screening-axonal-degeneration-carpal-tunnel-syndrome-using

Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies

Axonal degeneration, indicative of surgical decompression, may coexist in carpal tunnel syndrome (CTS) as the disease progresses. However, the current ...

The University of Hong Kong

Our previous studies have demonstrated the treatment benefits of dense cranial electroacupuncture stimulation (DCEAS), a novel brain stimulation therapy in patients with major depression, postpartum depression and obsessive-compulsive disorder. The purpose of the present study was to further evaluate the effectiveness of DCEAS combined with body acupuncture and selective serotonin reuptake inhibitors (SSRIs) in patients with post-stroke depression (PSD).

A pilot controlled trial of a combination of dense cranial electroacupuncture stimulation and body acupuncture for post-stroke depression.

Carpal tunnel syndrome (CTS) accompanied by secondary axonal degeneration cannot be clearly discriminated using the current cross-validated ultrasound severity classification system. This study aimed at exploring cut-off values of ultrasound parameters, including wrist cross-sectional area (W-CSA), wrist perimeter (W-P), ratio of cross-sectional area (R-CSA) and perimeter (R-P), changes of CSA and P from wrist to one third distal forearm (ΔCSA&ΔP) for differentiation. Seventy-three patients (13 male and 60 female) were assigned into group A (demyelination only, n = 40) and group B (demyelination with secondary axonal degeneration, n = 33) based on the outcomes of nerve conduction studies (NCS). Receiver Operative Characteristics (ROC) curves were plotted to obtain sensitivity, specificity, and accuracy of cut-off values for all the ultrasound parameters. The overall identified cut-off values (W-CSA 12.0 mm, W-P 16.27 mm, R-CSA 1.85, R-P 1.48, ΔCSA 6.98 mm, ΔP 5.77 mm) had good sensitivity (77.1-88.6%), fair specificity (40-62.2%) and fair-to-good accuracy (0.676-0.758). There were also significant differences in demographics (age and severity gradation, P < 0.001), NCS findings (wrist motor latency and conduction velocity, P < 0.0001; wrist motor amplitude, P < 0.05; distal sensory latency, P < 0.05; sensory amplitude, P < 0.001) and ultrasound measurements (W-CSA, W-P, R-CSA, R-P, ΔCSA&ΔP, P < 0.05) between groups. These findings suggest that ultrasound can be potentially used to differentiate demyelinating CTS with secondary axonal degeneration and provide better treatment guidance.

Article	Year
A pilot controlled trial of a combination of dense cranial electroacupuncture stimulation and body acupuncture for post-stroke depression. BMC complementary and alternative medicine\| PubMed ID: 25038733	2014
Exploratory use of ultrasound to determine whether demyelination following carpal tunnel syndrome co-exists with axonal degeneration. Neural regeneration research\| PubMed ID: 29557383	2018

Kwok-Pui Leung

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