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常用感觉和运动神经传导研究的参考数据。

Reference data for commonly used sensory and motor nerve conduction studies.

作者信息

Benatar Michael, Wuu Joanne, Peng Limin

机构信息

Department of Neurology, Emory University School of Medicine, Woodruff Memorial Building, Suite 6000, 101 Woodruff Circle, Atlanta, Georgia 30322, USA.

出版信息

Muscle Nerve. 2009 Nov;40(5):772-94. doi: 10.1002/mus.21490.

Abstract

INTRODUCTION

The goal of this study was to generate reference data for a wide range of sensory and motor nerve conduction studies (NCSs) that are commonly used in routine electrodiagnostic practice.

METHODS

NCS data were collected from control subjects with a normal neurological examination and no known risk factors for or symptoms to suggest disease of the peripheral nervous system. Thirteen sensory and motor nerves were studied in the upper and lower limbs using standard recording techniques. Quantile regression was used to obtain estimates of the lower (e.g., 5th) percentiles for sensory and motor amplitudes and conduction velocities, as well as estimates of the upper (e.g., 95th) percentiles for distal motor latency and F-wave latencies.

RESULTS

Reference data for sensory and motor amplitudes required adjustment for age; F-wave latencies required adjustment for gender. Covariate adjustments were not required for other reference data. Data from N = 100 and N = 190 subjects permitted estimation of as low as the 4th and 2nd percentile, respectively, but further increases to N = 296 did not permit estimation of a more extreme percentile.

DISCUSSION

Efforts to develop reference data require careful selection of study subjects; sufficient sample size; adjustment for relevant covariates; and appropriate statistical methods for analysis. Reference data that cannot be estimated reliably due to absent potentials or data variability must be interpreted with caution. We present data for a range of clinically applicable reference percentiles, but judgment regarding which is most appropriate for diagnostic purpose awaits empiric evaluation in a disease population.

摘要

引言

本研究的目的是生成一系列常用于常规电诊断实践的感觉和运动神经传导研究(NCS)的参考数据。

方法

从神经系统检查正常且无已知周围神经系统疾病危险因素或症状的对照受试者中收集NCS数据。使用标准记录技术对上肢和下肢的13条感觉和运动神经进行研究。采用分位数回归获得感觉和运动幅度及传导速度的较低百分位数(如第5百分位数)估计值,以及远端运动潜伏期和F波潜伏期的较高百分位数(如第95百分位数)估计值。

结果

感觉和运动幅度的参考数据需要根据年龄进行调整;F波潜伏期需要根据性别进行调整。其他参考数据无需进行协变量调整。来自N = 100和N = 190名受试者的数据分别允许估计低至第4和第2百分位数,但进一步增加到N = 296时不允许估计更极端的百分位数。

讨论

开发参考数据的工作需要仔细选择研究对象;足够的样本量;对相关协变量进行调整;以及适当的统计分析方法。由于电位缺失或数据变异性而无法可靠估计的参考数据必须谨慎解释。我们提供了一系列临床适用的参考百分位数数据,但关于哪种最适合诊断目的的判断有待在疾病人群中进行实证评估。

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