Servicio de Neurofisiología Clínica (Unidad de EMG), Hospital Universitario de San Juan, Alicante, Spain.
Eur J Neurol. 2009 Nov;16(11):1233-9. doi: 10.1111/j.1468-1331.2009.02764.x. Epub 2009 Jul 29.
The F wave, a late response of low amplitude, is widely used in the study of peripheral nerve lesions, and its persistence and latencies are the main parameters that are usually considered. The analysis of repeater F-waves, which are commonly observed in association with focal or generalized motor neuropathy, is not always performed as a standard electrodiagnostic protocol.
We recorded and quantified the F waves from 13 healthy subjects and 22 patients with unilateral lumbosacral radiculopathy (ULSR) affecting the L5 or S1 roots.
We found differences between the injured and normal sides of patients with ULSR in several F-wave parameters. Taking into consideration the normalized and pooled values of tibial and peroneal nerves in the injured side of patients with ULSR, the minimum and mean latencies were higher (1.05 and 1.04 with respect to 1.00; P < 0.01), the relative amplitude of the F waves was higher (1.95 with respect to 1.00; P < 0.001), and the percentage of repeater F-waves was also higher (4.19 with respect to 1.00; P < 0.001). This latter parameter was the most sensitive to detect lateral differences as indicated by the percentage of change and its high z score.
Our results show that the use of F-waves may improve the electrodiagnosis of the ULSR if the number of repeater waves is evaluated given the clear and consistent increase of this variable in patients with lumbosacral root injury.
F 波是一种低振幅的迟发反应,广泛用于周围神经病变的研究,其潜伏期和持续时间是通常考虑的主要参数。重复 F 波的分析,常见于局灶性或全身性运动神经病,并不总是作为标准电诊断方案进行。
我们记录并量化了 13 名健康受试者和 22 名单侧腰骶神经根病变(ULSR)患者的 F 波,病变影响 L5 或 S1 神经根。
我们发现 ULSR 患者患侧的几个 F 波参数与健侧不同。考虑到 ULSR 患者患侧胫神经和腓总神经的归一化和汇总值,最小和平均潜伏期较高(分别为 1.05 和 1.04,而 1.00;P <0.01),F 波的相对幅度较高(1.95 与 1.00;P <0.001),重复 F 波的百分比也较高(4.19 与 1.00;P <0.001)。后一个参数是最敏感的,因为其百分比变化和高 z 分数表明可以检测到侧向差异。
我们的结果表明,如果评估重复 F 波的数量,F 波的使用可能会改善 ULSR 的电诊断,因为在腰骶神经根损伤患者中,该变量明显且一致增加。