Advancing possibilities in noninvasive nerve function testing with miniature sensory and motor nerve conduction
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Nerve conduction studies (NCS) are one of the most important tests of peripheral nerve function, but conventionally relies on specific equipment and expertise limiting its availability outside clinical neurophysiological laboratories. In addition, real time neurophysiological testing during movement such as gait and postural tasks are cumbersome with bulky equipment and cables. We present the electronic design, construction and programming of a miniaturized prototype device for NCS having the following features: Voltage controlled arbitrary waveform current stimulation, separate channels for sensory and motor potential recording, current delivery monitoring, electrical safety measures, wireless operation, relatively low component costs and a size suitable for wearable tests. We demonstrate performance of the device with examples of motor and sensory NCS from the median nerve with compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) results, tibial nerve CMAP and F-waves, and Hoffman reflexes from the soleus nerve. Performance, possibilities and limitations are discussed with respect to potential applications of the device. In summary, we have demonstrated the feasibility of miniaturized instrumentation for easy and cost-effective NCS solutions aiding newer and far-reach applications outside specialized centers.Clinical Relevance-The feasibility of miniaturized instrumentation for the advancement of possibilities in nerve function testing is demonstrated and an engineering approach is presented.
