Diffusion MRI as A Biomarker for Monitoring Recovery After Surgical Repair of Traumatic Peripheral Nerve Injuries: A Longitudinal Case Series

Diffusion MRI as A Biomarker for Monitoring Recovery After Surgical Repair of Traumatic Peripheral Nerve Injuries: A Longitudinal Case Series | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Diffusion MRI as A Biomarker for Monitoring Recovery After Surgical Repair of Traumatic Peripheral Nerve Injuries: A Longitudinal Case Series Isaac V. Manzanera Esteve, Barite Gutama, Ronald M. Cornely, Ling Yan, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9282445/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 11 You are reading this latest preprint version Abstract After transection, peripheral nerve regeneration requires repair surgery in a timely manner. Unfortunately, up to 40% of peripheral nerve repairs fail to achieve functional recovery. Patients with failed peripheral nerve repairs require additional surgical interventions, but current methods detecting clinical failure offer limited information, resulting in delayed management and suboptimal outcomes. Diffusion tensor imaging can serve as a biomarker of nerve regeneration; however, the complex spatial and temporal changes along the distal segment of the nerve remains challenging to interpret. To address this, we applied the Gompertz function to automatically characterize these changes and capture the nonlinear dynamics of recovery following nerve trauma. Severe peripheral nerve injuries of the ulnar or median nerve were analyzed in this study. Medical Research Council sensory grades representing absent to normal sensation, motor grades representing visible muscle contraction to normal strength and diffusion tensor imaging scans were performed longitudinally over twelve months postoperatively. Values of fractional anisotropy closely matched clinical evaluations and levels of nerve recovery. We provided an automated, noninvasive approach for characterizing recovery and reducing user-dependent variability in interpretation. These results support Fractional Anisotropy as a potential biomarker to monitor nerve recovery after surgical repair, potentially guiding clinical decisions for additional interventions. Health sciences/Biomarkers Health sciences/Medical research Health sciences/Neurology Biological sciences/Neuroscience Full Text Additional Declarations No competing interests reported. Supplementary Files 20260331Supplementary.docx Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 15 May, 2026 Reviews received at journal 15 May, 2026 Reviews received at journal 02 May, 2026 Reviewers agreed at journal 23 Apr, 2026 Reviewers agreed at journal 21 Apr, 2026 Reviewers agreed at journal 20 Apr, 2026 Reviewers invited by journal 20 Apr, 2026 Editor assigned by journal 20 Apr, 2026 Editor invited by journal 15 Apr, 2026 Submission checks completed at journal 10 Apr, 2026 First submitted to journal 10 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9282445","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":628173348,"identity":"2fad00e5-1261-49ec-9e6e-4bb67ec602c0","order_by":0,"name":"Isaac V. 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Unfortunately, up to 40% of peripheral nerve repairs fail to achieve functional recovery. Patients with failed peripheral nerve repairs require additional surgical interventions, but current methods detecting clinical failure offer limited information, resulting in delayed management and suboptimal outcomes. Diffusion tensor imaging can serve as a biomarker of nerve regeneration; however, the complex spatial and temporal changes along the distal segment of the nerve remains challenging to interpret. To address this, we applied the Gompertz function to automatically characterize these changes and capture the nonlinear dynamics of recovery following nerve trauma.\u003c/p\u003e \u003cp\u003eSevere peripheral nerve injuries of the ulnar or median nerve were analyzed in this study. 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