-title":"Blood flow velocity but not tendon mechanics relates to nerve function in carpal tunnel syndrome patients","volume":"411","author":"Ghavanini","year":"2020","journal-title":"J. Neurol. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.orthres.2004.05.014","article-title":"Carpal tunnel pressure alters median nerve function in a dose-dependent manner: A rabbit model for carpal tunnel syndrome","volume":"23","author":"Diao","year":"2005","journal-title":"J. Orthop. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1002\/1097-4598(200008)23:8<1280::AID-MUS20>3.0.CO;2-Y","article-title":"A neurophysiological grading scale for carpal tunnel syndrome","volume":"23","author":"Bland","year":"2000","journal-title":"Muscle Nerve"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s40064-014-0779-4","article-title":"Ultrasound assessment of the median nerve: A biomarker that can help in setting a treat to target approach tailored for carpal tunnel syndrome patients","volume":"4","author":"Youssef","year":"2015","journal-title":"Springerplus"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"729","DOI":"10.7863\/jum.2012.31.5.729","article-title":"Relationship Between Intraneural Vascular Flow Measured With Sonography and Carpal Tunnel Syndrome Diagnosis Based on Electrodiagnostic Testing","volume":"31","author":"Evans","year":"2012","journal-title":"J. Ultrasound Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jns.2011.06.042","article-title":"Combined Doppler and B-mode sonography in carpal tunnel syndrome","volume":"308","author":"Joy","year":"2011","journal-title":"J. Neurol. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1136\/annrheumdis-2012-202328","article-title":"Ultrasound for diagnosis of carpal tunnel syndrome: Comparison of different methods to determine median nerve volume and value of power Doppler sonography","volume":"72","author":"Dejaco","year":"2013","journal-title":"Ann. Rheum. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/S0363-5023(89)80048-6","article-title":"Intraoperative assessment of median nerve blood flow during carpal tunnel release with laser Doppler flowmetry","volume":"14","author":"Seiler","year":"1989","journal-title":"J. Hand Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1080\/01616412.2022.2072101","article-title":"Microvascular neural blood flow assessment for a chronic nerve compression neuropathy mouse model by fluorescein angiography","volume":"44","author":"Hama","year":"2022","journal-title":"Neurol. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/S0161-6420(91)32165-1","article-title":"frequency of Adverse Systemic Reactions after fluorescein Angiography Results of a Prospective Study","volume":"98","author":"Kwiterovich","year":"1991","journal-title":"Ophthalmology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"106597","DOI":"10.1016\/j.clineuro.2021.106597","article-title":"Intra-operative fluorescein videoangiography-related nephrotoxicity in intracranial aneurysm surgery: Single center, observational cohort study","volume":"203","author":"Urbaniak","year":"2021","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.pain.2011.10.001","article-title":"Chronic sciatic nerve injury impairs the local cutaneous neurovascular interaction in rats","volume":"153","author":"Pelletier","year":"2012","journal-title":"Pain"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.expneurol.2004.02.009","article-title":"Chronic nerve compression induces local demyelination and remyelination in a rat model of carpal tunnel syndrome","volume":"187","author":"Gupta","year":"2004","journal-title":"Exp. Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1002\/cne.10692","article-title":"Chronic nerve compression induces concurrent apoptosis and proliferation of Schwann cells","volume":"461","author":"Gupta","year":"2003","journal-title":"J. Comp. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1002\/mus.22208","article-title":"Electrodiagnostic evaluation of carpal tunnel syndrome","volume":"44","author":"Werner","year":"2011","journal-title":"Muscle Nerve"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.2106\/JBJS.16.00719","article-title":"The American Academy of Orthopaedic Surgeons Evidence-Based Clinical Practice Guideline on","volume":"98","author":"Graham","year":"2016","journal-title":"J. Bone Jt. Surg."},{"key":"ref_26","first-page":"77","article-title":"Surgical treatment of paralysis of opponens muscle of thumb","volume":"65","author":"Camitz","year":"1929","journal-title":"Acta Chir. Scand."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Onode, E., Uemura, T., Takamatsu, K., Yokoi, T., Shintani, K., Hama, S., Miyashima, Y., Okada, M., and Nakamura, H. (2021). Bioabsorbable nerve conduits three-dimensionally coated with human induced pluripotent stem cell-derived neural stem\/progenitor cells promote peripheral nerve regeneration in rats. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-83385-9"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Saito, K., Hisasue, S.I., Ide, H., Aoki, H., Muto, S., Yamaguchi, R., Tsujimura, A., and Horie, S. (2015). The impact of increased bladder blood flow on storage symptoms after holmium laser enucleation of the prostate. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0129111"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1016\/j.clinph.2008.03.018","article-title":"Evaluation and management of peripheral nerve injury","volume":"119","author":"Campbell","year":"2008","journal-title":"Clin. Neurophysiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"565","DOI":"10.2519\/jospt.2004.34.10.565","article-title":"Clinical and Electrodiagnostic Testing of Carpal Tunnel Syndrome: A Narrative Review","volume":"34","author":"MacDermid","year":"2004","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0030-5898(20)30326-6","article-title":"Intraneural microcirculation","volume":"19","author":"Lundborg","year":"1988","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s10072-009-0213-9","article-title":"Diagnosis, treatment and follow-up of the carpal tunnel syndrome: A review","volume":"31","author":"Alfonso","year":"2010","journal-title":"Neurol. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/00000637-198711000-00008","article-title":"A Model of Chronic Nerve Compression in the Rat","volume":"19","author":"Mackinnon","year":"1987","journal-title":"Ann. Plast. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/BF03160057","article-title":"Laser-Doppler Flowmetry A Review of Its Application for Measuring Cerebral and Spinal Cord Blood Flow","volume":"12","author":"Frerichs","year":"1990","journal-title":"Mol. Chem. Neuropathol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1080\/01616412.1996.11740415","article-title":"Laser Doppler monitoring of cerebral blood flow","volume":"18","author":"Borgos","year":"1996","journal-title":"Neurol. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0303-8467(00)00082-2","article-title":"Intraoperative measurement of spinal cord blood flow in syringomyelia","volume":"102","author":"Young","year":"2000","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Roeykens, H.J.J., and De Moor, R.J.G. (2016). Laser doppler flowmetry. Lasers in Endodontics: Scientific Background and Clinical Applications, Springer International Publishing.","DOI":"10.1007\/978-3-319-19327-4_9"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Lee, Y.C., You, Y.K., Lee, S., Moon, D.H., and Lee, J.W. (2022). Evaluation of blood perfusion using laser doppler flowmetry during endoscopic lumbar sympathectomy in patients with plantar hyperhidrosis: A retrospective observational study. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-14778-7"},{"key":"ref_39","first-page":"179","article-title":"Permeability of Intraneural Microvessels and Perineurium Following Acute, Graded Experimental Nerve Compression","volume":"11","author":"Rydevik","year":"1977","journal-title":"Scand. J. Plast. Reconstr. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1136\/jnnp-2012-302312","article-title":"Biology of the blood-nerve barrier and its alteration in immune mediated neuropathies","volume":"84","author":"Kanda","year":"2013","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/978-1-60761-938-3_6","article-title":"The Blood-Nerve Barrier: Structure and Functional Significance","volume":"686","author":"Weerasuriya","year":"2011","journal-title":"Methods Mol. Biol."}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/16\/5\/74\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:49:25Z","timestamp":1760111365000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/16\/5\/74"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,5]]},"references-count":41,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["neurolint16050074"],"URL":"https:\/\/doi.org\/10.3390\/neurolint16050074","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,5]]}}}