Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

Study on the Validity of F wave for Diagnosis of Carpal Tunnel Syndrome

손목터널증후군 진단 시 F파의 유용성에 관한 연구

  • Park, Jong-Kwon (Department of Biomedical Laboratory Science, Kyungwoon University) ;
  • Kang, Ji-Hyuk (Department of Biomedical Laboratory Science, Daejeon University) ;
  • Kim, Hye-Jeong (Department of Biomedical Laboratory Science, Kyungwoon University)
  • 박종권 (경운대학교 임상병리학과) ;
  • 강지혁 (대전대학교 임상병리학과) ;
  • 김혜정 (경운대학교 임상병리학과)
  • Received : 2017.07.12
  • Accepted : 2017.10.13
  • Published : 2017.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study compared the median nerve, ulnar never, and F waves of patients diagnosed with early Carpal Tunnel Syndrome to a control group to determine whether F waves could be a useful indicator in the diagnosis of early CTS. The terminal motor latency (TML), terminal motor amplitude and sensory nerve conduction velocity (SNCV) of the section from the palms to the wrists, which are the key indicators to use in a nerve conduction study, and F waves were compared with the control group using the t-test. A correlation analysis was performed to analyze the correlation between the main indicators. The comparison between the median nerve's TML of the early CTS patients and that of the control group shows that there are 2 sections which have high significance (p<0.001). In the comparison of the SNCV of the median nerve between the control group and early CTS patients, high significance was observed (p<0.001). In the analysis of the F waves, there was high significance (p<0.001) between the control group and early CTS patients for the median nerve, but not for the ulnar nerve. The correlation analysis revealed that both the SNCV-TML and F wave-TML had significance. These results suggested that, along with TML and SNCV, F waves can be a useful indicator to diagnose CTS.

본 연구는 초기 손목터널증후군으로 진단된 환자의 정중신경(median nerve)과 자신경(ulnar never)의 및 F파를 대조군과 비교 분석하여 초기 손목터널증후군의 진단에서 F파가 유용한 지표가 될 수 있는지 알아보고자 하였다. 신경전도검사 결과의 주요 지표인 말단잠복기, 말단진폭, 손바닥-손목 구간의 감각신경전도속도 및 F파 잠복기를 대조군과 t-test 검정으로 비교분석하고, 또한 주요 지표간의 상관성 분석을 위하여 상관분석을 실시하였다. 연구결과, 대조군과 초기 손목터널증후군 환자의 정중신경 말단잠복기 비교에서 두 군 간에 유의성이 높은 것으로 나타났다(p<0.001). 정중신경의 감각신경전도속도 비교에서는 대조군과 손목터널증후군 간의 유의성이 높은 것으로 관찰되었다(p<0.001). 후기반응검사인 F파 잠복기 분석에서 정중신경의 경우 대조군과 손목터널증후군간 높은 유의성(p<0.001)을 보였으나, 자신경의 경우는 차이가 없는 것으로 나타났다. 상관분석 결과는 감각신경전도속도와 말단잠복기, F파와 말단잠복기에서 모두 상관성이 있는 것으로 나타났다. 이러한 결과로, F파는 말단잠복기, 감각신경전도속도와 같이 손목터널증후군의 진단에 있어 유용한 지표가 될 수 있다고 사료된다.

Keywords

References

  1. D. M. Dawson, "Entrapment neuropathies of the upper extremities", N Engl J Med, vol. 329, no. 27, pp. 2013-2018, 1993. DOI: https://doi.org/10.1056/NEJM199312303292707
  2. G. S. Phalen, "The carpal tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundreds fifty four hands", J Bone Joint Surg Am, vol. 48, no. 2, pp. 211-228, 1966. DOI: https://doi.org/10.2106/00004623-196648020-00001
  3. S. H. Lee, Y. C. Cho, "Musculoskeletal disorder symptoms and its related factors among male workers in manufacturing industries", KAIS, vol. 16, no. 10, pp. 6627-6640, 2015. DOI: https://doi.org/10.5762/KAIS.2015.16.10.6627
  4. H. A. Frederick, P. R. Carter, J. W. Little, "Injection injuries to the median and ulnar never at the wrist", J Hand Surg, vol. 17, no. 4, pp. 645-647, 1992. DOI: https://doi.org/10.1016/0363-5023(92)90309-D
  5. C. W. Seo, C. S. Kim, "Evaluation of nerve conduction study result in carpal tunnel syndrome before and after operation in eastern area of Jeonnam", KAIS, vol. 13, no. 11, pp. 5305-5310, 2012. DOI: https://doi.org/10.5762/KAIS.2012.13.11.5305
  6. C. K. Jablecki, M. T. Andary, M. K. Floeter, R. G. Miller, C. A. Quartly, M. J. Vennix, J. R. Wilson, "Practice parameter: Electrodiagnostic studies in carpal tunnel syndrome. Report of the American Association of Electrodiagnostic Medicine, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation", Neurology, vol. 58, no. 11, pp. 1589-1592, 2002. DOI: https://doi.org/10.1212/WNL.58.11.1589
  7. S. H. Lim, "Suggestions for the effective intraoperative neurophysiological monitoring in microvascular decompression surgery of hemifacial spasm", Korean J Clin Lab Sci, vol. 48, no. 3, pp. 262-268, 2016. DOI: https://doi.org/10.15324/kjcls.2016.48.3.262
  8. E. B. Bodofsky, S. J. Cohen, R. J. Kumar, A. Schindelheim, J. Gaughan, "The relationship between sensory latency and amplitude", J Electromyogr Kinesiol, vol. 31, no. 4, pp. 1-6, 2016. DOI: https://doi.org/10.1016/j.jelekin.2016.08.008
  9. R. K. Sethi, L. L. Thompson, "The electromyographer's handbook. 2nd ed.", pp. 107, Little Brown and Company, Boston/Toronto, 1989.
  10. Y. H. Hong, "Carpal tunnel syndrome techniques", J Korean Society for Clinical Neurophysiology, vol. 9, no. 2, pp. 103-105, 2007.
  11. S. H. Kim, B. G. Yoo, K. S. Kim, K. M. Yoo, "F-Wave analysis in patients with clinically diagnosed carpal tunnel syndrome", Ann Clin Neurophysiol, vol. 4, pp. 108-113, 2002.
  12. J. H. Kang, H. J. Kim, E. R. Lee, "Electrophysiological evaluation of chronic inflammatory demyelinating polyneuropathy and charcot-marie-tooth type 1: dispersion and correlation analysis", J Phys Ther Sci, vol. 25, no. 10, pp. 1265-1268, 2013. DOI: https://doi.org/10.1589/jpts.25.1265
  13. S. H. Bae, K. Y. Kim, "Effects of vibration stimulation method on upper limbs spasticity in patients with brain lesion", KAIS, vol. 12, no. 7, pp. 3109-3116, 2011. DOI: https://doi.org/10.5762/KAIS.2011.12.7.3109
  14. E. Chroni, C. P. Panayotopoulas, "F tacheodispersion: Quantative analysis of motor fiber conduction velocities in patients with polyneuropathy", Muscle Nerve, vol. 16, no. 8, pp. 1302-1309, 1993. DOI: https://doi.org/10.1002/mus.880161206
  15. S. J. Oh, "Anatomical guide for common nerve conduction studies. clinical electromyography-nerve conduction studies. 2nd ed.", pp. 56-77, William & Wilkins, Baltimore, 1933.
  16. D. Simovic, D. H. Weinberg, "The median nerve terminal latency index in carpal tunnel syndrome: a clinical case selection study", Muscle Nerve, vol. 22, no. 5, pp. 573-577, 1999. DOI: https://doi.org/10.1002/(SICI)1097-4598(199905)22:5<573::AID-MUS4>3.0.CO;2-A
  17. B. T. Shahani , R. R. Young, F. Potts, P. Maccabee, "Terminal latency index and late response studies in motor neuron disease, peripheral neuropathies and entrapment syndromes", Acta Neurol Scand, vol. 60(Suppl 73), pp. 118, 1979.
  18. D. Simovic, D. H. Weinberg, "Terminal latency index in the carpal tunnel syndrome", Muscle Nerve, vol. 20, no. 9, pp. 1178-1180, 1997. DOI: https://doi.org/10.1002/(SICI)1097-4598(199709)20:9<1178::AID-MUS14>3.0.CO;2-P
  19. W. K. Paek, S. H. Koh, H. Y. Kim, K. Y. Lee, Y. J. Lee, H. T. Kim, S. H. Kim, J. H. Kim, "Median wrist-to-palm motor conduction velocity and median-ulnar latency differences in carpal tunnel syndrome", J Korean Neurol Assoc, vol. 23, no. 5, pp. 650-654, 2005.
  20. T. N. Monga, G. L. Shanks, B. J. Poole, "Sensory palmar stimulation in diagnosis of carpal tunnel syndrome", Arch Phys Med Rehabil, vol. 66, no. 9, pp. 598-600, 1985.
  21. R. Cioni, S. Passero, C. Paradiso, F. Giannini, N. Battistini, G. Rushworth, "Diagnositc specificity of sensory and motor nerve conduction variables in early detection of carpal tunnel syndrome", J Neurol, vol. 236, no. 4, pp. 208-213, 1989. DOI: https://doi.org/10.1007/BF00314501
  22. T. Kuntzer, "Carpal tunnel syndrome in 100 patients: sensitivity, specificity of multi-neurophysiological procedures and estimation of axonal loss of motor, sensory and sympathetic median nerve fibers", J Neurol Sci, vol. 127, no. 2, pp. 221-229, 1994. DOI: https://doi.org/10.1016/0022-510X(94)90076-0
  23. F. Buchthal, A. Rosenfalck, W. Trojaborg, "Electrophysiological findings in entrapment of the median nerve at wrist and elbow", J Neurol Neuro surg Psychiatry, vol. 37, no. 3, pp. 340-360, 1974. DOI: https://doi.org/10.1136/jnnp.37.3.340