Median Motor Nerve Conduction Velocity Research Articles

ЕФЕКТИВНІСТЬ ПСИХІЧНОЇ САМОРЕГУЛЯЦІЇ, ЕМОЦІЙНА СТІЙКІСТЬ І СТРЕС-УРАЗЛИВІСТЬ СПОРТСМЕНІВ-ТЕНІСИСТІВ ЗА МЕТОДИКОЮ ВИБОРУ КОЛЬОРІВ У ЗВ'ЯЗКУ З ФУНКЦІОНАЛЬНИМ СТАНОМ НЕРВОВО-М'ЯЗОВОГО АПАРАТУ

The relationship among electromyographic and psychological indices in athletes performing in tennis was found. Higher motor nerve conduction velocity response corresponded to a lower level of stress, a higher level of effectiveness of mental self-regulation and adaptability, a higher level of emotional stability. Statistically significant positive correlation between autonomic nervous system balance coefficient (by M.Lusher's test) and median motor nerve conduction velocity was revealed. This might be due to functional state of cardiovascular system. The obtained results can be used to correct the training process of young athletes.

Study of motor nerve conduction velocity in patients of thyroid dysfunction in central India

Background: Hypothyroidism is a clinical disorder due to the deficiency of thyroid hormone. This hormone is a key regulator of cellular metabolism in our body. Hypothyroid state is usually asymptomatic, symptoms in the early phase while associated with a number of symptoms later affecting skin, heart, endocrine, brain, and nerves. Hyperthyroidism is less commonly associated with neuromuscular disorders and polyneuropathy. Objective: The objective of the study was to assess motor nerve functions in thyroid dysfunction patients. Study Design: This study design was a comparative study. Population: The study population was clinically diagnosed thyroid dysfunction patients and healthy individuals. Sample Size: The sample size was 82 (41 each in cases and control group). Materials and Methods: Neuro Perfect 2 – Channel EMG NCV EP, Medicaid, instrument was used. Parameters such as distal motor latency (DML), compound motor action potential CMAP amplitude, conduction velocity (CV) for motor nerve, and F-wave minimum latency of motor nerve were recorded and analyzed. Results: The median motor nerve CV (MNCV) and F-minimum latency were significantly reduced in cases as compared to controls on the right side (P

The electrophysiological response to immunoglobulin therapy in chronic inflammatory demyelinating polyneuropathy.

To characterize changes in motor nerve conduction studies (MNCS) and motor unit number index (MUNIX) following treatment with subcutaneous immunoglobulin and to assess whether these changes are related to muscle strength. Data from 23 patients participating in a randomized, controlled trial were analyzed. MNCS and MUNIX were performed before and after 12weeks of treatment. Isokinetic strength (IMS) was measured in various muscles together with grip strength (GS). Proximally evoked compound muscle action potential (CMAP) amplitudes and MUNIX tended to be better preserved in treated patients (P=.049 and .045). Changes in other parameters did not differ between groups. There was no correlation between changes in electrophysiological parameters and IMS. Changes in GS were related to median nerve motor conduction velocity, distal motor latency, CMAP amplitudes, and distally evoked CMAP duration (P=.013-.035). Proximally evoked CMAP amplitudes appear to be the best MNCS parameter to assess treatment outcome in chronic inflammatory demyelinating polyneuropathy.

Mutation Analysis of Gap Junction Protein Beta 1 and Genotype-Phenotype Correlation in X-linked Charcot-Marie-Tooth Disease in Chinese Patients.

Background:Among patients with Charcot–Marie–Tooth disease (CMT), the X-linked variant (CMTX) caused by gap junction protein beta 1 (GJB1) gene mutation is the second most frequent type, accounting for approximately 90% of all CMTX. More than 400 mutations have been identified in the GJB1 gene that encodes connexin 32 (CX32). CX32 is thought to form gap junctions that promote the diffusion pathway between cells. GJB1 mutations interfere with the formation of the functional channel and impair the maintenance of peripheral myelin, and novel mutations are continually discovered.Methods:We included 79 unrelated patients clinically diagnosed with CMT at the Department of Neurology of the Chinese People's Liberation Army General Hospital from December 20, 2012, to December 31, 2015. Clinical examination, nerve conduction studies, and molecular and bioinformatics analyses were performed to identify patients with CMTX1.Results:Nine GJB1 mutations (c.283G>A, c.77C>T, c.643C>T, c.515C>T, c.191G>A, c.610C>T, c.490C>T, c.491G>A, and c.44G>A) were discovered in nine patients. Median motor nerve conduction velocities of all nine patients were < 38 m/s, resembling CMT Type 1. Three novel mutations, c.643C>T, c.191G>A, and c.610C>T, were revealed and bioinformatics analyses indicated high pathogenicity.Conclusions:The three novel missense mutations within the GJB1 gene broaden the mutational diversity of CMT1X. Molecular analysis of family members and bioinformatics analyses of the afflicted patients confirmed the pathogenicity of these mutations.

Severe Epidermal Nerve Fiber Loss in Diabetic Neuropathy Is Not Reversed by Long-Term Normoglycemia After Simultaneous Pancreas and Kidney Transplantation.

Whether nerve fiber loss, a prominent feature of advanced diabetic neuropathy, can be reversed by reestablishment of normal glucose control remains questionable. We present 8-year follow-up data on epidermal nerve fiber (ENF) density and neurological function in patients with type 1 diabetes after simultaneous pancreas and kidney transplantation (SPK) with long-term normoglycemia. Distal thigh skin biopsies with ENF counts, vibration perception thresholds (VPTs), autonomic function testing (AFT) and electrophysiological examinations were performed at time of SPK and 2.5 and 8 years after SPK in 12 patients with type 1 diabetes. In comparison to controls, baseline ENF density, VPT and AFT results of patients indicated severe neuropathy. At follow-up, all SPK recipients were insulin independent with excellent glycemic control and kidney graft function; however, the severe ENF depletion present at baseline had not improved, with total ENF absence in 11 patients at 8-year follow-up. Similarly, no amelioration occurred in the VPT and AFT results. Numerical improvement was seen in some electrophysiological parameters; however, statistical significance was achieved only in median motor nerve conduction velocity. ENF loss and functional deficits in advanced diabetic peripheral neuropathy are rarely reversible, even by long-term normoglycemia, which underscores the importance of neuropathy prevention by early optimal glycemic control.

Huangqi Guizhi Wuwu Decoction for treating diabetic peripheral neuropathy: a meta-analysis of 16 randomized controlled trials.

This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction (HGWWD) for treating diabetic peripheral neuropathy. Six electronic databases, including the Cochrane Library, MEDLINE database, Chinese Biomedical Database, Chinese National Knowledge Infrastructure Database, Chinese Science and Technique Journals Database, and the Wanfang Database, were searched on the internet for randomized controlled trials published up until 1 December 2015. The search terms included "Chinese herbal medicine", "diabetic peripheral neuropathy" and "randomized controlled trials" in Chinese and in English. We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group, without restriction for the control group. We assessed literature quality in accordance with the Cochrane Review Handbook. A random or a fixed effects model was used to analyze outcomes using RevMan 5.2 software. The primary outcomes were changes in symptoms and nerve conduction velocities. The secondary outcomes were fasting blood glucose and hemorheological indexes. Sixteen randomized controlled trials, with a total of 1,173 patients, were included. Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment (i.e., control group) (risk ratio = 0.36, 95% confidence interval (CI): 0.29-0.46, Z =8.33, P < 0.00001) Compared with the control group, there was an increase in median motor nerve conduction velocity (mean difference (MD) = 3.46, 95%CI: 1.88-5.04, Z = 4.30, P < 0.01) and median sensory nerve conduction velocity (MD = 3.30, 95%CI: 2.04-4.56, Z = 5.14, P < 0.01). There was also an increase in peroneal motor nerve conduction velocity (MD = 3.22, 95%CI: 2.45-3.98, Z = 8.21, P < 0.01) and peroneal sensory nerve conduction velocity (MD = 3.05, 95%CI: 2.01-4.09, Z = 5.75, P < 0.01) in the treatment groups. No significant difference in fasting blood glucose was found between the treatment groups and the control groups (MD = -0.12, 95%CI: -0.42-0.19, Z = 0.76, P = 0.45). Plasma viscosity was significantly decreased after treatment (MD = -0.11, 95%CI: -0.21 to -0.02, Z = 2.30, P = 0.02). No significant difference in fibrinogen was detectable (MD = -0.53, 95%CI: -1.28-0.22, Z = 1.38, P = 0.17). Four trials reported that treatment groups experienced no adverse reactions. Adverse events were not mentioned in the other 12 trials. No trial reported the incidence of complications, quality of life outcomes, or health economics. HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities. Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy. However, the methodological quality of the randomized controlled trials was generally low. Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.

A neurophysiological study of large- and small-diameter nerve fibers in the hands of hemodialysis patients

Polyneuropathy in patients with advanced clinical kidney disease is a very disabling condition. The aim of this study was to evaluate neurophysiological abnormalities of large- and small-diameter nerve fibers in the hands of hemodialysis patients. A total of 38 hemodialysis patients and 38 healthy control subjects underwent a conventional electrophysiological examination. The function of small nerve fibers was assessed using cutaneous silent period (CSP) measurement. Slower median nerve motor conduction velocities were recorded in patients with fistula (p < 0.0001) and without fistula (p < 0.001). Sensory median and ulnar nerve conduction velocities were slower in both patient groups compared with the control group (p = 0.001). Median sensory nerve action potential amplitudes were lower in patients with fistulas (p = 0.009) and without fistulas (p = 0.005) compared with the control group. Significantly prolonged F-wave latencies of the median (p = 0.002) and ulnar nerves (p = 0.023) in patients with fistulas hands were observed. In 12/38 (32 %) patients, the onset latencies of CSPs were significantly delayed (p = 0.001). There was an inverse correlation of β2-microglobulin and decreased conduction velocities of the median nerves, while Kt/V was associated with improved sensory nerve conduction velocity of the median nerve. An inverse correlation between motor velocity of both nerves and hemodialysis duration was observed in the patient groups. The measurement of CSPs provides a useful method for assessing small nerve fibers. The role of A-delta fibers is often overlooked.

Effect of Height and BMI on Nerve Conduction Velocity

Objective: To know the effect of Height and BMI on median motor nerve conduction velocity. Background: Nerve conduction study is part of the electro diagnostic procedures that help in establishing the type and degree of abnormalities of nerve. Nerve conduction velocity is affected by many physiological and technical factors. So we have conducted this study, to know the effect of height and BMI on median motor nerve conduction velocity. Materials and Methods: A Cross – Sectional study was conducted in 50 female medical students with mean age 19 to 22 years. Nerve conduction velocity was calculated by recording evoked electromyogram (EMG) by stimulating median nerve at elbow and at wrist with the help of EMG electrodes and isolated stimulator by using Power lab 8/30 series with dual Bioamplifier. Statistical analysis was done by using Karl Pearson Correlation coefficient. Results: There is moderately negative correlation with the height on motor nerve conduction velocity with “r” value -0.23487 and also slight negative correlation with BMI on conduction velocity with “r” value -0.1832. Conclusion: With increasing height and BMI, nerve conduction velocity is decreased so this phenomenon should be considered for comparative studies and diagnosing pathological conditions. Keywords: BMI; Height; Nerve Conduction velocity

Effects of placebo-controlled continuous and pulsed ultrasound treatments on carpal tunnel syndrome: a randomized trial

OBJECTIVE:The aim of this placebo-controlled study was to evaluate the effects of pulsed and continuous ultrasound treatments combined with splint therapy on patients with mild and moderate idiopathic carpal tunnel syndrome.METHODS:The study included 46 carpal tunnel syndrome patients who were randomly divided into 3 groups. The first group (n = 15) received a 0 W/cm2 ultrasound treatment (placebo); the second group (n = 16) received a 1.0 W/cm2 continuous ultrasound treatment and the third group (n = 15) received a 1.0 W/cm2 1:4 pulsed ultrasound treatment 5 days a week for a total of 15 sessions. All patients also wore night splints during treatment period. Pre-treatment and post-treatment Visual Analogue Scale, Symptom Severity Scale and Functional Status Scale scores, median nerve motor conduction velocity and distal latency and sensory conduction velocities of the median nerve in the 2nd finger and palm were compared. Clinicaltrials.gov: NCT02054247.RESULTS:There were significant improvements in all groups in terms of the post-treatment Functional Status Scale score (p<0.05 for all groups), Symptom Severity Scale score (first group: p<0.05, second group: p<0.01, third group: p<0.001) and Visual Analogue Scale score (first and third groups: p<0.01, second group: p<0.001). Sensory conduction velocities improved in the second and third groups (p<0.01). Distal latency in the 2nd finger showed improvement only in the third group (p<0.01) and action potential latency in the palm improved only in the second group (p<0.05).CONCLUSION:The results of this study suggest that splinting therapy combined with placebo and pulsed or continuous ultrasound have similar effects on clinical improvement. Patients treated with continuous and pulsed ultrasound showed electrophysiological improvement; however, the results were not superior to those of the placebo.

Meta-analysis of methylcobalamin alone and in combination with prostaglandin E1 in the treatment of diabetic peripheral neuropathy

This study aimed to compare the efficacy and safety of prostaglandin E1 plus methylcobalamin (PGE1-MC) with that of methylcobalamin alone (MC) on diabetic peripheral neuropathy (DPN). We searched published randomized controlled trials (RCTs) of PGE1 combined with MC for DPN up to June 1, 2013. Data were extracted to evaluate methodological quality and describe characteristics of studies in duplicate. A random or a fixed effect model was used to analyze outcomes which were expressed as relative risk (RR) or mean difference with a 95 % confidence interval (CI). All data were analyzed using Review Manager 5.2 software. Twenty-six RCTs involving 2,107 individuals were included. Meta-analysis showed that PGE1-MC combination therapy was significantly better than MC monotherapy (RR = 1.40; 95 % CI 1.33-1.48) on efficacy. The weighted mean differences in nerve conduction velocities (NCVs) were 6.72 (95 % CI: 5.42-8.02) for median motor nerve conduction velocity (MNCV), 5.13 (CI 4.13-6.13) for median sensory nerve conduction velocity (SNCV), 5.74 (CI 4.87-6.61) for peroneal MNCV and 4.62 (CI 3.89-5.34) for peroneal SNCV in favor of the PGE1 + MC combination group. Moreover, there were no serious adverse events in both groups during the treatment period. The results of the meta-analysis show that treatment with PGE1-MC is safe and can gain better outcomes in neuropathic symptoms and NCVs compared with MC alone. However, the conclusion may not be strong because most of the studies included in this meta-analysis have poor methodological quality.

High‐Resolution Median Nerve Sonographic Measurements

To study relationships between median wrist and forearm sonographic measurements and median nerve conduction studies. The study population consisted of a prospective convenience sample of healthy adults. Interventions included high-resolution median nerve sonography and median motor and sensory nerve conduction studies. Main outcome measures included median motor nerve compound muscle action potential amplitude, distal latency, and conduction velocity; sensory nerve action potential amplitude and distal latency; and sonographic median nerve cross-sectional area. Median motor nerve and sensory nerve conduction studies of the index finger were performed using standard published techniques. A second examiner blinded to nerve conduction study results used a high-frequency linear array transducer to measure the cross-sectional area of the median nerve at the distal volar wrist crease (carpal tunnel inlet) and forearm (4 cm proximally), measured in the transverse plane on static sonograms. The outer margin of the median nerve was traced at the junction of the hypoechoic fascicles and adjacent outer connective tissue layer. Fifty median nerves were evaluated in 25 participants. The compound muscle action potential amplitude with wrist stimulation was positively related to the cross-sectional area, with the area increasing by 0.195 mm(2) for every millivolt increase in amplitude in the dominant hand (95% confidence interval, 0.020, 0.370 mm(2); P < .05) and 0.247 mm(2) in the nondominant hand (95% confidence interval, 0.035, 0.459 mm(2); P < .05). There was no significant linear association between the wrist median cross-sectional area and median motor and sensory distal latencies. Conduction velocity through the forearm was not significantly linearly associated with the forearm area or forearm-to-wrist area ratio (tapering ratio). The wrist area was inversely related to the sensory nerve action potential amplitude. Although associations were found between median nerve conduction study amplitudes and sonographic nerve measurements, they were not found for other parameters. Studying these relationships may increase our understanding of when to best use these procedures.

Relationships of Nerve Conduction Parameters with the Thyroid Hormones in Hypothyroid Patients

Background: Impairment of nerve conduction may occur in hypothyroidism which usually develops insidiously over a long period of time due to irregular taking of drugs or lack of thyroid hormone replacement. Objectives: To evaluate the thyroid hormone status and the clinical and electrophysiological changes in hypothyroid patients in order to observe their relationships with nerve conduction changes. Methods: Thirty healthy euthyroid subjects with the age range from 20 to 50 years of both sexes were as control and 15 hypothyroids with TSH with &lt;60 MIU /L and the duration of 6 months to 5 years were as experimental. Serum TT3, TT4 were measured by RIA and IRMA method. The distal latency (D L) and Nerve Conduction Velocities (NCV) for sensory and motor function were measured by a standard electrophysiological technique in median and ulnar nerve for upper limb and for lower limb, in sural nerve for sensory function and common peroneal nerve for motor function. Data were analyzed statistically by unpaired ’t’ test, Z test, Pearson’s correlation coefficient test. Results: Both TT3, TT4 levels were significantly (P&lt;0.001) lower in hypothyroids. Again, 60% hypothyroids and 10% euthyroids (P&lt;.001) had abnormal NCV. The relationships of TSH with both the median and ulnar sensory and motor distal latencies, common peroneal motor and sural sensory distal latencies and ulnar sensory conduction velocity were positive. But these relationships were negative with the median and common peroneal motor nerve conduction velocities, sural sensory conduction velocities. Only the relationships between median sensory distal latency and TSH was statistically significant (P &lt;0.05). Again, a positive correlation of TT3 and TT4 with the median, and sural sensory and common peroneal motor conduction velocities, but negative correlation with median motor and sural sensory latencies were found. In addition, positive correlation between TT3 and ulnar sensory and between TT4 and Ulnar motor conduction velocities were observed. Again the relationships median and ulnar sensory latencies were negative with TT4 only. The value of coefficient between TT4 and sural distal latency and conduction velocities were statistically significant (P&lt;0.05). Conclusion: Results of this study showed that the impairment of nerve conduction occurs in hypothyroidism. DOI: http://dx.doi.org/10.3329/jbsp.v8i1.16638 J Bangladesh Soc Physiol. 2013, June; 8(1): 1-5

A study of retrograde degeneration of median nerve forearm segment in carpal tunnel syndrome of variable severities

IntroductionCarpal tunnel syndrome (CTS) is a disorder of the hand which results from compression of the median nerve within its fibro-osseous tunnel at the wrist. The slowing in the forearm motor conduction velocity suggests the presence of retrograde degeneration. Existing studies conflict regarding a correlation between the severities of the entrapment neuropathy in CTS and slowing of median motor nerve conduction velocity in the forearm. AimsThe objective of this work was to study retrograde degeneration (RGD) of the median nerve forearm segment in patients with CTS and its relation to variable severity of CTS in Egyptian patients. Patients and methodsTwenty-four patients with CTS were included in this study. The Forearm mixed nerve conduction is presumed to be indicative of the conduction of the median nerve over the forearm and is used widely to assess the causes of slowing forearm conduction velocity in CTS. In addition to conventional nerve conduction studies of the upper limb, forearm median mixed conduction studies were performed. Median motor forearm amplitudes and nerve conduction velocities (NCVs) as well as forearm median mixed amplitudes and NCVs were considered as parameters of RGD. ResultsThere were statistically significant differences as regards forearm mixed nerve action potential (MNAP) amplitude and median motor amplitude in the forearm segment but there were no statistically significant differences as regards forearm median mixed peak latency and NCV. There was no statistically significant relation between grades of severities of CTS in the studied hands and both forearm median motor NCV and forearm MNAP amplitude using Monte Carlo test (MCp=0.323 and 0.464). ConclusionsRetrograde degeneration exists in patients with CTS. Forearm median motor NCV and median mixed conduction study are valid electrophysiologic tools for the assessment of RGD in patients with CTS. Retrograde degeneration is not related to grade of severity of CTS.

Early Electrophysiological Abnormalities and Clinical Neuropathy

OBJECTIVEThe aim of this study was to elucidate whether subclinical nerve dysfunction as reflected by neurophysiological testing predicts the development of clinical neuropathy in patients with type 1 diabetes.RESEARCH DESIGN AND METHODSFifty-nine patients were studied twice with neurophysiological measurements at baseline and at follow-up. At baseline, patients were 15.5 ± 3.22 years (range 7–22 years) of age, and duration of diabetes was 6.8 ± 3.3 years. At follow-up, patients were 20–35 years of age, and disease duration was 20 ± 5.3 years (range 10–31 years).RESULTSAt baseline, patients showed modestly reduced nerve conduction velocities and amplitudes compared with healthy subjects, but all were free of clinical neuropathy. At follow-up, clinical neuropathy was present in nine (15%) patients. These patients had a more pronounced reduction in peroneal motor nerve conduction velocity (MCV), median MCV, and sural sensory nerve action potential at baseline (P < 0.010–0.003). In simple logistic regression analyses, the predictor with the strongest association with clinical neuropathy was baseline HbA1c (R2 = 48%, odds ratio 7.9, P < 0.002) followed by peroneal MCV at baseline (R2 = 38%, odds ratio 0.6, P < 0.006). With the use of a stepwise forward analysis that included all predictors, first baseline HbA1c and then only peroneal MCV at baseline entered significantly (R2 = 61%). Neuropathy impairment assessment showed a stronger correlation with baseline HbA1c (ρ = 0.40, P < 0.002) than with follow-up HbA1c (ρ = 0.034, P < 0.007).CONCLUSIONSEarly defects in nerve conduction velocity predict the development of diabetic neuropathy. However, the strongest predictor was HbA1c during the first years of the disease.

Evaluation of median nerve in children with type1 diabetes using ultrasonographic imaging and electrophysiology

BackgroundDiabetic peripheral neuropathy (DPN) is a worldwide costly complication of diabetes. ObjectiveTo evaluate the relationship between the sonographically measured cross-sectional area (CSA) of the median nerve and nerve conduction study (NCS) in children with type1 diabetes (T1DM) complaining of DPN. Material and methodsForty children with T1DM and 20 age-matched healthy subjects were enrolled in this study. The diabetic children were divided into 2 groups (without and with DPN). All participants underwent NCS and sonographic measurement of CSA for the median nerve in the carpal tunnel. ResultsThe CSA of the median nerve in children with DPN was higher than that in the control subjects yet with no significant difference with that of children without DPN. The increased median nerve CSA in the carpal tunnel was considerably correlated with the median nerve motor latency and duration of diabetes, nevertheless, with no correlation with median nerve motor conduction velocity (MNCV). ConclusionSonographic measurement of CSA of the median nerve in the carpal tunnel serves as a good discriminator for diabetic children from healthy individuals. Moreover, it has significant positive correlation with duration of disease and the nerve motor latency.

The Effects of Median Nerve Self-Mobilization in Open Kinetic Chain and Closed Kinetic Chain Conditions on Median Motor Nerve Conduction Velocity

The Effects of Median Nerve Self-Mobilization in Open Kinetic Chain and Closed Kinetic Chain Conditions on Median Motor Nerve Conduction Velocity

Comparison of Median Motor Nerve Conduction Velocity in Dominant and Non-Dominant Hand of Normal Individual

The cross sectional observational study design is used to study the effect of limb dominance on the median NCV of forearm segment. 30 healthy volunteers (20 Female, 10 Male) with the mean age of 23 yrs (20-26yrs) participated in the study. Edinburgh handedness inventory was used to assess the laterality of subjects. Median NCV for the forearm segment was calculated for each upper limb of 30 subjects. Comparing median NCV between dominant and non-dominant hand of right handed subjects showed no significant difference. Similar results were obtained for left handed subjects. It is concluded that limb dominance has no significant effect on median NCV.

A study of interpolation method in diagnosis of carpal tunnel syndrome

Context:The low correlation between the patients’ signs and symptoms of carpal tunnel syndrome (CTS) and results of electrodiagnostic tests makes the diagnosis challenging in mild cases. Interpolation is a mathematical method for finding median nerve conduction velocity (NCV) exactly at carpal tunnel site. Therefore, it may be helpful in diagnosis of CTS in patients with equivocal test results.Aim:The aim of this study is to evaluate interpolation method as a CTS diagnostic test.Settings and Design:Patients with two or more clinical symptoms and signs of CTS in a median nerve territory with 3.5 ms ≤ distal median sensory latency <4.6 ms from those who came to our electrodiagnostic clinics and also, age matched healthy control subjects were recruited in the study.Materials and Methods:Median compound motor action potential and median sensory nerve action potential latencies were measured by a MEDLEC SYNERGY VIASIS electromyography and conduction velocities were calculated by both routine method and interpolation technique.Statistical Analysis Used:Chi-square and Student's t-test were used for comparing group differences. Cut-off points were calculated using receiver operating characteristic curve.Results:A sensitivity of 88%, specificity of 67%, positive predictive value (PPV) and negative predictive value (NPV) of 70.8% and 84.7% were obtained for median motor NCV and a sensitivity of 98.3%, specificity of 91.7%, PPV and NPV of 91.9% and 98.2% were obtained for median sensory NCV with interpolation technique.Conclusions:Median motor interpolation method is a good technique, but it has less sensitivity and specificity than median sensory interpolation method.

THERAPY OF ENDOCRINE DISEASE: A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy

To evaluate the effects and safety of 300-600 mg α-lipoic acid (ALA) given i.v. for diabetic peripheral neuropathy (DPN). We searched the databases of Medline, Embase, and Cochrane central register of Controlled Trials and Chinese biological medicine for clinical trials of ALA in the treatment of DPN. Data were extracted to examine methodological quality and describe characteristics of studies. The primary outcomes were efficacy, median motor nerve conduction velocity (MNCV), median sensory nerve conduction velocity (SNCV), peroneal MNCV, and peroneal SNCV. Secondary outcomes were adverse events. Fifteen randomized controlled trials met the inclusion criteria. The treatment group involved the administration of ALA 300-600 mg i.v. per day. And the control group used the same interventions except for ALA. Compared with the control group, nerve conduction velocities increased significantly in the treatment group. The weighted mean differences in nerve conduction velocities were 4.63 (95% confidence interval 3.58-5.67) for median MNCV, 3.17 (1.75-4.59) for median SNCV, 4.25 (2.78-5.72) for peroneal MNCV, and 3.65 (1.50-5.80) for peroneal SNCV in favor of the treatment group. The odds ratio in terms of efficacy was 4.03 (2.73-5.94) for ALA. Furthermore, no serious adverse events were observed during the treatment period. The results of this meta-analysis provide evidence that treatment with ALA (300-600 mg/day i.v. for 2-4 weeks) is safe and that the treatment can significantly improve both nerve conduction velocity and positive neuropathic symptoms. However, the evidence may not be strong because most of the studies included in this meta-analysis have poor methodological quality.

Clinical characteristics of the patients with occupational chronic carbon disulfide poisoning in a chemical fiber factory of Nanjing

To analyze the clinical characteristics of 267 cases with occupational chronic carbon disulfide (CS(2)) poisoning and to provide the basis for revising the items of periodical medical examination of workers occupationally exposed to CS(2). The subjects of present study were 267 patients with mild CS(2) poisoning diagnosed according to "Diagnostic Criteria of Occupational Chronic Carbon Disulfide Poisoning (GBZ4-2002)" from April in 2006 to May in 2010. All patients were from the same chemical fiber factory. When a subject was diagnosed as patient with CS(2) poisoning, who should interview with questionnaire which included the illness and occupational history, symptoms, individual habits. The physical examination, nervous test, cardiovascular test, biochemical test and electromyogram were performed. The rate of decreased motor conduction velocity was 87.3% (233/267 roots). The highest detection rate of slowing conduction velocity was the common peroneal motor nerve which was 48.6% (138/248 roots) and the second was median motor nerve with delay rate of 37% (155/419 roots). The main symptoms of the patients were neurasthenia, numbness and paresthesia. The rates of abnormal achilles tendon reflex and knee jerk reflex in patients were were 79.4% and 49.8%, respectively. The detected rates of patients with ST-segment changes and hypertension were 19.1% and 27.5%, respectively. The rates of hypertension, systolic pressure and diastolic pressure were 27.3%, 22.5% and 21.1%, respectively. The rates of lactate dehydrogenase (LDH), triglycerides (TG) and low density lipoprotein (LDL) were high. The detected rates of urine acid, indirect bilirubin and total bilirubin in male patients were higher than those in female patients. In addition, the abnormal detected rate of urea nitrogen and indirect bilirubin increased with exposure years. Occupational chronic CS(2) poisoning mainly affects the nervous system, as well as liver and kidney function. Detecting the median and common peroneal motor nerve conduction velocities could be the screening indicators for the peripheral nerve injury induced by CS(2) in the occupational exposure population during the periodical occupational medical examinations.