Talk:Denervation

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Gilbertoenriquez, Vschloegel, Andrewh998 (article contribs).

The goal of our edits or improvements to this wikipedia page is to expand upon the very limited definition that existed on the page before. Since the scope of denervation is so large, we decided to begin with a more general approach and discuss the causes of nerve loss and some histological/physiological differences in the denervated tissue. Vschloegel (talk) 21:25, 31 March 2016 (UTC)

I've tagged this article as it contains only the meaning of denervation and some usage examples. Expansion should include clinical significance, cite medical references, and be written for a general audience rather than medical professionals. twirligig_T to^the C 04:58, 27 October 2015 (UTC)

Primary Review : Overall the article is well written. However, one of the sentences in the introduction “If this nerve supply is part of the neuronal communication to a function in the body then denervation can lead to altered or a loss of physiological functioning” was a little confusing. Maybe it could be worded in a clearer way? For the sentence “the three main causes of a loss of nerve supply is,” “is” should be replaced with “are.” Also for the phrase, “Home-based Functional Electrical Stimulation have,” “have” should be replaced with “has.” It follows the manual style of guidelines and the layout is correct. The article meets the criteria for “verifiable with no original research.” All of the facts which were not common knowledge were followed by a citation. The source I looked at was ^ Jump up to: a b Midrio, Menotti (2006-08-03). "The denervated muscle: facts and hypotheses. A historical review". European Journal of Applied Physiology 98 (1): 1–21. doi:10.1007/s00421-006-0256-z. ISSN 1439-6319. Because this was a review of previously done studies, this article met the criteria for a secondary source. The information in this article is accurately reflected in the Wikipedia page and is cited correctly. However, I feel that there is additional information in this article that could be included in the Wikipedia page. For example, I thought that the idea that denervation caused slower contractions in fast and slow muscle could be included. Another useful fact was that denervation results in a decrease in tension for the twitch and more so for the tetanic tension. This this article did a really good job of discussing the different causes and physiological differences. However, there was no separate section for discussion of histological differences, which was one of the goals stated by the group. The article was very neutral. It presented only the facts in a logical way and did not express opinions. Lastly, there are no pictures in this article. It may be helpful to include a picture of one of the surgical procedures in the Surgical Procedures section, such as sympathectomy or a rhizotomy. This is because readers may be unfamiliar with these procedures. Hmarie18 (talk) 21:04, 16 April 2016 (UTC)

Secondary Review

First, there are several topics that you mentioned on leading paragraph regarding denervation, but they are not explained. For example, you mentioned briefly about harmful side effect of denervation: increased risk of infection and tissue dysfunction. It would be necessary to understand risk of having denervation surgery. Also, there must be some important facts about denervation such as any early symptoms and history. Topic titles should be changed. For "Reinnervation possibilities", I think it would be better to change it to treatment, since what is mentioned under reinnervation possibilities is specifically explained about how to treat. The title almost sound like there could be a natural cure without any treatment. I think "Physiological differences" is a great paragraph. Again, this should be mentioned briefly on the leading paragraph. --Jungi0714 (talk) 22:44, 17 April 2016 (UTC)

Primary Review

Hi, I've broken down my review into the good article criterion we are supposed to focus on in order to make editing easier for you. Overall, this is a great article filled with information. It is clear that your group did a lot of reading and research.
Well written: In the first paragraph, the first sentence is rather awkward, as it uses "nerve supply" twice, and there should be a comma after "additionally." Your section on Injury/Disorders is very well-written. It flows well from each idea and you use simple words to describe the processes. The first paragraph for surgical procedures has very repetitive wording, especially the last sentence, which is also long and hard to follow. In the second paragraph of the same section, instead of saying "or more specifically the spinal cord," just say "in the spinal cord." It sounds more neutral & less fluffy. The second paragraph in physiological differences has awkward structuring. For example, instead of saying, "Within these muscles is also a... " you could say, "These muscles also exhibit..." Essentially, try to be as concise as possible when it comes to sentence structure. In the MRI paragraph, it should say "diagnoses," not "diagnosis." Also, choose a different word for "propagation" and "ensuing." In the last paragraph of the Physiological differences section, there are several commas missing. In the Reinnervation possibilities section, you should link "Functional Electrical Stimulation." In the last paragraph, you say "in vivo" several times--find a synonym.
Verifiable with no original research: It looks like almost all of your sources are reviews, nor was there any focus on a specific researcher's work, which is great. I randomly chose reference #11 (the MRI & US reference) and it looks like you were able to properly summarize what the review authors said. That being said, the article was a great pick for a review of various nerve dysfunction imaging. It would be great if you could use any of those images for your article (maybe check to see if similar ones are in Wikipedia's pool?)
Broad in coverage: Sometimes the article was a little too broad. When you mention renal denervation in the first paragraph, it's great that you linked it, but you should write a quick definition for what it is so that people don't have to click on it unless they're very interested in renal denervation. The same goes for neurapraxia, axonotmesis, and neurotmesis. It's easier for the reader to get a quick definition from you than to have to keep clicking on these links. Other than that, you have a great array of topics pertaining to denervation. If possible, maybe talk a bit more about prognosis. Besides reinnervation possibilities, what lifestyle changes does a person with denervation have to encounter? Are there any pharmaceuticals to help with any side effects or pain?
Neutral: As previously mentioned, your article is generally neutral. There are just a couple sentences (listed above) that should be rephrased to remain more objective/dry and less fluffy.
Here is a list of potential images: Any images of cells/tissue affected by denervation, MRI or ultrasonography comparisons of healthy vs. denevation patients, chemical structure of Acetylcholine, Functional Electrical Stimulation, myogenic cells. It's important to have some sort of image because people with no scientific background could benefit from any visuals to help them understand more about the topic. If you have any questions about this review, please feel free to contact me. Sarapardej (talk) 04:39, 19 April 2016 (UTC)

Secondary Review

I really support how you divided the “Causes” into “injury/disorders” and “surgical procedures” because there is so much information for both of them. Also, make sure to look for grammatical errors. I would suggest adding pictures on your page and specifically when you talk about the causes or results of denervation. An example of this would be a picture of the results of, “Magnetic resonance imaging (MRI) and high-resolution ultrasonography (US) are two clinical imaging examinations performed to classify the different diagnosis.”

Egaietto13 (talk) 01:34, 20 April 2016 (UTC)

Secondary Review

This is an very informative and well written article. Some changes that I would suggest is adding some pictures, so when someone is reading this they are able to visualize it. Additionally, in your intro paragraph you say "Denervation can be caused by injury or be a symptom of a disorder" is there a particular disorder that causes denervaation, if so, you may want to quickly mention it. Also, in the reinnervation possibilities section you talk about home-based Functional Electrical Stimulation, you might want to explain what that is because the reader may not know what that is. Overall, great job! Kmorun (talk) 01:47, 20 April 2016 (UTC)

Secondary Review

Over all I think this is a great page. The information presented is clear and supported by numerous secondary sources. Because you found so much information about this topic, if possible, it might be beneficial to add a history, syndromes or etiology section to your page. Additionally, it would be helpful to the reader if some imagery was added to this page as well. Nickcallard (talk) 14:02, 20 April 2016 (UTC)Nicholas Callard

Primary Review

Overall, I believe that you have a great start in defining and expanding denervation. I believe you have solid information regarding the background causes of denervation, as well as interesting information about the application of denervation. I have split my analysis into the five different review conditions.

Well Written: Your page is written pretty well, but I do have some suggestions regarding wording and organization. Starting with the causes section, “Amyotrophic lateral sclerosis” shouldn’t be capitalized as it is in the middle of a sentence. It also might be beneficial to put “ALS” in parentheses, as this is a fairly recognizable acronym, thus it might help readers understand/connect to amyotrophic lateral sclerosis so they don’t have to follow the link to realize it is ALS. Other grammatical things to look for include: adding a comma immediately following the word sympathectomy (surgical procedures section), changing “in clinical and experimental studies there is an observed increase” to “Clinical and experimental studies have shown excitability… (physiological differences section), not capitalizing acetylcholine when its mid-sentence (“upon injection…; end of physiological differences section).

In regards to organization, one of your headers titled “injury/disorders” could be split up.  I believe it looks more professional and helps the readers categorize the information you tell them if you separate “injury” and “disorders” into different subheadings.  If you did this, “disorders” would probably go after your first paragraph in the “Injury” section and before you say “Denervation processes have strong association…”.  In addition, you may want to take a look at moving the “physiological differences” section before you discuss surgical procedures.  This is because “surgical procedures” seems to be more of an application section (which would naturally fall later in the article), while “physiological differences” seems to be more of a prognosis section.  

I also have some other general suggestions that may help make your article even more informative. In your “Injury/Disorders” section, you state the three types of nerve injury, however I wasn’t really able to understand what they are and how they differed. Granted, you did explain that they are distinguished by severity, but which ones specifically are more severe than the rest? I liked how you linked these three types of nerve injury to their respective pages, but I think it would be good if you had a short description of each. These descriptions wouldn’t deviate from your topic significantly if you briefly summarized the how denervation results due to each type of nerve injury and/or provide an example that causes the nerve injury (ex. for neurapraxia, you could say “it is the least severe form of nerve injury that causes denervation. Blunt force causes a blockage of action potential transduction, thus denervation results because…” etc.). In your physiological differences section, I was a little confused about the entrapment and compressive, and non-entrapment neuropathies. I think you do a good job in explaining entrapment/compressive neuropathies, but I don’t see where you discuss non-entrapment neuropathies. Are there any examples of non-compressive neuropathies? How do they arise vs. entrapment neuropathies? In the reinnervation possibilities section, you mention a treatment called “Home-based Functional Electrical Simulation”. I think it would be beneficial to your article if you put in a sentence or two about the process/theory of this treatment, how it goes about reinnervating or “rescuing” atrophic muscles, etc., and/or you could link your description to functional electrical stimulation https://en.wikipedia.org/wiki/Functional_electrical_stimulation so that people can further research how one can potentially heal from denervation.

Verifiable with no original research: All of your information is verifiable. You do not leave out any citations in your causes, physiological difference and reinnervation possibilities sections. Each paragraph has at least one source, so good job with finding information and constructing it into an article. I briefly skimmed each source that you used and although I was not able to access some of them, the ones that I viewed appeared to be reviews and not primary research articles. The source that I analyzed more in-depth was “Persistent muscle fiber regeneration in long term denervation. Past, present, future”. This article was an indeed a review, as it compiled information, data, and images from multiple different sources. The main findings of this review was that there is long term survival of denervated muscle fibers in mammals (specifically rats and humans, with human fibers lasting up to 6 years), and that home-based FES trained muscles showed regenerative events, thus enabling the rescue of severely atrophied muscle fibers. That said, I believe your article summarizes this information pretty well in the first paragraph of “Reinervation possibilities”. However, if you wish to further describe the actual process of stimulation, page 88 of this review summarizes the new equipment used to improve muscle recovery. You could add this information into your first paragraph of the “reinnervation” section if you think it fits in.

Broad in Coverage: I feel like denervation is general process in it of itself. That said, I think you cover a decent range with this topic. You talk about the injuries and the disorders that cause denervation, uses of denervation from a surgical standpoint, physiological effects of denervation on muscle fibers, and muscle recover after denervation. However, I do not see where you address your goal of discussing the histological differences in denervated tissue. If you still would like to explain/show histological imaging, I think the review I analyzed, “Persistent muscle fiber regeneration in long term denervation. Past, present, future”, has some good images/data that could be used for discussion of denervated muscle tissue.

Neutral: I do not see or feel any sort of bias in the article. Your wording is informative and fairly concise. Maybe look at some of the grammatical things that were mentioned in this review or other reviews to continue to improve your article. Otherwise, good job.

Illustrated: There is no pictures or images in your article. Like I said before, if you want to talk about histological imaging, you can look at the source “Persistent muscle fiber regeneration in long term denervation. Past, present, future” for some ideas. However, I believe photos of human muscle atrophy as a result of denervation would be fantastic for your article if they can be found. I suggest looking for a photograph of a normal human muscle (i.e. a leg—the quadriceps seem to be the muscle most discussed with respect to denervation) and place it next to a photograph of the same muscle that is in an atrophied state due to denervation. If you cannot find a photograph of denervation in a human, you can look for it in other organisms. This would be great for your article if you are able to find these types of images to show that the effects of denervation are real. If found, these images would probably either go in the introduction or in your “physiological differences section” where you describe muscular atrophy. If you cannot find these images, maybe there is an image of a healthy nerve that could be put alongside a nerve that has deteriorated or had been damaged due to neurapraxia, axonotmesis, neurotmesis, entrapment/compressive neuropathies and/or non-entrapment neuropathies. These images could be placed in the “physiological differences section”, or in the “injury/disorders” section.

Conclusion: Overall, I think your article is good. You have solid information, an interesting topic, and quality sources. Look over some of the organizational/grammatical things mentioned and maybe research some images if possible. If you want, I’d be happy to look over it another time. Feel free to message me with any questions.ADRUCK22 (talk) 04:00, 21 April 2016 (UTC)