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Median-radial sensory nerve comparative studies in the detection of median neuropathy at the wrist in diabetic patients.
Clin Neurophysiol. 2007 Jun; 118(6):1405-9.CN

Abstract

OBJECTIVE

Median-ulnar comparative studies (MUCS) play an important role in the electrodiagnosis of carpal tunnel syndrome, but in diabetes concomitant involvement of Guyon's canal (ulnar nerve compression at the wrist) would reduce the sensitivity of MUCS. This study tested the utility of median-radial comparative studies (MRCS) in diabetic patients.

METHODS

Anti-dromic MUCS and MRCS were prospectively performed in 120 patients with diabetes, and 64 normal controls. In 28 diabetic patients, latent addition using threshold tracking was performed in superficial radial sensory axons to estimate persistent nodal sodium currents.

RESULTS

MUCS was abnormal in 49% of the diabetic patients, and MRCS was abnormal in 58%. Median motor distal latencies were prolonged in 38%, and median sensory nerve conduction velocities were slowed in 40%. The longer latency differences in MRCS were associated with smaller persistent sodium currents, suggesting that intra-axonal sodium accumulation mediated by hyperglycemia enhances nerve compression.

CONCLUSIONS

MRCS appears to be the most sensitive electrodiagnostic test in the detection of median neuropathy at the wrist in diabetic patients. Nerve conduction slowing across the carpal tunnel may be associated with metabolic abnormalities under hyperglycemia.

SIGNIFICANCE

Assessment of nerve conduction across the common entrapment sites could provide new insights into the pathophysiology of diabetic neuropathy related to metabolic factors.

Authors+Show Affiliations

Department of Clinical Laboratory, Graduate School of Medicine, Chiba University, 1-8-1 Inohama, Chiba, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17452013

Citation

Imada, Megumi, et al. "Median-radial Sensory Nerve Comparative Studies in the Detection of Median Neuropathy at the Wrist in Diabetic Patients." Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, vol. 118, no. 6, 2007, pp. 1405-9.
Imada M, Misawa S, Sawai S, et al. Median-radial sensory nerve comparative studies in the detection of median neuropathy at the wrist in diabetic patients. Clin Neurophysiol. 2007;118(6):1405-9.
Imada, M., Misawa, S., Sawai, S., Tamura, N., Kanai, K., Sakurai, K., Sakamoto, S., Nomura, F., Hattori, T., & Kuwabara, S. (2007). Median-radial sensory nerve comparative studies in the detection of median neuropathy at the wrist in diabetic patients. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, 118(6), 1405-9.
Imada M, et al. Median-radial Sensory Nerve Comparative Studies in the Detection of Median Neuropathy at the Wrist in Diabetic Patients. Clin Neurophysiol. 2007;118(6):1405-9. PubMed PMID: 17452013.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Median-radial sensory nerve comparative studies in the detection of median neuropathy at the wrist in diabetic patients. AU - Imada,Megumi, AU - Misawa,Sonoko, AU - Sawai,Setsu, AU - Tamura,Noriko, AU - Kanai,Kazuaki, AU - Sakurai,Kenichi, AU - Sakamoto,Setsuko, AU - Nomura,Fumio, AU - Hattori,Takamichi, AU - Kuwabara,Satoshi, Y1 - 2007/04/23/ PY - 2007/01/11/received PY - 2007/02/18/revised PY - 2007/03/08/accepted PY - 2007/4/25/pubmed PY - 2007/7/25/medline PY - 2007/4/25/entrez SP - 1405 EP - 9 JF - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology JO - Clin Neurophysiol VL - 118 IS - 6 N2 - OBJECTIVE: Median-ulnar comparative studies (MUCS) play an important role in the electrodiagnosis of carpal tunnel syndrome, but in diabetes concomitant involvement of Guyon's canal (ulnar nerve compression at the wrist) would reduce the sensitivity of MUCS. This study tested the utility of median-radial comparative studies (MRCS) in diabetic patients. METHODS: Anti-dromic MUCS and MRCS were prospectively performed in 120 patients with diabetes, and 64 normal controls. In 28 diabetic patients, latent addition using threshold tracking was performed in superficial radial sensory axons to estimate persistent nodal sodium currents. RESULTS: MUCS was abnormal in 49% of the diabetic patients, and MRCS was abnormal in 58%. Median motor distal latencies were prolonged in 38%, and median sensory nerve conduction velocities were slowed in 40%. The longer latency differences in MRCS were associated with smaller persistent sodium currents, suggesting that intra-axonal sodium accumulation mediated by hyperglycemia enhances nerve compression. CONCLUSIONS: MRCS appears to be the most sensitive electrodiagnostic test in the detection of median neuropathy at the wrist in diabetic patients. Nerve conduction slowing across the carpal tunnel may be associated with metabolic abnormalities under hyperglycemia. SIGNIFICANCE: Assessment of nerve conduction across the common entrapment sites could provide new insights into the pathophysiology of diabetic neuropathy related to metabolic factors. SN - 1388-2457 UR - https://www.unboundmedicine.com/medline/citation/17452013/Median_radial_sensory_nerve_comparative_studies_in_the_detection_of_median_neuropathy_at_the_wrist_in_diabetic_patients_ DB - PRIME DP - Unbound Medicine ER -