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Article: Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
Title | Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies |
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Authors | |
Keywords | Axonal degeneration Carpal tunnel syndrome Demyelination Diagnostic accuracy Nerve conduction studies |
Issue Date | 2019 |
Publisher | Journal of Visualized Experiments. The Journal's web site is located at http://www.jove.com |
Citation | Journal of Visualized Experiments, 2019, v. 2019 n. 143, p. article no. e58681 How to Cite? |
Abstract | Axonal 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 Identifier | http://hdl.handle.net/10722/278218 |
ISSN | 2021 Impact Factor: 1.424 2020 SCImago Journal Rankings: 0.596 |
ISI Accession Number ID |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | DENG, X | - |
dc.contributor.author | CHAU, LHP | - |
dc.contributor.author | CHIU, SY | - |
dc.contributor.author | Leung, KP | - |
dc.contributor.author | Hu, Y | - |
dc.contributor.author | Ip, WY | - |
dc.date.accessioned | 2019-10-04T08:09:46Z | - |
dc.date.available | 2019-10-04T08:09:46Z | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | Journal of Visualized Experiments, 2019, v. 2019 n. 143, p. article no. e58681 | - |
dc.identifier.issn | 1940-087X | - |
dc.identifier.uri | http://hdl.handle.net/10722/278218 | - |
dc.description.abstract | Axonal 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.language | eng | - |
dc.publisher | Journal of Visualized Experiments. The Journal's web site is located at http://www.jove.com | - |
dc.relation.ispartof | Journal of Visualized Experiments | - |
dc.rights | Journal of Visualized Experiments. Copyright © Journal of Visualized Experiments. | - |
dc.subject | Axonal degeneration | - |
dc.subject | Carpal tunnel syndrome | - |
dc.subject | Demyelination | - |
dc.subject | Diagnostic accuracy | - |
dc.subject | Nerve conduction studies | - |
dc.title | Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies | - |
dc.type | Article | - |
dc.identifier.email | Leung, KP: kpleungb@hkucc.hku.hk | - |
dc.identifier.email | Hu, Y: yhud@hku.hk | - |
dc.identifier.email | Ip, WY: wyip@hkucc.hku.hk | - |
dc.identifier.authority | Hu, Y=rp00432 | - |
dc.identifier.authority | Ip, WY=rp00401 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.3791/58681 | - |
dc.identifier.pmid | 30688308 | - |
dc.identifier.scopus | eid_2-s2.0-85060609992 | - |
dc.identifier.hkuros | 306520 | - |
dc.identifier.volume | 2019 | - |
dc.identifier.issue | 143 | - |
dc.identifier.spage | article no. e58681 | - |
dc.identifier.epage | article no. e58681 | - |
dc.identifier.isi | WOS:000458012000097 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1940-087X | - |