Use of collision tests to identify physiological differences between the median and ulnar nerves

Koszewicz, Magdalena; Szydło, Mariusz; Gosk, Jerzy; Wieczorek, Małgorzata; Budrewićz, Sławomir

doi:10.1002/mus.26428

Cited by 3 publications

(9 citation statements)

References 24 publications

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“…As a result, safer and more effective surgical interventions, and individually selected, appropriate rehabilitation treatments could be easier to determine. Although our research needs to be extended, e.g., by application of CHEPS, we can state, based on the present study, and our previous findings on motor conduction in the median and ulnar nerves (Koszewicz et al, 2019), that physiological differences between these two nerves should be fully included during the examination of hand…”

Section: Discussionmentioning

confidence: 77%

“…This is important, because these nerves are often compared in the evaluation of hand nerve pathology, above all in carpal tunnel syndrome examination ( Sable, 1998 ; Sander et al, 1999 ; Nouraei et al, 2015 ; Barton et al, 2016 ; Wyner and Dissabandara, 2018 ). In our previous study ( Koszewicz et al, 2019 ) we showed faster motor conduction velocities in the ulnar nerve using a more advanced neurophysiological technique: the conduction velocity distribution (CVD) test. The findings confirmed the presence of more larger fibers in the ulnar than in the median nerve.…”

Section: Introductionmentioning

confidence: 95%

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The Use of Quantitative Sensation Testing to Identify the Physiological Differences Between the Median and Ulnar Nerves

Koszewicz

Szydło

Gosk

et al. 2021

Front. Hum. Neurosci.

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IntroductionSimilarities in morphology, physiological function, and neurophysiological findings between median and ulnar nerves are not unequivocal. Our previous study confirmed differences in motor fiber parameters between these nerves in healthy persons. We made an attempt to assess and compare the physiological parameters of different sensation modalities (temperature, pain, and vibration) in median and ulnar nerves.MethodsThe study was performed in 31 healthy, right-handed volunteers: 17 women, 14 men, mean age 44.8 ± 15.5 years. Standard sensory conduction tests in the median and ulnar nerves were performed together with the estimation of vibratory, temperature, and warm- and cold-induced pain thresholds in the C7 and C8 dermatomes on the palm, using quantitative sensory testing.ResultsThere were no statistically significant differences in the standard sensory conduction test in the median and ulnar nerves across the whole group: between right and left hands, and between women and men. We revealed differences in the temperature and pain thresholds between these nerves, mainly in low temperature perception. There were no differences in estimated thresholds between sides or in female and male groups. The vibratory limits did not differ significantly between nerves, and subgroups.ConclusionThe study confirmed the differences in the physiological sensory perception between the median and ulnar nerves. The median nerve is more sensitive to temperature stimulation than the ulnar nerve, but simultaneously less sensitive to pain-inducing temperature stimuli. These findings should be considered during the examination of hand nerve pathology.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 95%

The Use of Quantitative Sensation Testing to Identify the Physiological Differences Between the Median and Ulnar Nerves

Koszewicz

Szydło

Gosk

et al. 2021

Front. Hum. Neurosci.

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“…The peripheral nerves consist of axons of different diameter, unmyelinated and myelinated with different thicknesses of the myelin sheaths. The conduction velocity depends on both the diameter of the axons and the thickness of the myelin (Ugrenović et al, 2016;Koszewicz et al, 2019). The collision method of CVD allowed us to explore virtually the whole spectrum of fibers forming the group A nerve fibers connecting alpha motoneurons and extrafusal muscle fibers including large and small myelinated fibers (Kiziltan et al, 2007;Ni et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…We performed CVD tests based on the antidromic recurrent block of the proximal stimulus (the so-called collision method) (Dalkilic et al, 2015;Koszewicz et al, 2019;Ni et al, 2020) in the median, ulnar, peroneal nerves. Two supramaximal stimuli were delivered subsequently at the distal and proximal stimulation points along the nerves, the two evoked CMAPs were recorded.…”

Section: Cvd Studymentioning

confidence: 99%

“…But the analysis of F-waves increased the sensitivity of NCS (Pan et al, 2014). In addition, the method to calculate the contribution of each nerve fiber group of different conduction velocities that makes up the compound muscle action potential, so called the conduction velocity distribution (CVD), is an accurate way to detect nerve damages and more sensitive for early diabetic neuropathy compared to routine NCS (Tuncer et al, 2011;Koszewicz et al, 2019). CVD can detect the loss of motor fibers with different conductive velocities in diabetic patients when NCS remains normal, thus can serve as a supplement for routine NCS in early DPN (Kiziltan et al, 2007;Tuncer et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

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The Physiological Significance of A-Waves in Early Diabetic Neuropathy: Assessment of Motor Nerve Fibers by Neurophysiological Techniques

Cai

Aimair

et al. 2021

Front. Syst. Neurosci.

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Objective: This study aimed to investigate how early A-waves could occur in type II diabetes, and what it implied functionally.Methods: We performed conduction velocity distribution (CVD) test in peroneal nerves of 37 type II diabetic patients with normal nerve conduction study (NCS) and 22 age-matched controls. The electrophysiological data and clinical information were analyzed.Results: A-waves were observed in 45.9% of diabetic patients and only in 1 person in healthy controls, all detected in the tibial nerves. The diabetic patients with A-waves showed faster conduction velocity in all quartiles in the motor peroneal nerves compared to the patients without A-waves, and their CVD histograms were shifted to the right side, consisting of a significantly larger percentage of fast conducting fibers. There was no significant difference in the CVD values of the upper extremity nerves among the patients with and without A-waves and the healthy controls.Conclusion: A-waves could occur in type II diabetes as early as when NCS showed normal, and represented as a sign of neuropathy as well as a sign of rescued motor nerve function.

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Modified collision study to isolate and study small fibre neuropathy in patients with Type 2 diabetes

Hazeena

Shanmugam

Ramesh

et al. 2022

Journal of Family Medicine and Primary Care

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Introduction: Diabetic distal symmetrical polyneuropathy (DSPN) can be categorized as small fibre, large fibre, and mixed neuropathy. Even though small fibre neuropathy is the most prevalent, unfortunately it is usually not recognized by routine electrophysiologic studies. In this study, we intend to examine the slow velocity small fibres responsible for small fibre DSPN, by isolating them using collision technique principle in patients with diabetes. Methods: This is an observational case-control study designed to compare nerve conduction values with application of collision technique in 60 patients with T2D and in 60 age and sex matched controls. Results: The collision study in patients with Type 2 Diabetes showed mean Latency of 10.5 ± 1.7 ms and mean Amplitude of 3.4 ± 2.3 mV on the right side and mean Latency of 10.5 ± 1.7 ms and the mean Amplitude of 3.5 ± 2.2 mV on the left side. There was a statistically significant difference ( P value < 0.001) in the amplitute and latency of CNAPs of small fibres in median nerve innervated APBs of both arms between those with T2D and controls. Discussion and Conclusion: Collision study helps to examine the slower conducting fibres of the larger nerves. Our study suggests that the Collision Technique can be used to identify early peripheral neuropathy regardless of the diabetes status, thus making it more practically feasible and cost-effective.

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Use of collision tests to identify physiological differences between the median and ulnar nerves

Cited by 3 publications

References 24 publications

The Use of Quantitative Sensation Testing to Identify the Physiological Differences Between the Median and Ulnar Nerves

The Use of Quantitative Sensation Testing to Identify the Physiological Differences Between the Median and Ulnar Nerves

The Physiological Significance of A-Waves in Early Diabetic Neuropathy: Assessment of Motor Nerve Fibers by Neurophysiological Techniques

Modified collision study to isolate and study small fibre neuropathy in patients with Type 2 diabetes

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