The current perception threshold test differentiates categories of mechanical neck disorder

Area of Science:

• Neurology
• Orthopedics
• Musculoskeletal Disorders

Background:

• Neck pain is a prevalent musculoskeletal disorder affecting a significant portion of the adult population annually.
• Mechanical neck disorders (MNDs) present with varying degrees of musculoskeletal and neurological signs.
• Current Perception Threshold (CPT) testing assesses sensory perception alterations, potentially indicating neurological changes.

Purpose of the Study:

• To evaluate the efficacy of Current Perception Threshold (CPT) testing in discriminating between different categories of mechanical neck disorders (MNDs).
• To determine if CPT can distinguish patients with neurological signs from those without within the MND classification.

Main Methods:

• A cross-sectional discriminative analysis was conducted on 106 patients with MNDs, categorized into three groups: MND I (no signs), MND II (musculoskeletal signs), and MND III (neurological signs).
• CPT was measured using a rapid protocol at three frequencies (5, 250, 2000 Hz) across three hand dermatomes.
• Statistical analyses included ANOVA with post hoc tests and logistic regression with ROC curve analysis to compare CPT scores and predict group differentiation.

Main Results:

• Significant differences in mean CPT scores were observed across the three MND groups (MND I: 9.7, MND II: 10.6, MND III: 11.8; P<.001).
• CPT testing demonstrated large effect sizes in differentiating between MND I and II (d=1) and MND II and III (d=2.2).
• A CPT threshold of >11 showed 73% sensitivity and 81% specificity for identifying MND III, with an odds ratio of 11.5 (P=.001) and an AUC of 0.84.

Conclusions:

• CPT testing exhibits moderate discriminatory accuracy, sensitivity, and specificity for classifying MND categories, particularly in distinguishing patients with neurological involvement.
• The findings support the utility of CPT as a diagnostic tool for categorizing patients with mechanical neck disorders based on neurological signs.
• CPT assessment can aid clinicians in identifying and classifying the severity of neurological involvement in patients presenting with neck pain.