Quantification of human upper extremity nerves and fascicular anatomy
Open accessAbstract
INTRODUCTION: In this study we provide detailed quantification of upper extremity nerve and fascicular anatomy. The purpose is to provide values and trends in neural features useful for clinical applications and neural interface device design. METHODS: Nerve cross-sections were taken from 4 ulnar, 4 median, and 3 radial nerves from 5 arms of 3 human cadavers. Quantified nerve features included cross-sectional area, minor diameter, and major diameter. Fascicular features analyzed included count, perimeter, area, and position. RESULTS: Mean fascicular diameters were 0.57 ± 0.39, 0.6 ± 0.3, 0.5 ± 0.26 mm in the upper arm and 0.38 ± 0.18, 0.47 ± 0.18, 0.4 ± 0.27 mm in the forearm of ulnar, median, and radial nerves, respectively. Mean fascicular diameters were inversely proportional to fascicle count. CONCLUSION: Detailed quantitative anatomy of upper extremity nerves is a resource for design of neural electrodes, guidance in extraneural procedures, and improved neurosurgical planning. Muscle Nerve 56: 463-471, 2017.
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The human nerve has many more fascicles than the pre-clinical animal models.
“The human nerve, however, has many more fascicles than the pre-clinical animal models [26].”
From Directed stimulation with interfascicular interfaces for peripheral nerve stimulation (2021) · cites this paper as [26]
The Results (Fascicular Characterization; page unavailable) quantify fascicle counts in human upper-extremity nerves. The Discussion (Implications for Neural Interface Design; page unavailable) says preclinical animal nerve structures differ significantly from human ones, but does not say that animal models have fewer fascicles. (LLM, conf=0.83)
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Cites
Osserman, R. (1978) · Bulletin of the American Mathematical Society · doi:10.1090/s0002-9904-1978-14553-4 · Cited by 885 · see citing works
Navarro, X., Krueger, T. B., Lago, N., Micera, S., Stieglitz, T., & Dario, P. (2005) · Journal of the Peripheral Nervous System · doi:10.1111/j.1085-9489.2005.10303.x · Cited by 845 · see citing works
A neural interface provides long-term stable natural touch perception
Tan, D. W., Schiefer, M. A., Keith, M. W., Anderson, J. R., Tyler, J., & Tyler, D. J. (2014) · Science Translational Medicine · doi:10.1126/scitranslmed.3008669 · Cited by 751 · see citing works
Self-citationChapter 8 Current Techniques and Concepts in Peripheral Nerve Repair
Siemionow, M., & Brzezicki, G. (2009) · International review of neurobiology · doi:10.1016/s0074-7742(09)87008-6 · Cited by 454 · see citing works
Sonography in the diagnosis of carpal tunnel syndrome.
Duncan, I., SULLIVAN, P. P., & Lomas, F. E. (1999) · American Journal of Roentgenology · doi:10.2214/ajr.173.3.10470903 · Cited by 431 · see citing works
THE INTRANEURAL TOPOGRAPHY OF THE RADIAL, MEDIAN AND ULNAR NERVES
SUNDERLAND, S. (1945) · Brain · doi:10.1093/brain/68.4.243 · Cited by 426 · see citing works
Functionally selective peripheral nerve stimulation with a flat interface nerve electrode
Tyler, D. J., & Durand, D. M. (2002) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2002.806840 · Cited by 398 · cited 1× · see citing works
“interior fascicles can guide selection of electrode designs, such as spiral(55,56) or flat interface nerve electrodes (FINEs).(7,53) Penetrating electrodes, such as slowly penetrating interfascicular nerve electrodes (SPINEs),(57) longitudinal intrafascicular electrodes (LIFEs),(58,59) transverse intrafascicular multi…”
BackgroundSelf-citationKempe, L. G. (1979) · Military Medicine · doi:10.1093/milmed/144.9.613 · Cited by 368 · see citing works
Selective Stimulation of Cat Sciatic Nerve Using an Array of Varying-Length Microelectrodes
Branner, A., Stein, R. B., & Normann, R. A. (2001) · Journal of Neurophysiology · doi:10.1152/jn.2001.85.4.1585 · Cited by 358 · see citing works
Selective control of muscle activation with a multipolar nerve cuff electrode
Veraart, C., Grill, W. M., & Mortimer, J. T. (1993) · IEEE Transactions on Biomedical Engineering · doi:10.1109/10.237694 · Cited by 320 · see citing works
Lundborg, G., Myers, R., & Powell, H. (1983) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.46.12.1119 · Cited by 316 · see citing works
Miedany, Y. M. E. (2004) · British journal of rheumatology · doi:10.1093/rheumatology/keh190 · Cited by 267 · see citing works
Internal topography of major nerves of the forearm and hand: A current view
Jabaley, M. E., Wallace, W. H., & Heckler, F. R. (1980) · The Journal Of Hand Surgery · doi:10.1016/s0363-5023(80)80035-9 · Cited by 257 · see citing works
Lago, N., Yoshida, K., Koch, K. P., & Navarro, X. (2007) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2006.886617 · Cited by 227 · see citing works
Sub-clinical entrapment neuropathy in man
Neary, D., Ochoa, J. L., & Gilliatt, R. W. (1975) · Journal of the Neurological Sciences · doi:10.1016/0022-510x(75)90248-8 · Cited by 217 · see citing works
Yeşildağ, A., Kutluhan, S., Sengul, N., et al. (2004) · Clinical Radiology · doi:10.1016/j.crad.2004.03.020 · Cited by 211 · see citing works
Selective stimulation of peripheral nerve fibers using dual intrafascicular electrodes
Yoshida, K., & Horch, K. (1993) · IEEE Transactions on Biomedical Engineering · doi:10.1109/10.243412 · Cited by 208 · see citing works
A nerve cuff technique for selective excitation of peripheral nerve trunk regions
Sweeney, J. D., Ksienski, D. A., & Mortimer, J. T. (1990) · IEEE Transactions on Biomedical Engineering · doi:10.1109/10.55681 · Cited by 196 · see citing works
STRESS-STRAIN PHENOMENA IN HUMAN PERIPHERAL NERVE TRUNKS
Sunderland, S., & BRADLEY, K. C. (1961) · Brain · doi:10.1093/brain/84.1.102 · Cited by 189 · see citing works
The shrinkage of the human brain stem during formalin fixation and embedding in paraffin
Quester, R., & Schröder, R. (1997) · Journal of Neuroscience Methods · doi:10.1016/s0165-0270(97)00050-2 · Cited by 177 · see citing works
Fascicular perineurium thickness, size, and position affect model predictions of neural excitation
Grinberg, Y., Schiefer, M. A., Tyler, D. J., & Gustafson, K. J. (2008) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2008.2010348 · Cited by 145 · cited 1× · see citing works
“Important design parameters include the nerve flattening ratio,(53) fascicular counts, fascicular diameter distribution in each cross-section, and the location of fascicles.(54) These 3 parameters affect the electrical activation of axonal populations within nerves or the recording capabilities.”
BackgroundPolasek, K. H., Hoyen, H. A., Keith, M. W., Kirsch, R. F., & Tyler, D. J. (2009) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2009.2032603 · Cited by 142 · see citing works
Self-citationBiopsy Diagnosis of Peripheral Neuropathy
Bilbao, J. M., & Schmidt, R. E. (2014) · Springer eBooks · doi:10.1007/978-3-319-07311-8 · Cited by 130 · see citing works
Topographic mapping of motor pools onto skeletal muscles
Laskowski, M., & Sanes, J. (1987) · Journal of Neuroscience · doi:10.1523/jneurosci.07-01-00252.1987 · Cited by 130 · see citing works
Selective stimulation of the human femoral nerve with a flat interface nerve electrode
Schiefer, M. A., Polasek, K. H., Triolo, R. J., Pinault, G. C. J., & Tyler, D. J. (2010) · Journal of Neural Engineering · doi:10.1088/1741-2560/7/2/026006 · Cited by 130 · see citing works
Self-citationPeripheral Nerve Repair and Grafting Techniques. A Revrew.
MATSUYAMA, T., Mackay, M., & Midha, R. (2000) · Neurologia medico-chirurgica · doi:10.2176/nmc.40.187 · Cited by 117 · see citing works
Technical advances in ultrasound and MR imaging of carpal tunnel syndrome
Keberle, M., Jenett, M., Kenn, W., et al. (2000) · European Radiology · doi:10.1007/s003300000386 · Cited by 112 · see citing works
A slowly penetrating interfascicular nerve electrode for selective activation of peripheral nerves
Tyler, D. J., & Durand, D. M. (1997) · IEEE Transactions on Rehabilitation Engineering · doi:10.1109/86.559349 · Cited by 108 · see citing works
Self-citationGustafson, K. J., Pinault, G. C. J., Neville, J. J., Syed, I., Jr, J. A. D., Jean-Claude, J., & Triolo, R. J. (2009) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2008.08.0097 · Cited by 107 · see citing works
Nerve cross‐sectional area in extremes of age
Cartwright, M. S., Mayans, D. R., Gillson, N., et al. (2012) · Muscle & Nerve · doi:10.1002/mus.23718 · Cited by 105 · see citing works
Interfaces with the Peripheral Nerve for the Control of Neuroprostheses
del Valle, J., & Navarro, X. (2013) · International Review of Neurobiology · doi:10.1016/b978-0-12-420045-6.00002-x · Cited by 105 · see citing works
Topographical distribution of motor fascicles in the sciatic‐tibial nerve of the rat
Badia, J., Pascual‐Font, A., Vivó, M., Udina, E., & Navarro, X. (2010) · Muscle & Nerve · doi:10.1002/mus.21652 · Cited by 98 · see citing works
Fisher, L. E., Tyler, D. J., Anderson, J. S., & Triolo, R. J. (2009) · Journal of Neural Engineering · doi:10.1088/1741-2560/6/4/046010 · Cited by 89 · see citing works
Self-citationKundu, A., Harreby, K. R., Yoshida, K., Boretius, T., Stieglitz, T., & Jensen, W. (2014) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2013.2267936 · Cited by 83 · see citing works
Intrafascicular stimulation of monkey arm nerves evokes coordinated grasp and sensory responses
Ledbetter, N. M., Ethier, C., Oby, E. R., Hiatt, S. D., Wilder, A. M., Ko, J. H., Agnew, S. P., Miller, L. E., & Clark, G. A. (2013) · Journal of Neurophysiology · doi:10.1152/jn.00688.2011 · Cited by 69 · see citing works
Different volume changes of cerebral cortex and white matter during histological preparation.
Kretschmann, H., Tafesse, U., & Herrmann, A. (1982) · PubMed · Cited by 69 · see citing works
Levinthal, R., Brown, W. J., & Rand, R. W. (1977) · Journal of neurosurgery · doi:10.3171/jns.1977.47.5.0744 · Cited by 68 · see citing works
Fascicular topography of the median nerve: A computer based study to identify branching patterns
Watchmaker, G. P., Gumucio, C. A., Crandall, R. E., Vannier, M. W., & Weeks, P. M. (1991) · The Journal Of Hand Surgery · doi:10.1016/s0363-5023(10)80013-9 · Cited by 66 · see citing works
Central course of digital axons within the median nerve of macaca mulatta
Brushart, T. M. E. (1991) · The Journal of Comparative Neurology · doi:10.1002/cne.903110203 · Cited by 59 · see citing works
The internal anatomy of the median nerve in the region of the elbow
Gunther, S. F., DiPasquale, D., & Martin, R. (1992) · The Journal Of Hand Surgery · doi:10.1016/0363-5023(92)90310-l · Cited by 58 · see citing works
Fascicular anatomy and surgical access of the human pudendal nerve
Gustafson, K. J., Zelkovic, P. F., Feng, A. H., Draper, C. E., Bodner, D. R., & Grill, W. M. (2005) · World Journal of Urology · doi:10.1007/s00345-005-0032-4 · Cited by 55 · see citing works
Transcardial perfusion versus immersion fixation for assessment of peripheral nerve regeneration
Kasukurthi, R., Brenner, M. J., Moore, A. M., et al. (2009) · Journal of Neuroscience Methods · doi:10.1016/j.jneumeth.2009.08.019 · Cited by 54 · see citing works
Chow, J. A., Beek, A. L. V., Bilos, Z. J., Meyer, D. L., & Johnson, M. (1986) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-198668020-00013 · Cited by 54 · see citing works
Schiefer, M. A., Tyler, D. J., & Triolo, R. J. (2012) · Journal of Computational Neuroscience · doi:10.1007/s10827-011-0381-5 · Cited by 53 · see citing works
Self-citationKent, A. R., & Grill, W. M. (2013) · Journal of Neural Engineering · doi:10.1088/1741-2560/10/3/036010 · Cited by 52 · see citing works
Effect of Serum Hyperosmolality on Morphometry of Healthy Human Sural Nerve
Dyck, P. J. B., Low, P. A., SPARKS, M. F., et al. (1980) · Journal of Neuropathology & Experimental Neurology · doi:10.1097/00005072-198005000-00005 · Cited by 49 · see citing works
THE ADIPOSE TISSUE OF PERIPHERAL NERVES
Sunderland, S. (1945) · Brain · doi:10.1093/brain/68.2.118 · Cited by 38 · see citing works
A Practical Approach to Nerve Grafting in the Upper Extremity
Slutsky, D. J. (2005) · Atlas of the Hand Clinics · doi:10.1016/j.ahc.2004.09.005 · Cited by 36 · see citing works
Kato, H., Minami, A., Kobayashi, M., et al. (1998) · The Journal Of Hand Surgery · doi:10.1016/s0363-5023(05)80465-4 · Cited by 33 · see citing works
Enlargement of the ulnar nerve behind the medial epicondyle
Chang, K. S. F., Low, W. D., Chan, S. T., et al. (1963) · The Anatomical Record · doi:10.1002/ar.1091450205 · Cited by 25 · see citing works
Optimizing nerve cuff stimulation of targeted regions through use of genetic algorithms
Brill, N., & Tyler, D. J. (2011) · doi:10.1109/iembs.2011.6091438 · Cited by 24 · see citing works
Self-citationFascicular analysis at perineurial level of the branching pattern of the human common peroneal nerve
Kudoh, H., & Sakai, T. (2007) · Anatomical Science International · doi:10.1111/j.1447-073x.2007.00184.x · Cited by 20 · see citing works
Mani, B., Sarawagi, R., & Cherian, R. A. (2011) · Journal of Medical Imaging and Radiation Oncology · doi:10.1111/j.1754-9485.2010.02225.x · Cited by 19 · see citing works
Charged by GSK investment, battery of electroceuticals advance
Sinha, G. (2013) · Nature Medicine · doi:10.1038/nm0613-654 · Cited by 18 · see citing works
Applied anatomy of the lingual nerve: Relevance to dental anaesthesia
Tan, V. L., Andrawos, A., Ghabriel, M. N., et al. (2013) · Archives of Oral Biology · doi:10.1016/j.archoralbio.2013.12.002 · Cited by 18 · see citing works
Nielsen, K. K., Andersen, C. B., & Kromann‐Andersen, B. (1995) · The Journal of Urology · doi:10.1016/s0022-5347(01)66722-3 · Cited by 10 · see citing works
Ide, H. (1930) · The Journal of Comparative Neurology · doi:10.1002/cne.900510210 · Cited by 9 · see citing works
Verhoef, S. P. M., van Dijk, P., & Westerterp, K. R. (2012) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2012.03.001 · Cited by 8 · see citing works
The Ulnar Nerve at the Elbow: An Anatomic, Sonographic, and Histology Comparison
Thoirs, K. A., Scutter, S., & Wilkinson, M. (2003) · Journal of diagnostic medical sonography · doi:10.1177/8756479302239546 · Cited by 5 · see citing works
Velde, K., Ross, M. W., Orsini, J. A., Parente, E. J., Foley, B. T., Richardson, D. W., & Miselis, R. R. (2004) · Journal of Investigative Surgery · doi:10.1080/08941930490446937 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [4]Tukey JW Exploratory data analysis (limited preliminary edition) Reading, MA Addison-Wesley 1970
- [39]Gustafson KJ Pinault GC Neville JJ Syed I Davis JA Jr Jean-Claude J Fascicular anatomy of human femoral nerve: implications for neural prostheses using nerve cuff electrodes J Rehabil Res Dev 2009 46 973 20104420 PMC2967182
- [42]Kundu A Harreby K Jensen W Comparison of median and ulnar nerve morphology of Danish landrace pigs and Gottingen mini pigs Annual Conference of the International Functional Electrical Stimulation Society 2012
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Tan, D. W., Schiefer, M. A., Keith, M. W., Anderson, J. R., & Tyler, D. J. (2015) · Journal of Neural Engineering · doi:10.1088/1741-2560/12/2/026002 · Cited by 175 · see citing works
Self-citationTissue-engineered peripheral nerve interfaces
Spearman, B. S., Desai, V. H., Mobini, S., McDermott, M. D., Graham, J. B., Otto, K. J., Judy, J. W., & Schmidt, C. E. (2018) · Advanced Functional Materials · doi:10.1002/adfm.201701713 · Cited by 96 · see citing works
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Self-citationDirected stimulation with interfascicular interfaces for peripheral nerve stimulation
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“The human nerve, however, has many more fascicles than the pre-clinical animal models [26].”
BackgroundSelf-citation
- Authors
- Brill, N. A., & Tyler, D. J.
- Affiliations
- Case Western Reserve University (US)
- Louis Stokes Cleveland VA Medical Center (US)
- Corresponding author
- Tyler, Dustin J.
- ORCID
- Tyler, Dustin J.
- Venue
- Muscle & Nerve
- Publisher
- Wiley
- Published
- 2017-04
- Volume
- 56
- Issue
- 3
- Pages
- 463-471
- ISSN
- 0148-639X (ISSN-L)
- 1097-4598
- PMC
- PMC5712902
- OpenAlex
- W2560953689
- Cited by
- 64
- References
- 60
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 11 · 2022: 10 · 2021: 5 · 2020: 8 · 2019: 6 · 2018: 2 · 2017: 3 · 2015: 1
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- Locations
- Muscle & Nerve (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Defense Advanced Research Projects Agency
- National Institutes of Health (NIH R21NS058705, 2R01NS053603, FT32EB004314)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Undergraduate Neuroscience Education and Research
- Keywords
- upper extremity nerves, ulnar nerve, median nerve, radial nerve, nerve cross-sectional area, neural electrodes
- MeSH terms
- Arm, Cadaver, Female, Humans, Male, Median Nerve, Peripheral Nerves, Radial Nerve, Ulnar Nerve, Upper Extremity
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