Accelerating nerve regeneration with botulinum toxin and electrical stimulation therapies

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Project Summary Peripheral nerve injuries are an under-appreciated public health problem. There are about 200,000 new cases per year in the USA. Recovery is incomplete for the vast majority of patients who suffer from one because nerve regrowth is slow and inefficient. Unfortunately, there are no approved treatments to improve the process of nerve regeneration. We have identified two complimentary therapies in order to target the (i) early and (ii) late phases of the nerve regeneration process. They each may work as stand-alone therapy or potentially in combination, as we predict they will have an additive benefit on nerve repair. The present proposal will set the stage for a follow up clinical trial to bring the most promising therapy to patients. We believe we can make rapid progress towards this goal because one therapy represents a repurposing of an already FDA-approved drug, and the other therapy is a form of electrical stimulation that already has shown efficacy in small clinical trials for nerve injury. The electrical stimulation therapy is in need of a new mode of delivery to remove barriers to clinical implementation, which we offer by means of novel transient bio-electric implant system. Overall, this proposal will deliver a new horizon in how we can improve the treatment of patients with peripheral nerve injuries to maximize their functional recovery.