Validity of the upper limb neurodynamic test 1 for the diagnosis of carpal tunnel syndrome. The role of structural differentiation

Bueno-Gracia, E.; Tricás-Moreno, José Miguel; Fanlo-Mazas, Pablo; Malo-Urriés, Miguel; Haddad-Garay, María; Miguel, Elena Estébanez de; Hidalgo-García, César; Krauss, John; Ruiz-de-Escudero-Zapico, Alazne

doi:10.1016/j.math.2016.10.063

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“…Therefore, a selective and reliable test to assess VN functions with no or possibly negligible side effects is necessary. Peripheral nerve selective tension tests or neurodynamic tests (NDT) are bedside examinations and reliable clinical tests validated for the detection of neuropathies of the somatic nerves ( Taenzer et al, 2000 ; Wasan et al, 2011 ; Bueno-Gracia et al, 2016 ; Verwoerd et al, 2016 ; Ekedahl et al, 2018 ; Koulidis et al, 2019 ). NDTs assess the nerve response to mechanical stimuli which are transduced by stretch-sensitive ion channels in peripheral nerves also present in the VN axons and cell body membranes ( Beaulieu-Laroche et al, 2020 ; Bonet et al, 2021 ).…”

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confidence: 99%

Validation and Reliability of a Novel Vagus Nerve Neurodynamic Test and Its Effects on Heart Rate in Healthy Subjects: Little Differences Between Sexes

et al. 2021

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BackgroundThe vagus nerve (VN), also called the pneumogastric nerve, connects the brainstem to organs contained in the chest and abdomen. Physiologically, VN stimulation can rapidly affect cardiac activity and heart rate (HR). VN neuropathy can increase the risk of arrhythmias and sudden death. Therefore, a selective test of VN function may be very useful. Since peripheral neurodynamic tests (NDT) are reliable for the assessment of neuropathies in somatic nerves, we aimed to validate a novel NDT to assess VN activity, namely, the VN-NTD.MethodsIn this cross-sectional double-blind, sex-balanced study, 30 participants (15 females) completed a checklist of autonomic dysfunction symptoms. During the VN-NDT administration, HR and symptoms (i.e., mechanical allodynia) were monitored in parallel to a real-time ultrasonography imaging (USI) and motion capture analysis of the neck. The VN-NDT impact on HR and its accuracy for autonomic symptoms reported in the last 7 days were tested.ResultsThe VN-NDT induced a significant HR reduction of about 12 and 8 bpm in males and females [t(1, 119) = 2.425; p < 0.017; ηp2 = 0.047, 95% confidence interval (CI): 0.93–9.18], respectively. No adverse events were observed during VN-NDT. A substantial interexaminer agreement between the evaluators in symptoms induction by VN-NDT was detected [F(1, 119) = 0.540; p = 0.464; ηp2 = 0.005, low effect]. Notably, mechanical allodynia accuracy for gastrointestinal dysfunctions was excellent (p < 0.05; 95% CI: 0.52–0.73; p < 0.001; 95% CI: 0.81–0.96).ConclusionsThe novel VN-NDT is a valid and accurate test capable of detecting VN activation with high sensitivity. Data provided are suitable for both sexes as a hallmark of HR variation due to VN normal response. The proposed VN-NDT may be reliable as daily routine neurological examination tests for the evaluation of neuropathic signs related to neuroinflammation of the VN.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT04192877.

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