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Nomogram for determining lower limit of the sural response
P Kokotis1, D Mandellos, A Papagianni
1University of Athens, Eginition Hospital 72-74 Vas. Sofias Avenue, Athens 11528, Greece. pkokotis@med.uoa.gr
Summary
This study developed a predictive equation for normal sural sensory nerve action potential (SNAP) amplitude, accounting for both age and height in healthy adults.
Area of Science:
- Neurology
- Neurophysiology
- Clinical Electrophysiology
Background:
- Sural sensory nerve action potential (SNAP) is a key electrophysiological measure.
- Age and height are known to independently affect SNAP amplitude.
- A combined predictive model for normal SNAP limits is lacking.
Purpose of the Study:
- To develop a regression equation to predict the lower normal limits of sural SNAP amplitude.
- To incorporate both age and height as predictors for individualized normal values.
Main Methods:
- 158 healthy volunteers (63 male, mean age 45.8, mean height 167.3 cm) participated.
- Sural SNAP amplitude was recorded using surface electrodes at the ankle.
- Antidromic stimulation was applied at the posterior midcalf.
Main Results:
- Mean sural SNAP amplitude was 19.9 ± 6.89 microV.
- Negative correlations were observed between SNAP amplitude and both age (R=-0.22) and height (R=-0.19).
- A multiple linear regression equation was derived: SNAP amplitude = 62.45 - 0.1447 × Age - 0.2147 × Height.
Conclusions:
- The developed equation provides individualized normal lower limits for sural SNAP amplitude.
- This equation is crucial for accurate interpretation of sural nerve conduction studies.
- The findings aid in distinguishing normal age- and height-related variations from neuropathy.
