An Anatomically-Based Model of the Nerves in the Human Foot

Authors: Muhammad Zeeshan UlHaque, Peng Du, Leo K. Cheng, Marc D. Jacobs

Abstract:

Sensory nerves in the foot play an important part in the diagnosis of various neuropathydisorders, especially in diabetes mellitus.However, a detailed description of the anatomical distribution of the nerves is currently lacking. A computationalmodel of the afferent nerves inthe foot may bea useful tool for the study of diabetic neuropathy. In this study, we present the development of an anatomically-based model of various major sensory nerves of the sole and dorsal sidesof the foot. In addition, we presentan algorithm for generating synthetic somatosensory nerve networks in the big-toe region of a right foot model. The algorithm was based on a modified version of the Monte Carlo algorithm, with the capability of being able to vary the intra-epidermal nerve fiber density in differentregionsof the foot model. Preliminary results from the combinedmodel show the realistic anatomical structure of the major nerves as well as the smaller somatosensory nerves of the foot. The model may now be developed to investigate the functional outcomes of structural neuropathyindiabetic patients.

Keywords: Diabetic neuropathy, Finite element modeling, Monte Carlo Algorithm, Somatosensory nerve networks

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1056751

References:

[1] S. Bianchi, and C. Martiloni, "Foot," Ultrasound of Musculoskeletal System,Springer Verilog, pp.835-850, 2007.
[2] J. Craven, "Nerves of the leg and foot," Anaethesia and Intensive Care Medicine, Vol. 8:4, pp. 149-150, 2007.
[3] S. Grimnes, and O. J. Martinsen, Excitable tissues and Bioelectric Signal: Bio impedance and Bioelectricity Basics, San Diego, Calif., London: Academic. 2000, pp. 139- 159.
[4] C. Sylantiev, R. Schwartz, J. Chapman, and A. S. Buchman, "Medial Plantar Nerve Testing Facilities Identification of Polyneuropathy," Muscle and Nerve Vol. 38, pp. 1595-1598, 2008.
[5] J. Y. An, M. S. Park, J. S. Kim, Y. M. Shon, S. J. Lee, Y. I. Kim, K. S. Lee, and B. J. Kim, "Comparison of Diabetic Neuropathy Symptom Score and Medial Plantar Sensory Nerve Conduction Studies in Diabetic Patients showing Normal Routine Nerve Conduction Studies," International Medicine Vol. 47, 1395-1398, 2008
[6] S. J. Oh, K. W. Lee, J. S. Hah, D. E. Kim, M. Demirci, "Lateral Plantar Neuropathy," Muscle and Nerve, Vol. 22, pp. 1234-1238, 1999.
[7] S. J. Oh, H. S. Kim, and B. K. Ahmad, "Electrophysiological Diagnosis of Inter-digital Neuropathy of the foot," Muscle and Nerve, Vol. 7, pp. 218-225, 1984.
[8] S. H. Horowitz and C. Krarup C, "Conduction studies of the normal sural nerve," Muscle and Nerve, Vol. 15, pp. 374-383, 1992.
[9] S. J. Oh, M. Demirci, B. Dajani, A. C. Melo, and G. C. Claussen, "Distal Sensory Nerve Conduction of the Superficial Peroneal Nerve: New Method and its Clinical application," Muscle and Nerve, Vol. 24, pp. 689-694, 2001.
[10] B. Bakotic, "Epidermal Nerve fiber density: an overview," Podiatry management, pp. 141- 152, 2010.
[11] J. Kim, J. Davidson, O. Rohrle, T. Soboleva, and A. Pullan, "Anatomically based lower limb model for electrical stimulation," Biomedical Engineering online, Vol. 6:48, 2007.
[12] S. Chiu, J. Ritchie, R. Rogart, D. Stagg, and Sweeney,"A quantitative description of membrane currents in rabbit myelinated nerve,"The Journal of Physiology,Vol. 292, pp. 149-166, 1979.
[13] H. C. Yeh, "Modeling of Biological Structure," Bulletin of Mathematical Modeling, vol. 41, pp. 893-898, 1979.
[14] V. Olsbo, and L. Waller, "A point process approach to modeling epidermal nerves fiber patterns," Technical report 08-03, pp. 1-20, 2008.
[15] M. H. Tawhai, A. J. Pullan, and P. J. Hunter, "Generation of an anatomically based three dimensional model of the conducting airways," Annals of Biomedical Engineering, Vol. 28, pp. 793-802, 2000.
[16] CMISS: http://www.cmiss.org.
[17] V. Spitzer, M. Ackerman, A. Scherzinger, and D. Whitlock, "The Visible Human Male: a technical report," Journal of American Medical Informatics Ass Vol. 3, No. 2, pp. 118-130, 1996.
[18] Zinc Digitizer: http://www.cmiss.org/cmgui/zinc.
[19] P. L. William, R. Warwick, M. Dyson, and L. H. Bannister, "Neurology: The Tibial Nerve," The Gray-s Anatomy, 37 Editions, pp. 1142 - 1149, 1989.
[20] K. L. Moore, A. M. Ragur, and A. F. Dalley,"Lower Limb,"Clinically oriented anatomy, Edition 6, pp. 614-618,2011.
[21] R. Birch, "The peripheral Nervous system: Gross Anatomy," Surgical disorders of the peripheral nerves. Springer-verlag London limited, pp. 1-41, 2011.
[22] J. A. Gilroy, B. R. MacPhason, L. M. Roses, "Ankle and foot," Atlas of Anatomy, Stuttgart; New York: Thieme, pp. 432-445, 2008.
[23] T. Arakawaa, S. Sekiyab, K. Kumakic, and T. Terashimaa, "Ramification pattern of the deep branch of the lateral plantar nerve in the human foot," Annals of Anatomy, Vol. 187(3):287-96, 2005.
[24] E. Garner, and D. J. Gray, "The innervation of the joint of the foot," The Anatomical Record, Vol. 161 (2), pp. 141-148, 1968.
[25] N. K. Narendiran, R. K. G. Mohandas, S. N. Somayaji and V. Rodriques, "Clinically important anatomical variation of cutaneous branches of superficial peroneal nerve in the foot," The open anatomy journal, Vol. 2, pp 1-4, 2010.
[26] C. Madhavi, B. Isaac, B. Antoniswamy, and S. J. Holla, "Anatomical variations of the cutaneous innervation patterns of the sural nerve on the dorsum of the foot," Clinical anatomy, Vol. 18, pp. 206-209, 2005.
[27] MATHWORKS: http://www.mathworks.com/products/matlab/.
[28] C. Bradley, A. Pullan, and P. Hunter, (1997). "Geometric Modeling of the Human Torso," Annals of Biomedical Engineering, Vol. 27(1), pp. 96-111, 1997.
[29] J. W. Fernandez, K. Mithraratne, S. F. Thrupp, M. H. Tawhai, and P. Hunter, "Anatomically based geometric modelling of the musculoskeletal system and other organs," Biomechanics and Modeling in Mechanobiology, Vol. 2(3), pp.139-155, 2004.
[30] J. W. Fernandez, J. Jor, M. Z. Ul Haque, M. D. Jacobs, P. J. Hunter, and K. Mithraratne, "Nerve excitation in the diabetic foot: An anatomically based model to explore external therapies for mechano-stimulation of sensory nerves," Proceedings of the 23rd Congress of the International Society of Biomechanics, Brussels, 3-7 July 2011.
[31] J. W. Fernandez, M. Z. Ul Haque, P. J. Hunter, and and K. Mithraratne, "Mechanics of the foot - Part 1: Part 1: A continuum framework for evaluating soft tissue stiffening in the pathologic foot," in International Journal for Numerical Methods in Biomedical Engineering; (in press).
[32] C. Y. Wang, J. B. Bassingtwaighte, and L. J. Weissman, "Bifurcating distributive system using Monte Carlo method," Math. Computational modeling, Vol.16 (3), pp. 91-98, 1992.
[33] M. C. Ferreira, S. A. T. Vieira, and V. F. D. Carvalho, "Comparative study of the sensitivity of diabetic lower extremities with and without ulcers suing the PSSDTM," ActaOrtop Bras, Vol. 18(2), pp. 71-4, 2010.
[34] K. Horsfield, and G. Cumming, "Angles of branching and diameters of branches in the human bronchial tree," Bulletin Math. Biophysics, Vol. 29, pp. 245-259, 1967.
[35] O. Shefi, A. Harel, D. B. Chklovskii, E. B. Jacobs, and A. Ayali, "Biophysical constraints on neural branching," Neurocomputing, Vol. 58(60), pp. 487-495, 2004.
[36] O. Shefi, S. Golebowicz, E. B. Jacobs, and A. Ayali, "A two phase growth strategy in cultured neural networks as reflected by the distribution of neurite branching angles," Inc. J Neurobiol, Vol. 62, pp. 361-368, 2005.