Das Pinaki, Ghosh Parasar, Halder Subhankar, Kumar Subhankar
Department of Physiology, Calcutta National Medical College, Beniapukur, Kolkata, West Bengal, India.
Department of Rheumatology and Clinical Immunology, Institute of Post Graduate Medical Education & Research and Seth Sukhlal Karnani Memorial Hospital (IPGME&R and SSKM Hospital), Bhowanipore, Kolkata, West Bengal, India.
Ann Neurosci. 2023 Jul;30(3):154-162. doi: 10.1177/09727531221142399. Epub 2023 Jan 9.
Conduction velocity of the short segment of the median motor nerve, (transcarpal motor conduction velocity (TCMCV)), has been used to increase diagnostic yield in carpal tunnel syndrome (CTS). However, repeatability of this parameter has not been studied till date. It has not been used as an indicator of response to treatment. Using surface stimulation techniques, it is difficult to localize the sites of stimulation of transcarpal segment of median nerve in palm. As a result, small errors in measurements of TCMCV can be magnified and variability of TCMCV may occur on successive measurements. Despite this possible variation, TCMCV can be a useful tool for assessing response to therapy, if its repeatability is assessed and a cut-off value determined for a significant change in nerve conduction velocity.
In this study, it was determined whether TCMCV is repeatable. If found to be repeatable, we show a method to determine the cut-off value of the change in this parameter for it to be considered significant.
Difference between values of TCMCV on successive measurements was obtained in hands of 26 controls. Repeatability of this parameter was determined in this control population following criteria of British Standards Institution. In 19 patients of CTS, treated with intracarpal steroid injection, pre-treatment and post-treatment values of TCMCV, and of symptom severity scale (SSS) and functional status scale (FSS), were obtained at 1, 2, and 3 months .
Repeat measurements of TCMCV were made in each hand of all controls. After applying criteria of British Standards Institution, to such recordings, TCMCV was found to be repeatable and the cut-off value for significant change determined. According to this cut-off value, 4 patients of CTS showed improvement in TCMCV, with improvement in SSS and FSS. Change in TCMCV corroborated qualitatively with changes in SSS and FSS.
Repeatability of TCMCV can be assessed by criteria of British Standards Institution and a cut-off value determined to use it as an indicator of response to treatment in CTS.
正中神经运动短节段的传导速度（经腕部运动传导速度（TCMCV））已被用于提高腕管综合征（CTS）的诊断率。然而，该参数的可重复性至今尚未得到研究。它也未被用作治疗反应的指标。使用表面刺激技术时，难以在手掌中定位正中神经经腕部节段的刺激部位。因此，TCMCV测量中的小误差可能会被放大，并且连续测量时TCMCV可能会出现变异性。尽管存在这种可能的变化，但如果评估了TCMCV的可重复性并确定了神经传导速度显著变化的临界值，那么TCMCV可以成为评估治疗反应的有用工具。
在本研究中，确定TCMCV是否具有可重复性。如果发现具有可重复性，我们展示一种确定该参数变化临界值的方法，以便将其视为显著变化。
在26名对照者的手部获取连续测量的TCMCV值之间的差异。按照英国标准协会的标准在该对照人群中确定该参数的可重复性。在19例接受腕内类固醇注射治疗的CTS患者中，在1、2和3个月时获取TCMCV以及症状严重程度量表（SSS）和功能状态量表（FSS）的治疗前和治疗后值。
对所有对照者的每只手进行了TCMCV的重复测量。将英国标准协会的标准应用于此类记录后，发现TCMCV具有可重复性并确定了显著变化的临界值。根据该临界值，4例CTS患者的TCMCV有所改善，同时SSS和FSS也有所改善。TCMCV的变化在质量上与SSS和FSS的变化相符。
可以按照英国标准协会的标准评估TCMCV的可重复性，并确定一个临界值，以将其用作CTS治疗反应的指标。
