Effect of size and pressure of surface recording electrodes on amplitude of sensory nerve action potentials.

The influence of electrode size on sensory nerve action potential (SNAP) amplitude of the lateral antebrachial cutaneous nerve (LACN) and sural nerve (SN) was studied in 63 healthy volunteers. The SNAP amplitudes were measured using surface recording electrodes of three different sizes, positioned across the nerve. Mean amplitudes using a 5-mm electrode were 9.0% (SN) and 15.3% (LACN) higher than with a 20-mm electrode and 19.4% (SN) and 25.8% (LACN) higher than using a 40-mm electrode. To study the influence of pressure on surface recording electrodes, studies were performed on the LACN in 31 healthy volunteers. Light pressure of the recording electrodes on the skin gave lower amplitudes (15.3%) than did greater pressure or pressure applied between active and reference electrodes. These studies demonstrate that standardized surface recording electrode size and pressure are imperative for obtaining valid and reliable results in experimental studies or in clinical follow-up of patients undergoing nerve conduction studies.