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Article: Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies

TitleScreening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
Authors
KeywordsAxonal degeneration
Carpal tunnel syndrome
Demyelination
Diagnostic accuracy
Nerve conduction studies
Issue Date2019
PublisherJournal of Visualized Experiments. The Journal's web site is located at http://www.jove.com
Citation
Journal of Visualized Experiments, 2019, n. 143, article no. e58681 How to Cite?
AbstractAxonal degeneration, indicative of surgical decompression, may coexist in carpal tunnel syndrome (CTS) as the disease progresses. However, the current diagnostic and severity gradation system cannot clearly indicate its coexistence, resulting in confusion of appropriate treatment prescription. There are also constraints in conventional methods for differentiation as well. This study aims at introducing an innovative, efficient, and quick screening protocol to differentiate axonal degeneration associated with CTS, using ultrasound and nerve conduction studies (NCS). It starts by using NCS to perform orthodromic stimulation at the wrist, to obtain the sensory conduction of the median and the ulnar nerves respectively. Meanwhile, the motor conduction of the median nerve is collected by stimulating the palm, wrist, and elbow, followed by the stimulation of the ulnar nerve at the wrist, below and above the elbow. Then, an ultrasound assessment is performed, using a linear array transducer, with cross-sectional area (CSA) and perimeter (P) at the wrist and at the one-third distal forearm calipered. Ratios (R-CSA, R-P) and changes from wrist to one-third distal forearm (ΔCSA and ΔP) are calculated according to a standard format. Potential axonal degeneration coexisting in CTS will be screened according to the criteria of NCS and cut-off values of ultrasound measurements established in a previous study. In terms of its noninvasiveness, low cost, convenience, and efficiency, it is easy to apply ultrasound complimentarily in clinical practice to prescreen patients with potential coexisting axonal degeneration. Nevertheless, the ultrasonographic imaging cannot directly reflect axonal degeneration. It still relies on conventional but invasive methods such as electromyography (EMG) and biopsy for confirmation if needed.
Persistent Identifierhttp://hdl.handle.net/10722/278218
ISSN
2019 Impact Factor: 1.163
2015 SCImago Journal Rankings: 0.451

 

DC FieldValueLanguage
dc.contributor.authorDeng, X-
dc.contributor.authorChau, LHP-
dc.contributor.authorChiu, SY-
dc.contributor.authorLeung, KP-
dc.contributor.authorHu, Y-
dc.contributor.authorIp, WY-
dc.date.accessioned2019-10-04T08:09:46Z-
dc.date.available2019-10-04T08:09:46Z-
dc.date.issued2019-
dc.identifier.citationJournal of Visualized Experiments, 2019, n. 143, article no. e58681-
dc.identifier.issn1940-087X-
dc.identifier.urihttp://hdl.handle.net/10722/278218-
dc.description.abstractAxonal degeneration, indicative of surgical decompression, may coexist in carpal tunnel syndrome (CTS) as the disease progresses. However, the current diagnostic and severity gradation system cannot clearly indicate its coexistence, resulting in confusion of appropriate treatment prescription. There are also constraints in conventional methods for differentiation as well. This study aims at introducing an innovative, efficient, and quick screening protocol to differentiate axonal degeneration associated with CTS, using ultrasound and nerve conduction studies (NCS). It starts by using NCS to perform orthodromic stimulation at the wrist, to obtain the sensory conduction of the median and the ulnar nerves respectively. Meanwhile, the motor conduction of the median nerve is collected by stimulating the palm, wrist, and elbow, followed by the stimulation of the ulnar nerve at the wrist, below and above the elbow. Then, an ultrasound assessment is performed, using a linear array transducer, with cross-sectional area (CSA) and perimeter (P) at the wrist and at the one-third distal forearm calipered. Ratios (R-CSA, R-P) and changes from wrist to one-third distal forearm (ΔCSA and ΔP) are calculated according to a standard format. Potential axonal degeneration coexisting in CTS will be screened according to the criteria of NCS and cut-off values of ultrasound measurements established in a previous study. In terms of its noninvasiveness, low cost, convenience, and efficiency, it is easy to apply ultrasound complimentarily in clinical practice to prescreen patients with potential coexisting axonal degeneration. Nevertheless, the ultrasonographic imaging cannot directly reflect axonal degeneration. It still relies on conventional but invasive methods such as electromyography (EMG) and biopsy for confirmation if needed.-
dc.languageeng-
dc.publisherJournal of Visualized Experiments. The Journal's web site is located at http://www.jove.com-
dc.relation.ispartofJournal of Visualized Experiments-
dc.rightsCopyright © 2019 Journal of Visualized Experiments.-
dc.subjectAxonal degeneration-
dc.subjectCarpal tunnel syndrome-
dc.subjectDemyelination-
dc.subjectDiagnostic accuracy-
dc.subjectNerve conduction studies-
dc.titleScreening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies-
dc.typeArticle-
dc.identifier.emailLeung, KP: kpleungb@hkucc.hku.hk-
dc.identifier.emailHu, Y: yhud@hku.hk-
dc.identifier.emailIp, WY: wyip@hkucc.hku.hk-
dc.identifier.authorityHu, Y=rp00432-
dc.identifier.authorityIp, WY=rp00401-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.3791/58681-
dc.identifier.pmid30688308-
dc.identifier.scopuseid_2-s2.0-85060609992-
dc.identifier.hkuros306520-
dc.identifier.issue143-
dc.identifier.spagearticle no. e58681-
dc.identifier.epagearticle no. e58681-
dc.publisher.placeUnited States-

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