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Timothy T Griffiths1,2, Robert Flather1,2, Irvin Teh3

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Diffusion tensor imaging (DTI) reveals significant differences in ulnar nerve health for cubital tunnel syndrome (CuTS) patients compared to healthy individuals. These DTI metrics may offer an objective assessment for CuTS management.

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Area of Science:

  • Neuroimaging
  • Medical Physics
  • Neurology

Background:

  • Cubital tunnel syndrome (CuTS) is the second most common compressive neuropathy, necessitating improved diagnostic tools.
  • Current diagnostic methods for CuTS lack objectivity, impacting surgical patient selection.
  • Diffusion tensor imaging (DTI) offers a potential method to assess ulnar nerve microstructure and health.

Purpose of the Study:

  • To compare DTI metrics of the ulnar nerve in healthy adults and patients with CuTS awaiting surgery.
  • To determine if DTI can differentiate between healthy and affected ulnar nerves in CuTS.
  • To explore the potential of DTI as an objective measure for CuTS diagnosis and management.

Main Methods:

  • DTI was performed at 3.0T on 13 healthy controls and 8 CuTS patients.
  • Key DTI metrics including fractional anisotropy (FA) and radial diffusivity (RD) were extracted along the ulnar nerve.
  • Mixed-effects linear regression was used to compare DTI metrics between groups.

Main Results:

  • Patients with CuTS exhibited more isotropic diffusion in the ulnar nerve compared to controls.
  • A 6% lower FA was observed in CuTS patients, particularly proximal to the cubital tunnel.
  • CuTS patients showed higher RD within the forearm compared to healthy controls.

Conclusions:

  • Fractional anisotropy and radial diffusivity differ significantly between CuTS patients and healthy controls along the ulnar nerve.
  • DTI shows promise as an objective tool for assessing ulnar nerve integrity in CuTS.
  • These findings suggest DTI could enhance the objective assessment and management of cubital tunnel syndrome.