Nerve Conduction and Needle Electromyography

Kimura, Jun

doi:10.1016/b978-0-7216-9491-7.50038-7

Cited by 43 publications

(42 citation statements)

References 284 publications

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“…Patients marked with an asterisk were not included in the group of patients for the analysis. For comparison, Kimura (1993) reported the approximate maximal CV in the corresponding nerves in healthy volunteers: Median nerve: 59 Ϯ 2 m/s measured from palm, wrist, and elbow. Ulnar nerve: 62 Ϯ 1 m/s, measured from the wrist, below elbow, and above elbow.…”

Section: Apparatus and Instrumentationmentioning

confidence: 99%

Lack of On-Going Adaptations in the Soleus Muscle Activity During Walking in Patients Affected by Large-Fiber Neuropathy

Mazzaro

Grey²,

Sinkjær

et al. 2005

Journal of Neurophysiology

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of on-going adaptations in the soleus muscle activity during walking in patients affected by large-fiber neuropathy. J Neurophysiol 93: 3075-3085, 2005; doi:10.1152/jn.01071.2004. The aim of this study was to investigate the contribution of feedback from large-diameter sensory fibers to the adaptation of soleus muscle activity after small ankle trajectory modifications during human walking. Small-amplitude and slow-velocity ankle dorsiflexion enhancements and reductions were applied during the stance phase of the gait cycle to mimic the normal variability of the ankle trajectory during walking. Patients with demyelination of large sensory fibers (Charcot-Marie-Tooth type 1A and antibodies to myelin-associated glycoprotein neuropathy) and age-matched controls participated in this study. The patients had absent light-touch sense in the toes and feet and absent quadriceps and Achilles tendon reflexes, indicating functional loss of large sensory fibers. Moreover, their soleus stretch reflex response consisted of a single electromyographic (EMG) burst with delayed onset and longer duration (P Ͻ 0.01) than the short-and medium-latency reflex responses observed in healthy subjects. In healthy subjects, the soleus EMG gradually increased or decreased when the ankle dorsiflexion was, respectively, enhanced or reduced. In the patients, the soleus EMG increased during the dorsiflexion enhancements; however, the velocity sensitivity of this response was decreased compared with the healthy volunteers. When the dorsiflexion was reduced, the soleus EMG was unchanged. These results indicate that the enhancement of the soleus EMG is mainly sensitive to feedback from primary and secondary muscle spindle afferents and that the reduction may be mediated by feedback from the group Ib pathways. This study provides evidence for the role of sensory feedback in the continuous adaptation of the soleus activity during the stance phase of human walking. I N T R O D U C T I O NLarge-amplitude and fast-velocity dorsiflexion perturbations have been applied to the ankle to investigate the role of sensory feedback to the muscle activation during normal walking (Dietz et al. 1987;Sinkjaer et al. 1996;Yang et al. 1991). These unexpected destabilizing perturbations elicited compensatory stretch reflex responses in the plantar flexor muscles, demonstrating that afferent feedback can generate corrective responses to unexpected external perturbations during walking. However, the extrapolation of such results to normal unperturbed walking must be made cautiously. Recently, it has been suggested that sensory feedback during normal unperturbed walking, as part of the locomotor program, might be processed differently than the afferent signal associated to unexpected perturbations (Nielsen 2002;Nielsen and Sinkjaer 2002;Sinkjaer et al. 2000). Furthermore, Morita et al. (1998) proposed that sensory feedback may be centrally processed differently depending on the frequency components of the feedback signal.Sinkjaer et al. (2000) applied fast plantar flexion...

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Section: Apparatus and Instrumentationmentioning

confidence: 99%

Lack of On-Going Adaptations in the Soleus Muscle Activity During Walking in Patients Affected by Large-Fiber Neuropathy

Mazzaro

Grey²,

Sinkjær

et al. 2005

Journal of Neurophysiology

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“…In the final sample there were 38 patients valuable for the purpose of this study: 17 females and 21 males with a median age of 68.2 years (-7.4), all with diabetes and with a deficit in nerve velocity conduction (diabetic symmetric sensorimotor polyneuropathy). [23] All measured variables were tested for sex differences due to sex dimorphism suggested by clinical observation. In fact, nerve conduction abnormalities have been previously reported as more frequent and severe in males, while neuropathic pain and negative sensory symptoms seem to be more frequent in female patients.…”

Section: Resultsmentioning

confidence: 99%

“…[23] Patients were treated orally for 4 months with ALA 600 mg and SOD 140 IU/day (ALA600 SOD Ò , Alfa Wassermann, Bologna, Italy).…”

Section: Methodsmentioning

confidence: 99%

Combination of Alpha Lipoic Acid and Superoxide Dismutase Leads to Physiological and Symptomatic Improvements in Diabetic Neuropathy

Bertolotto

Massone

2012

Drugs R D

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Background and Objective: The management of diabetic neuropathy is still a challenge for physicians. The aim of this study was to assess the efficacy of a new combination of alpha lipoic acid and superoxide dismutase for the treatment of diabetic neuropathy. Methods: The setting of this study was ambulatory (outpatient) care. A prospective, non-randomized, open-label study was conducted in 50 patients with diabetes mellitus and with a deficit in both motor and sensory nerve conduction. Treatment was with a new combination of alpha lipoic acid and superoxide dismutase (ALA600SOD Ò ) for 4 months. Electroneurographic parameters and perceived pain were assessed at baseline and after treatment. Results: After 4 months of treatment, patients significantly (p < 0.001) improved their electroneurographic parameters and their perception of pain. Best improvements were observed in sensory nerve conduction. Conclusion: The combination of two powerful antioxidant agents leads to improvement in both subjective and objective parameters in patients with diabetic neuropathy. New profitable directions for investigations are opened for a non-invasive treatment of diabetic neuropathy in the future.

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“…In 1883, Wilhelm Erb described it as a cutaneous site located two to three centimeter superior to the clavicle, lateral to the posterior border of the sternocleidomastoid, at the level of the carotid tubercle of the C6 vertebra (referenced in Tubbs et al, 2007); this position is slightly inferior and lateral to the nerve point of the neck. Erb also reported that transcutaneous stimulation at ''Erb's point'' ''resulted in contraction of such muscles as the deltoid, biceps brachii, and brachialis'' (referenced in Tubbs et al, 2007); stimulation at ''Erb's point'' is used currently in the functional assessment of the brachial plexus (Kimura, 2005). Another application of the term ''Erb's point'' is to describe the third left intercostal space adjacent to the sternum, one of five traditional points of cardiac auscultation (also known as the second pulmonic area) that can be used to assess the pulmonary valve (Jarvis, 2007).…”

Section: Erb's Point-its Uses and Misusesmentioning

confidence: 99%

A modified dissection method to preserve neck structures

Hankin

Stoller

2009

Anatomical Sciences Ed

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The neck is not only one of the more challenging anatomical regions to dissect but also has important application to clinical conditions, diseases, and procedures. In this study, we describe two simple modifications for dissection of the neck that (1) aid in the identification and preservation of the cutaneous branches of the cervical plexus and the accessory nerve, and (2) provide wide exposure of the root of the neck. The cutaneous branches of the cervical plexus can be identified with relative ease at the nerve point of the neck, where they are largest. To accomplish this, the skin and platysma are reflected beginning from the anterior border of trapezius and proceeding anteriorly to the midline of the neck, rather than the conventional approach of reflecting the skin from the anterior midline. The accessory nerve is identified by its relationship to the nerve point and its course to the trapezius muscle. To achieve wide exposure of the root of the neck and its contents, the acromioclavicular and sternoclavicular joints are disarticulated, and then the clavicle removed completely, rather than the more common approach of removing only the middle section of the clavicle. These modified procedures can be readily performed by first-year medical students and integrate well with methods described in widely used anatomy dissection manuals.

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Nerve Conduction and Needle Electromyography

Cited by 43 publications

References 284 publications

Lack of On-Going Adaptations in the Soleus Muscle Activity During Walking in Patients Affected by Large-Fiber Neuropathy

Lack of On-Going Adaptations in the Soleus Muscle Activity During Walking in Patients Affected by Large-Fiber Neuropathy

Combination of Alpha Lipoic Acid and Superoxide Dismutase Leads to Physiological and Symptomatic Improvements in Diabetic Neuropathy

A modified dissection method to preserve neck structures

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