Effect of Single Perineural Injection of Platelet Rich Plasma on Nerve Function in Hansen’s Disease With Truncal Neuropathy: An Interventional Study

TL;DR

This study shows that injecting platelet-rich plasma near nerves may help improve nerve function in people with Hansen’s disease.

Contribution

The study introduces perineural PRP injection as a novel, safe treatment for neuropathy in Hansen’s disease.

Findings

PRP injection improved sensory discrimination, hand strength, and foot muscle power in patients.

Nerve conduction improved with increased amplitude and faster conduction velocity after 12 weeks.

No serious adverse effects were observed, with only minor injection site pain reported.

Abstract

Background

A large number of people with leprosy suffer from neuropathy and its associated complications. Platelet-rich plasma (PRP) is a simple therapy by which concentrations of natural growth factors are obtained that accelerate axonal recovery. With the intent to find an effective option for the improvement of neuropathy in Hansen’s disease, perineural injection of autologous PRP was used in this study. This study aims to investigate the potential therapeutic efficacy of perineural injection of PRP in alleviating the effects of neuropathy associated with Hansen's disease.

Methodology

A cohort of 30 patients with Hansen's disease experiencing ulnar or common peroneal neuropathy were administered a single perineural injection of autologous PRP (1 ml). Evaluations were conducted by a group of three investigators at baseline, six, and twelve weeks, encompassing two-point sensory discrimination, total sensory impairment area, nerve conduction study (NCS) parameters, Screening Activity Limitation and Safety Awareness Scale (SALSA) score, hand function, and extrinsic foot muscle power. Adverse effects were meticulously recorded.

Results

Significant improvements were observed in two-point discrimination, sensory loss area, hand dynamometry scores, and foot muscle power (p<0.05). The SALSA score exhibited a significant enhancement at the 12-week mark. Motor NCS demonstrated a substantial increase in amplitude, while sensory NCS revealed a noteworthy decrease in latency and an increase in conduction velocity at the 12-week assessment. No adverse effects were documented, aside from transient pain at the injection site for one or two days.

As the follow-up period in this study was 12 weeks, the long-term effects of peri-neural injection of PRP on Hansen’s neuropathy could not be assessed. COVID-19 also had an impact on the follow-up visits of the participants, resulting in three patients being lost to follow-up.

Conclusion

This study suggests that perineural injection of autologous PRP could be a safe and promising therapeutic option for Hansen's neuropathy. However, further research and long-term follow-up studies are imperative to establish its sustained efficacy.

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