Transcarpal Motor Conduction Velocity: Repeatability and Application in Carpal Tunnel Syndrome.

IF 1.8 Q4 NEUROSCIENCES Annals of Neurosciences Pub Date : 2023-07-01 Epub Date: 2023-01-09 DOI:10.1177/09727531221142399
Pinaki Das, Parasar Ghosh, Subhankar Halder, Subhankar Kumar
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Abstract

Background: Conduction velocity of the short segment of the median motor nerve, across wrist (transcarpal motor conduction velocity (TCMCV)), has been used to increase diagnostic yield in carpal tunnel syndrome (CTS). However, repeatability of this parameter has not been studied till date. It has not been used as an indicator of response to treatment. Using surface stimulation techniques, it is difficult to localize the sites of stimulation of transcarpal segment of median nerve in palm. As a result, small errors in measurements of TCMCV can be magnified and variability of TCMCV may occur on successive measurements. Despite this possible variation, TCMCV can be a useful tool for assessing response to therapy, if its repeatability is assessed and a cut-off value determined for a significant change in nerve conduction velocity.

Purpose: In this study, it was determined whether TCMCV is repeatable. If found to be repeatable, we show a method to determine the cut-off value of the change in this parameter for it to be considered significant.

Methods: Difference between values of TCMCV on successive measurements was obtained in hands of 26 controls. Repeatability of this parameter was determined in this control population following criteria of British Standards Institution. In 19 patients of CTS, treated with intracarpal steroid injection, pre-treatment and post-treatment values of TCMCV, and of symptom severity scale (SSS) and functional status scale (FSS), were obtained at 1, 2, and 3 months after treatment.

Results: Repeat measurements of TCMCV were made in each hand of all controls. After applying criteria of British Standards Institution, to such recordings, TCMCV was found to be repeatable and the cut-off value for significant change determined. According to this cut-off value, 4 patients of CTS showed improvement in TCMCV, with consistent improvement in SSS and FSS. Change in TCMCV corroborated qualitatively with changes in SSS and FSS.

Conclusion: Repeatability of TCMCV can be assessed by criteria of British Standards Institution and a cut-off value determined to use it as an indicator of response to treatment in CTS.

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腕骨运动传导速度:可重复性及其在腕管综合征中的应用。
背景:正中运动神经短段在手腕上的传导速度(经腕运动传导速度(TCMCV))已被用于提高腕管综合征(CTS)的诊断率。然而,到目前为止,还没有对该参数的可重复性进行研究。它还没有被用作对治疗反应的指标。利用表面刺激技术,很难定位手掌正中神经经皮段的刺激部位。因此,TCMCV测量中的小误差可能被放大,并且TCMCV的可变性可能在连续的测量中发生。尽管存在这种可能的变化,但如果评估其可重复性并确定神经传导速度显著变化的临界值,TCMCV可以成为评估治疗反应的有用工具。目的:在本研究中,确定TCMCV是否具有可重复性。如果发现是可重复的,我们展示了一种方法来确定该参数变化的截止值,使其被认为是显著的。方法:对26例正常人的TCMCV进行连续测量,得到TCMCV值之间的差异。根据英国标准协会的标准,在该对照人群中测定了该参数的重复性。在19例接受皮质内类固醇注射治疗的CTS患者中,在治疗后1、2和3个月获得TCMCV的治疗前和治疗后值,以及症状严重程度量表(SSS)和功能状态量表(FSS)。结果:在所有对照组的每只手上重复测量TCMCV。在将英国标准协会的标准应用于此类记录后,发现TCMCV是可重复的,并确定了重大变化的临界值。根据这个临界值,4名CTS患者的TCMCV有所改善,SSS和FSS持续改善。TCMCV的变化与SSS和FSS的变化在质量上得到了证实。结论:TCMCV可通过英国标准协会的标准进行重复性评估,并确定临界值,将其作为CTS治疗反应的指标。
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来源期刊
Annals of Neurosciences
Annals of Neurosciences NEUROSCIENCES-
CiteScore
2.40
自引率
0.00%
发文量
39
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