The Correlation between the Cutaneous Silent Period and Ultrasonographic Findings of Median Nerve in Patients with Carpal Tunnel Syndrome
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective To determine the relation between the latency and duration of the cutaneous silent period (CuSP) and ultrasonographic findings of patients with carpal tunnel syndrome (CTS). Method Subjects included 50 hands of 33 patients with CTS with electrophysiologic evidence of CTS and 50 hands of 39 adults with no evidence of CTS. CuSP was measured on abductor pollicis brevis (APB) and adductor digiti minimi (ADM) by stimulation of digit 3. All subjects were examined with ultrasonography (US). Using US, the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve were calculated under carpal tunnel. Analysis of differences between the control group and the CTS group was performed using ANOVA. Results Differences of CSA, FR, latency, and duration of CuSP in both APB, ADM muscles were observed between the two groups. Correlations were observed in the patient group in latency and duration of the APB muscle and only in duration of the ADM (p=0.048, r=0.159; p=0.035, r=−0.315; p=0.039, r=−0.293) muscle. Correlations were found only in duration of ADM (p=0.011, r=0.358) in the control group with respect to CSA. However, there was no correlation with FR. Conclusion There seems to be a significant correlation between the CSA of the median nerve and the latency and duration of CuSP in patients with CTS. In addition, there seems to be a significant difference of CSA, FR, and latency in both APB and ADM between the two groups. CuSP and CSA might be useful for study that reflects intact small fibers in patients with CTS.
Abstract
Objective To determine the relation between the latency and duration of the cutaneous silent period (CuSP) and ultrasonographic findings of patients with carpal tunnel syndrome (CTS). Method Subjects included 50 hands of 33 patients with CTS with electrophysiologic evidence of CTS and 50 hands of 39 adults with no evidence of CTS. CuSP was measured on abductor pollicis brevis (APB) and adductor digiti minimi (ADM) by stimulation of digit 3. All subjects were examined with ultrasonography (US). Using US, the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve were calculated under carpal tunnel. Analysis of differences between the control group and the CTS group was performed using ANOVA. Results Differences of CSA, FR, latency, and duration of CuSP in both APB, ADM muscles were observed between the two groups. Correlations were observed in the patient group in latency and duration of the APB muscle and only in duration of the ADM (p=0.048, r=0.159; p=0.035, r=−0.315; p=0.039, r=−0.293) muscle. Correlations were found only in duration of ADM (p=0.011, r=0.358) in the control group with respect to CSA. However, there was no correlation with FR. Conclusion There seems to be a significant correlation between the CSA of the median nerve and the latency and duration of CuSP in patients with CTS. In addition, there seems to be a significant difference of CSA, FR, and latency in both APB and ADM between the two groups. CuSP and CSA might be useful for study that reflects intact small fibers in patients with CTS.
참고문헌 (22)
- Higgins DC, "The muscle silent period: variability in normal man", Electroencephalogr Clin Neurophysiol, 24, pp.176~182 (1968)
- Higgins DC, "The muscle silent period and spindle function in man", Electroencephalogr Clin Neurophysiol, 25, pp.238~243 (1968)
- Uncini A, "Silent period induced by cutaneous stimulation", Electroencephalogr Clin Neurophysiol, 81, pp.344~352 (1991)
- Leis AA, "The cutaneous and mixed nerve silent period", Muscle Nerve, 16, pp.1130~1132 (1993)
- Kranz H, "Activity of motor neurones during isometric contraction", Proc Aust Assoc Neurol, 10, pp.123~127 (1973)
- Laxer K, "Silent period measurement in the differentiation of central demyelination and axonal degeneration", Neurology, 25, pp.740~744 (1975)
- Caccia MR, "Cutaneous reflexes in small muscles of the hand", J Neurol Neurosurg Psychiatry, 36, pp.960~977 (1973)
- Inghilleri M, "Silent period in upper limb muscles after noxious cutaneous stimulation in man", Electroencephalogr Clin Neurophysiol, 105, pp.109~115 (1997)
- Leis AA, "Spinal motor neuron excitability during the cutaneous silent period", Muscle Nerve, 18, pp.1464~1470 (1995)
- Svilpauskaite J, "Cutnaneous silent period in carpal tunnel syndrome", Muscle Nerve, 33, pp.487~493 (2006)
- Ochoa J, "Anatomical changes in peripheral nerves compressed by a pneumatic tourniquet", J Anat, 113, pp.433~455 (1972)
- Sunderland S, "The nerve lesion in the carpal tunnel syndrome", J Neurol Neurosurg Psychiatry, 39, pp.615~626 (1976)
- Kotevoglu N, "Ultrasound imaging in diagnosis of carpal tunnel syndrome and its relevance to clinical evaluation", Joint Bone Spine, 72, pp.142~145 (2005)
- Buchberger W, "High- resolution ultrasonography of the carpal tunnel", J Ultrasound Med, 10, pp.531~537 (1991)
- Wiesler ER, "The use of diagnostic ultrasound in carpal tunnel syndrome", J Hand Surg Am, 31, pp.726~732 (2006)
- 이종민, "수근관 증후군 환자에서 전기진단 중증도와 증상, 기능, 임상 중증도의 관계", Annals of Rehabilitation Medicine, 27(6), pp.16~911 (2003), 대한재활의학회
- Stenvens JC, "AAEM minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. American association of electrodiagnotic medicine", Muscle Nerve, 20, pp.1477~1486 (1997)
- Serrao M, "Cutaneous afferent mediating the cutaneous silent period in the upper limb: evidences for a role of low-threshold sensory fibres", Clin Neurophysiol, 112, pp.2007~2014 (2001)
- Shefner JM, "Factors affecting mixed nerve and cutaneous silent periods", Electroencephalogr Clin Neurophysiol, 98, pp.10~ (1996)
- 최원기, "진단초음파를 이용한 수근관증후군의 진단", Annals of Rehabilitation Medicine, 25(1), pp.134~139 (2001), 대한재활의학회
- Aurora SK, "Silent period abnormalities in carpal tunnel syndrome", Muscle Nerve, 21, pp.1213~1215 (1998)
- Kofler M, "Preserved cutaneous silent periods in severe entrapment neuropathies", Muscle Nerve, 28, pp.711~714 (2003)