Numerical Size Variability in the Peripheral Nerve

Tomasch, Joseph

doi:10.1159/000145678

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…1 Ultrasound is a reliable tool for assessing peripheral nerve size, [2][3][4][5][6][7][8][9] and demonstrates favorable correlation with dissected anatomical nerve measures. 10 Normal, healthy nerve size is known to vary with a number of factors, including anatomical location, sex, 11 body size, 12 age, 12 and race/ethnicity. 13 Sonographic measures of nerve size are also operator-dependent.…”

Section: Introductionmentioning

confidence: 99%

“…23 It is critical to establish the range of normal values for adult peripheral nerve CSA throughout the musculoskeletal system to facilitate future research identifying clinical correlations and diagnostic criteria. 13 Given the known variations in peripheral nerve size across healthy individuals, [11][12][13] it can be difficult to readily identify whether the CSA of a particular peripheral nerve is within or exceeds normal anatomical variation. Thus, drawing upon all available studies reporting healthy adult sonographic peripheral nerve CSA will provide a valuable resource for the neuromuscular sonographer in the clinic and the laboratory.…”

Section: Introductionmentioning

confidence: 99%

“…Normal, healthy nerve size is known to vary with a number of factors, including anatomical location, sex, 11 body size, 12 age, 12 and race/ethnicity 13 . Sonographic measures of nerve size are also operator‐dependent 8 .…”

Section: Introductionmentioning

confidence: 99%

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Sonographic peripheral nerve cross‐sectional area in adults, excluding median and ulnar nerves: A systematic review and meta‐analysis

et al. 2023

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Introduction/Aims Although electromyography remains the “gold standard” for assessing and diagnosing peripheral nerve disorders, ultrasound has emerged as a useful adjunct, providing valuable anatomic information. The objective of this study was to conduct a systematic review and meta‐analysis evaluating the normative sonographic values for adult peripheral nerve cross‐sectional area (CSA). Methods Medline and Cochrane Library databases were systematically searched for healthy adult peripheral nerve CSA, excluding the median and ulnar nerves. Data were meta‐analyzed, using a random‐effects model, to calculate the mean nerve CSA and its 95% confidence interval (CI) for each nerve at a specific anatomical location (= group). Results Thirty groups were identified and meta‐analyzed, which comprised 16 from the upper extremity and 15 from the lower extremity. The tibial nerve (n = 2916 nerves) was reported most commonly, followed by the common fibular nerve (n = 2580 nerves) and the radial nerve (n = 2326 nerves). Means and 95% confidence interval (CIs) of nerve CSA for the largest number of combined nerves were: radial nerve assessed at the spiral groove (n = 1810; mean, 5.14 mm2; 95% CI, 4.33 to 5.96); common fibular nerve assessed at the fibular head (n = 1460; mean, 10.18 mm2; 95% CI, 8.91 to 11.45); and common fibular nerve assessed at the popliteal fossa (n = 1120; mean, 12.90 mm2; 95% CI, 9.12 to 16.68). Publication bias was suspected, but its influence on the results was minimal. Discussion Two hundred thirty mean CSAs from 15 857 adult nerves are included in the meta‐analysis. These are further categorized into 30 groups, based on anatomical location, providing a comprehensive reference for the clinician and researcher investigating adult peripheral nerve anatomy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sonographic peripheral nerve cross‐sectional area in adults, excluding median and ulnar nerves: A systematic review and meta‐analysis

et al. 2023

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Quantitative Techniques in Neuropathology

Broxup¹,

Yipchuck²,

McMillan

et al. 1990

Toxicol Pathol

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In the future, quantitative techniques will probably be used in industry as part studies in the evaluation of compounds for neurotoxicity (1). These studies can be used to determine dose-responses or no-effect levels. Various factors need consideration in the design of a quantitative study (10,28). These include the quality of the samples, the standardization of techniques for sample preparation, the methods of measurement, the sampling procedures and the statistical analyses that will be used to evaluate the data.This study was undertaken to evaluate various parameters in a cross section of rat sural nerve using 3 different sampling methods. The sural nerve is studied frequently in human peripheral nerve disease (23) and determinations of fiber counts and measurements of fiber size are used as indicators of pathological change. The sural nerve is one of the peripheral nerves that is required to be evaluated in rats as part of an evaluation of the potential neurotoxicity ofchemical compounds (1 2). Little quantitative data has been published on the peripheral nerve fibers of rats in cross section (18). As nerve fibers of different sizes may not be homogeneously distributed within a nerve (9), the method of sampling may be critical for a definitive quantitative study. MATERIALS AND h h k i O D S Tissue PreparationAn 8-week-old male Sprague-Dawley rat (Charles River Canada Inc., St. Constant, Quebec, Canada) weighing 310 g was anesthetized by an intraperitoneal injection of sodium pentobarbital and perfused with a mixture of 3% glutaraldehyde, 3% formaldehyde, 0.05% calcium chloride and 0.1% picric acid in 0.1 M cacodylate buffer. A 3 mm section of the sural nerve proximal to the proximal end of the gastrocnemius muscle was removed, rinsed in cacodylate buffer, placed in 1.5% osmium tetroxide for 2 hr, rinsed in buffer and stained with a 1% aqueous solution of uranyl acetate for 2 hr. The tissue was then rinsed in distilled water, dehydrated in ascending concentrations of ethyl alcohol cleared in propylene oxide and embedded in a mixture of Jembed and Araldite. Semi-thin epoxy sections (0.5 pmj'were obtained'with a glass knife and stained with borate-buffered 1% toluidine blue. Thin sections were cut with a diamond knife and placed on slotted grids covered by a celloidin film and stained with 4% aqueous uranyl acetate and 0.4% lead citrate- Myelitrated Nerve Fiber hleasuretnetrtsBlack and white photomicrographs of the entire semi-thin cross section of the sural nerve were taken

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Numerical Size Variability in the Peripheral Nerve

Cited by 2 publications

References 13 publications

Sonographic peripheral nerve cross‐sectional area in adults, excluding median and ulnar nerves: A systematic review and meta‐analysis

Sonographic peripheral nerve cross‐sectional area in adults, excluding median and ulnar nerves: A systematic review and meta‐analysis

Quantitative Techniques in Neuropathology

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