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Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
Published on: January 11, 2019
Laser evoked potentials in carpal tunnel syndrome
Marina de Tommaso1, Giuseppe Libro, Olimpia Difruscolo
1Neurological and Psychiatric Sciences Department, Neurophysiopathology of Pain Unit, Bari University, Policlinico, Piazza G. Cesare 11, 70124 Bari, Italy. m.detommaso@neurol.uniba.it
Summary
Carpal Tunnel Syndrome (CTS) involves early Adelta fiber dysfunction, detectable by CO(2) laser evoked potentials (LEPs). Reduced LEP amplitude correlates with sensory symptom severity in CTS patients.
Area of Science:
- Neuroscience
- Neurology
- Pain Management
Background:
- Carpal Tunnel Syndrome (CTS) is a common neuropathy affecting the median nerve.
- Sensory and motor deficits characterize CTS, impacting hand function and quality of life.
Purpose of the Study:
- To investigate Adelta fiber function in the hand using CO(2) laser evoked potentials (LEPs) in patients with Carpal Tunnel Syndrome (CTS).
- To correlate LEP findings with symptom intensity, distribution, and Nerve Conduction Study (NCS) data.
Main Methods:
- CO(2) laser evoked potentials (LEPs) were recorded from the first, second, third, and fifth fingers and dorsum of the hand in 34 CTS patients and 23 controls.
- LEP components (N2, P2, N1) were analyzed for latency and amplitude.
- Data were compared with NCS results, clinical scales, and symptom characteristics.
Main Results:
- Reduced N2-P2 complex amplitude in CTS hands compared to controls, particularly after stimulation of the second and third fingers.
- LEP abnormalities were observed even in mild nerve conduction impairment.
- N2-P2 amplitude correlated positively with sensory symptom severity.
Conclusions:
- Adelta fiber involvement in CTS is an early event, preceding significant large fiber impairment.
- LEP findings suggest Adelta fiber dysfunction is linked to CTS severity.
- Reduced sensory symptoms in severe cases may indicate central sensitization.
