Premotor potential study in carpal tunnel syndrome

Kodama, Mitsuhiko; Sasao, Yu; Tochikura, Michi; Kasahara, Takashi; Koyama, Yuji; Aono, Koji; Fujii, Chieko; Hanayama, Kozo; Takahashi, Osamu; Kobayashi, Yohnosuke; Masakado, Yoshihisa

doi:10.1002/mus.23424

Cited by 6 publications

(4 citation statements)

References 14 publications

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“…The lumbrical muscles also have important clinical relevance. For example, the difference between the median motor latency to the second lumbrical muscle and the ulnar motor latency to the interossei muscles is sensitive for diagnosis of different grades of in carpal tunnel syndrome ( Brannegan and Bartt, 2007 ; Meena et al, 2008 ; Kodama et al, 2012 ; Ozben et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Motor Unit Number Estimation of the Second Lumbrical Muscle in Human Hand

Zong

Lu²,

Chen³

et al. 2022

Front. Physiol.

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The number of motor units of the lumbrical muscles in human hand has not been explored. The objective of this study was to fill this gap by estimating the number of motor units in the second lumbrical muscle. Compound muscle action potential scan of the second lumbrical muscle was performed in 12 healthy subjects, with 10 of them being tested on two separate occasions. Motor unit number estimation (MUNE) was derived from the MScanFit program. The average MUNE of the second lumbrical muscle was 41.6 ± 2.1 (mean ± standard error) from 12 subjects in the first test, and 42.0 ± 2.2 from 10 of the 12 subjects in the retest, demonstrating excellent measurement reliability. Findings of the study provide novel information about the motor unit number of the second lumbrical muscle in human hand. The relatively low motor unit number in the muscle can facilitate motor unit investigations, especially at high level muscle activation.

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Section: Introductionmentioning

confidence: 99%

Motor Unit Number Estimation of the Second Lumbrical Muscle in Human Hand

Zong

Lu²,

Chen³

et al. 2022

Front. Physiol.

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“…The diagnostic tests evaluated and their weighted mean sensitivity and specificity are outlined in Tables 2 and 3. 16-128 Although studies utilizing “clinical diagnosis” as a reference standard were treated as a unified subset, many studies 16-128 were found to utilize different definitions of clinical diagnosis. An outline of the utilized definitions for “clinical diagnosis” is presented in Supplemental Digital Content 1.…”

Section: Resultsmentioning

confidence: 99%

The Impact of Reference Standard on Diagnostic Testing Characteristics for Carpal Tunnel Syndrome: A Systematic Review

Bennett

Sears

2023

Plastic and Reconstructive Surgery - Global Open

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Background: Lack of a reliable reference standard for carpal tunnel syndrome (CTS) diagnosis could impact the diagnostic test characteristics. This systematic review sought to evaluate differences in the accuracy of CTS diagnostic modalities based on the reference standard used. Methods: A systematic review was performed following PRISMA guidelines to investigate diagnostic modalities used in CTS. A literature search of Embase, PubMed, and Cochrane Reviews was conducted for the years of 2010–2021 for primary data, and 113 studies met final inclusion criteria. Studies were stratified based on the reference standard utilized and diagnostic modality assessed, and the weighted means of the sensitivities and specificities were calculated. Results: Thirty-five studies used clinical diagnosis alone as a reference standard, and 78 studies used electrodiagnostic study (EDS). The specificity for MRI and ultrasound (US) were substantially lower when EDS was used as the reference standard. MRI was the test most affected by the reference standard used, showing increased sensitivity when using EDS as the reference compared to clinical diagnosis (77.1% versus 60.9%) and decreased specificity (87.6% versus 99.2%). Regardless of the reference standard used, all tests had anticipated false-positive and/or false-negative rates of at least 10%. Conclusions: Testing characteristics vary greatly based on the choice of reference standard, with the sensitivity of MRI most affected. Regardless of reference standard used, EDS, US, and MRI each had false-positive and/or false-negative rates too great to be appropriate for use as a screening examination.

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“…con unos parámetros de 100 uV de ganancia y 2ms de barrido, o la latencia de inicio marcada automáticamente por el software para el CMAP del segundo lumbrical en caso de superposición con el PMP-2L. (18,19) Neuroconducciones sensitivas: Se obtuvieron los siguientes potenciales de acción sensitivos:…”

Section: Estudios Electrofisiológicosunclassified

“…El origen del potencial premotor del segundo lumbrical (PMP-2L) es explicado en estudios electrofisiológicos experimentales más recientes, realizados por Takahashi et al (2007) y Masako et al (2011) en los cuales se concluye que dicho potencial es resultado de la suma de un potencial de campo cercano al electrodo de registro del 2do lumbrical y un potencial de campo lejano que viaja secundario a estimulación de las fibras sensitivas en la base del segundo dedo. (Takahashi 15, Masako 16) Basado en el origen del PMP-2 L algunos autores han teorizado la posibilidad de su uso en el diagnóstico de STC, dado que al momento de la prueba comparativa del primer interóseo palmar y el segundo lumbrical se podría llegar a obtener el PMP-2L, y dado su origen en fibras sensitivas del segundo dedo se podría correlacionar con el compromiso inicial de dichas fibras, Therimadasamy (2007) usando una escala paralela a la de Bland et al, implementando puntos de corte del PMP-2L, encontró valores predictivos positivos similares a la de las pruebas comparativas convencionales, yKodama (2012Kodama ( -2016 encontró una correlación entre la velocidad de conducción del PMP-2L y la velocidad del potencial sensitivo (SNAP) del segundo dedo ( r = 0.91), latencia del PMP-2L y severidad del STC ( r = 0.66) y la amplitud con diferentes valores de SNAP siendo la mayor con la del 4to dedo (r = 0.45)(Therimadasamy 17 , Kodama 2012 18) Además, Kodama et al, (2016) realizan un estudio para determinar la utilidad diagnóstica del PMP-2L encontrando una sensibilidad mayor en todos los grupos de diagnóstico, inclusive superior a la prueba de latencia del cuarto dedo 19.…”

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