Chodoroff G, Tashjian E A, Ellenberg M R
Arch Phys Med Rehabil. 1985 Sep;66(9):589-91.
Sensory nerve action potentials may be evoked antidromically (AD) by stimulating a nerve proximally and recording distally, or orthodromically (OD) by stimulating distally and recording over the nerve trunk proximally. The objective of this study was to compare OD and AD distal latencies in healthy subjects. Fifty-two volunteers (average age 30 years) were tested. Orthodromic and AD sensory distal latencies of the median and ulnar nerves of the nondominant hand were obtained. Hand temperature was controlled at 32C. Six subjects were also tested at a hand temperature of 24C. In all subjects tested the OD latency was shorter than the AD latency. Median nerve AD = 3.14 +/- 0.20 (mean latency in ms +/- 1 standard deviation); median nerve OD = 2.94 +/- 0.20; ulnar nerve AD = 3.07 +/- 0.22; ulnar nerve OD = 2.85 +/- 0.19. Mean difference between the latencies obtained (OD vs AD) for the median and ulnar nerves was statistically significant (p less than 0.001). In addition, this difference was over twice as great at 24C compared to 32C for both median and ulnar nerves. Because of the difference between OD and AD sensory latencies, the standard values obtained using one method cannot be rigorously applied when utilizing the other method. Individual laboratories should develop their own normal values for both OD and AD methods, or be specific in performance of the studies when utilizing standards from the literature.
通过近端刺激神经并在远端记录，可以逆向（AD）诱发感觉神经动作电位；或者通过远端刺激并在近端神经干上记录，可以顺向（OD）诱发感觉神经动作电位。本研究的目的是比较健康受试者的顺向和逆向远端潜伏期。测试了52名志愿者（平均年龄30岁）。获得了非优势手正中神经和尺神经的顺向和逆向感觉远端潜伏期。手部温度控制在32℃。6名受试者还在24℃的手部温度下进行了测试。在所有测试的受试者中，顺向潜伏期短于逆向潜伏期。正中神经逆向潜伏期=3.14±0.20（平均潜伏期，单位为毫秒±1个标准差）；正中神经顺向潜伏期=2.94±0.20；尺神经逆向潜伏期=3.07±0.22；尺神经顺向潜伏期=2.85±0.19。正中神经和尺神经获得的潜伏期（顺向与逆向）之间的平均差异具有统计学意义（p＜0.001）。此外，对于正中神经和尺神经，在24℃时这种差异比在32℃时大两倍多。由于顺向和逆向感觉潜伏期之间存在差异，当使用另一种方法时，不能严格应用用一种方法获得的标准值。各个实验室应该为顺向和逆向方法制定自己的正常值，或者在使用文献中的标准时，在研究的实施上做到具体明确。
