Effects of Suspension Exercise Therapy Combined with Soft Tissue Manipulation on Upper Limb Sensory Function in Patients with Radicular Cervical Spondylosis / 医用生物力学

bjective To observe the changes of upper extremity sensory function in patients with radicular cervical spondylosis and evaluate the treatment effect, by using the method of suspension exercise therapy (SET) and soft tissue manipulation. Methods A total of 72 patients with cervical spondylosis were divided into observation group (treated by SET combined with manipulation)and control group (treated by purely cervical traction) by simple random method. Both groups received 4-week continuous treatment for 6 times per week. The somatosensory evoked potential(SEP), current perception threshold (CPT) before and after the treatment in two groups were separatedly tested, and changes in visual analogue scale (VAS) pain scores of the affected limbs were examined, so as to determine the effective rate of treatment. Results After treatment, the latency of SEP was shortened mainly in brachial plexus potential N9 and cervical spinal potential N13 in two groups (P<0.05). The CPT levels and the VAS pain scores of the affected limbs were reduced in two groups (P<0.01), and the treatment effect in observation group was better that in control group (P<0.01)．Conclusion SET combined with soft tissue manipulation can effectively promote the repair of nerve sense function of cervical spondylotic radiculopathy.

Effect of sling exercise therapy combined with Tuina on nerve conduction of upper extremities after radicular cervical spondylosis / 中国康复理论与实践

@#Objective To observe the effect sling exercise therapy (SET) and Tuina on radicular cervical spondylosis. Methods From August, 2015 to December, 2016, 72 patients with radicular cervical spondylosis were randomly divided into control group (n = 36) and trial group (n = 36), who accepted traction and SET+Tuina, respectively, for four weeks. They were measured F-wave conduction velocity with electromyogram from median nerve and ulnar nerve, somatosensory evoked potential (SEP), and current perception threshold (CPT) before and after treatment. The clinical ratio of improvement was calculated. Results The ratio of improvement was 83.33% in the trial group more than 58.33% in the control group (Z = 2.093, P < 0.05). F-wave conduction velocity increased in both groups after treatment (t > 12.059, P < 0.001), and increased more in the trial group than in the control group (t > 3.266, P < 0.01); while the latency of SEP decreased in N9 and N13 in both groups (t > 7.061, P < 0.001), and decreased more in the trial group than in the control group (t > 8.033, P < 0.001); the grade of CPT decreased in both groups (t > 8.895, P < 0.001), and decreased more in the trial group than in the control group (t = 8.913, P < 0.001). Conclusion The combination of SET and Tuina can promote the repair of nerve conduction of cervical spondylotic radiculopathy.

To explore the characteristics of nerve injury in patients with diabetic peripheral neuropathy and the predictive value of current perception threshold combined with nerve conduction velocity / 中国医师进修杂志

Objective:To analyze the characteristics of nerve injury in patients with diabetic peripheral neuropathy (DPN) and explore the diagnostic value of current perception threshold (CPT) and nerve conduction velocity (NCV) for DPN.Methods:One hundred and thirty-six DPN patients admitted to Beijing Puren Hospital from June 2017 to December 2019 were selected, and 130 diabetic non-DPN patients admitted during the same period were used as controls. All the subjects were tested by CPT and NCV. Among them, the detection of NCV included sensory nerve conduction velocity (SCV) and motor nerve conduction velocity (MCV). Statistical analysis was performed on the relevant indicators of the two groups of subjects.Results:The CPT values of the upper limb median nerve and ulnar nerve at 2 000 Hz, 250 Hz, and 5 Hz, the superficial peroneal nerves at 250 Hz, and 5 Hz, and the CPT values of the sural nerve at 2 000 Hz and 250 Hz were higher than those of non-DPN patients, DPN injury mainly occurred in myelinated nerve fibers in the lower extremities [60.29%(82/136)], and the difference were statistically significant ( P<0.05). The SCV and MCV of the median nerve, ulnar nerve, and common peroneal nerve in the DPN group were lower than those in the non-DPN group, the SCV abnormal rate was higher than the MCV: 55.88%(76/136) vs. 37.50%(51/136); 58.82%(80/136) vs. 41.18% (56/136); 67.65%(92/136) vs. 50.00%(68/136), and the differences were statistically significant ( P<0.05). The area under the predictive value curve (AUC) of CPT for DPN was 0.815 (95% CI 0.735 ~ 0.895). The AUC of NCV for DPN was 0.875 (95% CI 0.813 ~ 0.944). The AUC of CPT and NCV for DPN was 0.923 (95% CI 0.876 ~ 0.970). Conclusions:DPT patients have abnormal CPT and NCV, and nerve damage occurs mostly in myelinated nerve fibers and SCV. Diagnosing DPN by combining CPT and NCV is helpful to improve the detection rate of DPN.

Application of Current Perception Threshold in Lumbar Radiculopathy / 中国康复理论与实践

@#Objective To investigate the change of current perception threshold (CPT) in patients with lumbar radiculopathy. Methods From September, 2014 to October, 2015, 86 patients with lumbar radiculopathy from lumbar disc herniation were measured with CPT in different frequencies (5, 250 and 2000 Hz) on proximal and distal points of affected dermatome of both legs. Results The CPT grades of both proximal and distal points were higher in the affected legs than in the contralateral legs (t=1.659, P<0.001). The abnormal CPT grades counted for 46.36% for both points, 35.45% for only distal points and 35.45% for only proximal points. CPT was abnormal in all the patients, and 93.6% of them appeared at 250 Hz, 57.4% at 2000 Hz, and 29.8% at 5 Hz.Conclusion CPT is sensitive in lumbar radiculopathy, especially in multiple frequencies and test points.

Assessment of sensory current threshold in the diagnosis of type 2 diabetic peripheral neuropathy clinical application of current perception threshold in the diagnosis of diabetic peripheral neuropathy / 中国糖尿病杂志

Objective To evaluate the diagnostic value of current perception threshold (CPT)diabetic peripheral neuropathy (DPN).Methods A total of 437 patients with type 2 diabetes (T2DM) were enrolled.The subjects were divided into DPN group and non-DPN group according to'the criteria of diagnosis and treatment of diabetic peripheral neuropathy in China'.The diagnostic value of CPT,10 g monofilament test,Toronto clinical scoring system (TCSS) and nerve conduction velocity (NCV) were evaluated.Results Compared with non-DPN group,the patients in DPN group were significantly older [(61.31±9.63) vs (58.09±10.38) year],with longer duration of diabetes [(8.81±6.04) vs (6.93±5.65) year],higher HbA1c [(8.60±2.05)％ vs (8.09±2.01) ％] and fasting plasma glucose (FPG) [(9.67± 3.92) vs (8.95 ± 3.45) mmol/L],more smokers (30.0％ vs 15.8％) and more likely complicated with retinopathy (36.4％ vs 22.2％).The proportion of hypoesthesia and hyperesthesia detected by CPT at all frequencies in DPN group were much higher than non-DPN group (P＜0.05).The correlation analysis showed that CPT values at each frequency were negatively correlated with NCV (r=-0.260,r=-0.155 and r=-0.168,respectively,P＜0.01).CPT 2000 Hz and 250 Hz were positively correlated with TCSS scores (r=0.105 and 0.142,respectively,P＜0.05).ROC analysis showed that CPT 2000 Hz had the largest areas under the curve (AUC=0.840),with the highest sensitivity (77.14％)and NCV test had the highest specificity (98.32％) in diagnosing DPN.Conclusion CPT can selectively and quantitatively determine different types of sensory nerve damage,which providing a useful method for early-screening of DPN.

Assessment of Diabetic Peripheral Neuropathy Using Current Perception Threshold / 계명의대학술지

The aim of this study was to compare the current perception threshold (CPT) with a nerve conduction study (NCS) to evaluate the usefulness of CPT in the diagnosis of diabetic Peripheral Neuropathy (DPN). CPT measurement is quantitative method for assessment of peripheral sensory nerve function using electrical impulse. Enrolled in this study were 142 patients with type 2 diabetes who underwent both CPT testing and NCS between January 2013 and April 2016. DPN was diagnosed by NCS. CPT was performed on the right index finger and great toe of each patient. Patients with burning, tingling sensation and with longer history of diabetes tended to have a higher prevalence of DPN. In all frequencies tested (2000, 250, 5 Hz), CPT values of the DPN group were higher than the normal group. After classification in either the normoesthesia or hypoesthesia group according to CPT, the DPN group had a significantly higher prevalence of hypoesthesia than normal group. The receiver operating characteristics curve analysis showed that CPT had a high area under curve value for predicting the presence of DPN. In conclusion, CPT measurement is clinically valuable in detecting nerve dysfunction in patients with type 2 diabetes.

Evaluation of current perception threshold in the diagnosis of diabetic peripheral neuropathy / 中国神经精神疾病杂志

Objective To evaluate the diagnostic value of current perception threshold (CPT) for diabetic peripheral neuropathy by comparing with nerve conduction velocity (NCV). Methods Sixty patients with type 2 diabetes were enrolled. The CPT and SNCV were examined respectively. Results The abnormal rates of the CPT and SNCV were 68.33％and 36.67％in all patients, respectively. The abnormal rates of the CPT and SNCV were 88.46％and 53.85％in symptomatic group. The abnormal rates of the CPT and SNCV were 47.06％ 17.65％ in asymptomatic group. In patients with disease less than five years, the abnormal rates of the CPT and SNCV were 55.17％ and 24.14％. In patients with disease greater than five years, the abnormal rates of the CPT and SNCV were 77.42％ and 48.39％. The abnormal rate was statistically significant difference (P<0.05) between two examination. Conclusion CPT and NCV were consistency in the diagnosis of diabetic peripheral neuropathy. For early asymptomatic patients, CPT have more advantages to inspect the sub-clinical patients.

Effects of current perception threshold in evaluating the peripheral nerves in diabetic patients / 中华神经科杂志

Objective To evaluate the impairment of large and small fibers of peripheral nerves in patients with diabetes mellitus according to the current perception threshold ( CPT ) comparing with nerve conduction studies ( NCS) and sympathetic skin response ( SSR).Methods Fourty-nine diabetic patients were enrolled from August to December 2014 in Tianjin Third Central Hospital.The CPT was examined by the Neurometer?CPT/C in diabetic patients and 23 healthy subjects.Electrical stimulations of 2 000, 250 and 5 Hz were delivered respectively to the first toe distal section , the bottom of the knee-patella middle line and the index finger distal section.NCS and SSR were performed in diabetic patients.The patients were divided into normal NCS ( NCSN) group and abnormal NCS ( NCSA) group according to the results of the nerve conduction.According to the results of SSR , the patients were divided into normal SSR ( SSRN) group and abnormal SSR ( SSRA ) group.Results In three testing areas , the CPT in NCSN group had no significant difference compared with control group , which was tested by different frequency;NCSA group had increased CPT (393.5 ±68.4, 213.1 ±39.7, 172.5 ±52.8, 221.6 ±48.0, 91.7 ±33.1, 76.2 ±27.8, 274.0 ±48.4, 120.1 ±26.6, 75.3 ±21.9) compared with control group (278.1 ±53.6, 128.9 ±46.7, 78.7 ±28.7, 149.3 ±54.6, 52.3 ±23.2, 41.9 ±18.7, 214.2 ±46.0, 96.0 ±29.3, 48.6 ±17.0; F=36.277, 40.827, 50.301, 10.240, 12.837, 13.832, 11.749, 5.559, 17.412,all P<0.01).At the first toe section, CPT decreased in SSRN group ( 91.0 ±29.0, 55.2 ±21.3 ) compared with control group (128.9 ±46.7, 78.7 ±28.7;F=23.071, 22.646, both P<0.05), which was tested by the currents of 250 Hz and 5 Hz frequency.In three testing areas , the SSRA group had increased CPT compared with control group , which was tested by different frequency.Conclusion Hyperesthesia as an early manifestation of small fiber damage can be detected by CPT in diabetic patients; CPT has no advantage in the evaluation of large fiber damage.

Assessment of Diabetic Polyneuropathy and Autonomic Neuropathy Using Current Perception Threshold in Korean Patients with Diabetes Mellitus

BACKGROUND: The current perception threshold (CPT) could be quantified by stimulating Abeta and C fibers at 2,000 and 5 Hz, respectively. C fibers play a role in the autonomic nervous system and are involved in temperature and pain sensation. We evaluated the usefulness of CPT for diagnosing distal polyneuropathy (DPN) and cardiovascular autonomic neuropathy (CAN) in diabetic patients. METHODS: The CPT was measured in the index finger (C7 level) and in the third toe (L5 level) in diabetic patients aged 30 to 69 years. We assessed DPN according to the neuropathy total symptom score-6 (NTSS-6) and 10-g monofilament pressure sensation. Subjects with a NTSS-6 >6 or with abnormal 10-g monofilament sensation were defined to have DPN. CAN was evaluated by spectral analysis of heart rate variability and by Ewing's traditional tests. RESULTS: The subjects with DPN had significantly higher CPT at all of the frequencies than the subjects without DPN (P6 could be most precisely predicted by CPT at 2,000 and 5 Hz, respectively. However, only 6.5% and 19.6% of subjects with DPN had an abnormal CPT at 2,000 Hz at the C7 and L5 levels. Although CPT at 5 Hz showed a negative correlation with the power of low and high frequency in the spectral analysis (P<0.05), only 16.7% of subjects with CAN exhibited an abnormal CPT at the same frequency. CONCLUSION: Although the CPT is significantly associated with neuropathic symptoms or signs corresponding to the nerve fiber stimulated, it provides little additional information compared with conventional evaluations.

The Effect of Different Frequency and Time of Transcutaneous Electrical Nerve Stimulation to Current Perception Threshold / 天津医药

Objective To analysis the consequence of current perception threshold (CPT) by different frequency and time of transcutaneous electrical nerve stimulation (TENS). Methods CPT of foramen area and arm area was measured to evaluate the effect of TENS. Different frequency and time of TENS was given to 30 healthy volunteers. Stimulating to Hegu, CPT of the foramen area and the arm area on the same side was measured. Results CPT of the foramen area increased with stimulation. Low frequency of TENS inhibited the chronic pain significantly(P＜0.05),high frequency of TENS inhibited both of the chronic pain and the acute pain(P＜0.05). The inhibition of pain is more influenced by the frequency of TENS than the time of it. Conclusion Channel and point of TENS can influence CPT of the specific reaction area. And the choice of appropriate frequency of the treatment is more important than extending the treatment time alone.

Current perception threshold and reaction time in the assessment of sensory peripheral nerve fibers through sinusoidal electrical stimulation at different frequencies

INTRODUCTION: The Perception Sensory Threshold (ST) for sinusoidal current stimuli at 5, 250, and 2,000 Hz is commonly used in the assessment of peripheral nerve fibers (C, Aδ, and Aβ, respectively). However, the neuroselectivity of these frequencies is far from consensus. In addition, Reaction Time (RT) measurements suggest that 2,000 Hz stimuli excite Aβ-fibers, 250 Hz Aβ- or Aδ-fibers, as well as 5 Hz Aβ-, Aδ- or C-fibers. Therefore, we suppose that the sinusoidal current neuroselectivity may be better observed if ST and RT parameters are jointly evaluated. In addition, we have investigated whether there are other sets of frequencies that could be used. METHODS: Thus this work investigates ST and RT for stimuli with frequency ranging from 1 to 3,000 Hz, on 28 healthy subjects aged from 19 to 44 years old (27.1±5.49). ST and RT dissimilarity among different frequencies was evaluated applying bi-dimensional Fisher Quadratic Discriminant. RESULTS: The lowest classification error (3.6%) was obtained for 1, 250, and 3,000 Hz. Error for 5, 250, and 2,000Hz was 16.7%. Stimulation frequency at 1 Hz evoked more sensations related to C-fibers (53% of reports) than to Aβ-fibers (36%). However, this behavior did not repeat itself at 5 Hz (only 21% of perceptions were related to C-fibers against 64% to Aβ-fibers). Sensations related to Aβ-fibers prevailed for the highest frequencies presented to the subjects (2,000 Hz - 82% and 3,000 Hz - 93%). Mean RT values showed a decreasing trend with frequency. CONCLUSION: These results suggest that frequencies 1, 250, and 3,000 Hz are more neuroselective than 5, 250, and 2,000 Hz for the evaluation of peripheral sensitive fibers. Furthermore, they show RT usefulness.

Diagnostic Usefullness of Current Perception Threshold Test in Carpal Tunnel Syndrome

BACKGROUND: Carpal tunnel syndrome (CTS) is the most commonly reported nerve entrapment syndrome. When performing routine nerve conduction studies (NCS) in clinically diagnosed CTS, we sometimes confronted with patients who have no definite electrophysiological evidence of CTS. Current perception threshold (CPT) test can evaluate the functioning of all major subpopulations of sensory nerve. The purpose of this study is to determine clinically usefulness of the CPT test in idiopathic CTS. METHODS: We prospectively studied 60 patients (90 hands) who were clinically diagnosed as CTS. Involved hands were grouped into three clinical grades (mild, moderate and severe). NCS was done using a standard technique and equipment. CPT test was measured at the distal interphalangeal joint of second, third and fifth fingers with electrical current of 5 Hz, 250 Hz and 2,000 Hz in frequency. RESULTS: Of 60 patients (90 hands), 8 (13.1%) were men and 52 (86.9%) were women. Mean age at evaluation was 56.00+/-8.94 years old. Positive rate of NCS and CPT was 0.80 (0.72, 0.88) and 0.61 (0.51, 0.71), respectively. Sensitive and specificity of CPT test was 0.49 and 0.57. As the clinical severity of CTS deteriorate, CPT test showed abnormality in low frequency stimulation. CONCLUSIONS: CPT test is an effective and relatively simple procedure for measuring perception in CTS. But CTS test is difficulty and subjectively at interpretation. We suggested that the usefullness of CPT test is lower than NCS in diagnosis of CTS.

Median Sensory Nerve Function and its Relationship with the Duration of Carpal Tunnel Syndrome and Body Mass Index / Jurnal Sains Kesihatan Malaysia

The study evaluated the function of median sensory nerve fibers, as well as determining the relationship between its function with the duration of Carpal Tunnel Syndrome (CTS) and body mass index (BMI) among CTS patients in Physiotherapy Unit, Universiti Kebangsaan Malaysia Hospital (HUKM). Thirty subjects (6 males and 24 females) with mean age 53.30 ± 9.20 years and duration of the CTS 51.17 ± 50.22 months participated in this study. The sensitivity of median sensory nerve was evaluated using Current Perception Threshold (CPT) Test with stimulation frequencies of 5 Hz, 250 Hz and 2000 Hz; which demonstrated the function of C, Aδ and Aβ nerve fiber respectively. Majority of the CTS patients had normal function in the 3 types of median sensory nerve fiber. Forty percents of the subjects had abnormality in the Aâ function, 7% had abnormality of the Aβ function and 27% demonstrated abnormality in the C fiber function. Spearman Correlation Test showed no significant relationship between the function of median sensory nerve and the duration of CTS and body mass index (BMI) (p > 0.05). In conclusion, although majority of the patients demonstrated normal median sensory nerve function, abnormality of the Aβ, Aδ and C fibers sensitivity in some patients requires attention to prevent worsening of the nerve function thus avoiding related complications. Physiotherapists in HUKM may intensify the use of nervestimulating modalities such as Transcutaneous Electrical Nerve Stimulation (TENS) to normalize the nerve functions of these patients.

Change to Current Perception and Pain Tolerance Thresholdsfollowing Repetitive Transcranial Magnetic Stimulation

OBJECTIVE: To investigate the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex on sensory and pain perception. METHOD: We measured the current perception threshold and the pain tolerance threshold with Neurometer? CPT/C in 14 healthy subjects (eleven males and three females, mean age: 25.0 years). Threshold testing was evaluated prior to, immediately after, 30 min after and 60 min after rTMS. The stimulation parameters were a frequency of 10 Hz and a field intensity of 100% of the active motor thresholds. Stimuli were provided in trains of 100 pulses, followed by a 50s rest period, 10 trains were applied in the session, resulting in 1,000 pulses in total. RESULTS: The current perception thresholds of 5, 250, 2,000 Hz were significantly increased immediately, 30 min after rTMS (p<0.05) and no effects at all were noticed after sham rTMS. The pain tolerance thresholds of 5, 250 Hz were significantly increased immediately, 30 min after rTMS and the pain tolerance threshold of 2,000 Hz were significantly increased immediately, 30 min, 60 min after rTMS (p< 0.05). No effects at all were noticed after sham rTMS. CONCLUSION: After high frequency rTMS over the primary motor cortex, we found that the current perception thresholds and the pain tolerance thresholds of 5, 250, 2,000 Hz were significantly increased.

Assessment and Treatment of Chronic Pain / 全日本鍼灸学会雑誌

The definition of Pain, “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (International Association for the Study of Pain : IASP, 1994), which is often used to explain its subjectivity. It is necessary to evaluate the pain objectively for diagnosis and effectiveness of therapy.<BR>As an evaluation method of chronic pain, Visual Analog Scale (VAS) and Numerical Rating Scale (NRS) are used. Recent years, face visual analog scale and Current Perception Threshold (CPT) testing are also used commonly. Drug challenge test draws attention as it combines an evaluation method and an effective therapy. Meanwhile as a therapy of chronic pain, the reports of epiduroscopy and phototherapy are increasing. The epiduroscopy is an endoscopic operation for patients with the chronic low back pain. In Japan the therapy is performed increasingly for patients with the low back pain of spinal canal stenosis, failed back syndrome and lumbar disc herniation. Regarding the phototherapy, the reports which show the effectiveness of linear polarized infrared raytherapy and xenon phototherapy are mainly observed. Though the nerve block is still the dominant therapy in pain clinics, acupuncture therapy and phototherapy are prospected to increase their demands in future.

Effectiveness of Current Perception Threshold in Follow up of the Patients with Carpal Tunnel Syndrome

OBJECTIVE: To compare the degree of change of current perception threshold (CPT) results with the degree of nerve conduction study (NCS) change and evaluate the effectiveness of the CPT in following up patients who went through operation for carpal tunnel syndrome (CTS). METHOD: Twenty hands with CTS were examined with CPT and NCS, before, 2 weeks after and 2 months after operation. In the CPT, the threshold of the median nerve was measured, in the NCS, amplitude and latency of the median nerve was measured. Subjects were divided into 3 groups according to the severity by NCS results and into 2 groups according to the subjective perception of improvement. RESULTS: The subjects mean age was 51.4. Changes of NCS results in amplitude and latency showed no statistical relevance. CPT study result changes demonstrated to be statistically significant. Improvement of CPT results seen in the period of 2 weeks and 2 months and the initial first 2 weeks showed no difference. Change of CPT results showed correlation not in accordance with the severity of the NCS study, but with the symptomatic improvement of the patients. CONCLUSION: CPT can be an effective tool in evaluating the improvement of symptoms and may be used as a follow up tool in patients with CTS.

Change of Current Perception Threshold of Median Nerve after Transcutaneous Electrical Nerve Stimulation

OBJECTIVE: We measured current perception threshold (CPT) with transcutaneous electrical nerve stimulation (TENS) to prove the selective increment of the threshold of C sensory fiber and to determine onset time and duration of effect for application of TENS. METHOD: TENS were applied to fifteen control volunteers for 20 minutes on hand three times per week for 2 weeks duration. The CPT was tested at the distal interphalangeal joint of the second finger with 5 Hz, 250 Hz, and 2,000 Hz in frequency, respectively. The test was repeated immediately and 30 minutes after cessation of TENS. These tests were performed on the first, eighth, and fifteenth day on application of TENS. RESULTS: The baseline CPT of C fiber was 32.7 +/- 6.4 10 2 mA, A gamma fiber 23.2 +/- 9.4 10(-2) mA, and A beta fiber 83.9 +/- 18.1 10(-2) mA. At 30 minutes after cessation of TENS in the fifteenth day, the CPT of C fiber increased markedly and that of A gamma fiber increased a little. The CPT of A beta fiber didn't increase for 2 weeks. CONCLUSION: With application of TENS, the threshold of C and A gamma fibers selectively increased, especially 30 minutes after removal of TENS application. This effect was outstanding after 2 weeks' application.

The Clinical Usefulness of Current Perception Threshold in Diabetic Neuropathy

OBJECTIVE: To evaluate the clinical usefulness of current perception threshold (CPT) test in diagnosing the diabetic neuropathy. METHOD: We have recorded the neuropathic symptom score (NSS), CPT and the parameters of nerve conduction study (NCS) in 45 patients with diabetes. NSS was calculated according to the clinical symptom and signs, and the score more than 3 was regarded as abnormal (neuropathic). CPT was measured at the 2nd finger and 1st toe delivering the three different frequencies (2000, 250 and 5 Hz) of current and conventional NCS were performed at the median, peroneal motor and sural nerves. All the patients were assigned to three groups according to the result of NSS and NCS; group A, abnormal NSS and NCS; group B, abnormal NSS only; group C, normal NSS and NCS. CPT was compared between groups, and we investigated the correlation between CPT and NSS, and parameters of NCS. Also the sensitivity and specificity of CPT test were calculated. RESULTS: The mean CPT was significantly increased in the entire diabetic groups as compared with control group (p<0.05). CPTs measured by 2000 Hz stimulation at the finger and toe were positively correlated with the most parameters of NCS (p<0.05), and CPT was more highly correlated with NCS (p<0.05) than NSS. The sensitivity and specificity of the CPT were 94.1% and 10.7%, respectively. CONCLUSION: The CPT test may have added value in diagnosing the diabetic neuropathy as a screening.

Quantitative Measurement of Current Perception Threshold in Carpal Tunnel Syndrome

OBJECTIVE: To compare current perception threshold with nerve conduction study, we measured current perception threshold (CPT) in healthy control and patients with carpal tunnel syndrome (CTS). METHOD: Twenty control subjects and twenty patients with CTS were included. Latency and amplitude of median and ulnar motor and sensory nerves were measured. The sensory current perception threshold was measured at the distal interphalangeal joint of third and fifth fingers and the palm with electrical current of 5 Hz, 250 Hz, and 2,000 Hz in frequency. We compared the results of the nerve conduction study with the data of the CPT. RESULTS: We found that measuring of the sensory threshold might detect carpal tunnel syndrome, especially with 2,000 Hz and 250 Hz stimulation and that CPT data correlated to sensory latency and amplitude of the median nerve. CONCLUSION: The sensory threshold test might be useful for diagnosis and follow up test in carpal tunnel syndrome.

The Correlation between Perception and Nociception Thresholds by Selected Current Stimuli in Adults / 대한마취과학회지

BACKGROUND: This study was designed to investigate the correlation between pain and non-pain sensation of the cutaneous nociceptors in healthy adults use 250 Hz and 5 Hz evoking neuroselective sinusoidal current to A delta and C-fiber separately. METHODS: Fifty healthy adult volunteers who have no history of neurological illness were examined. Twenty-five of them were male, and twenty-five were female. Their ages ranged from 20 to 46 years, with a mean equal to 29.5 years old. The thresholds for both current perception and nociceptive perception were measured bilaterally in volar aspect of wrist using a Neurometer CPT/C (Quantitative Sensory Nerve Testing Device). The manual mode for current perception threshold and the staircase method for nociceptive current perception threshold was performed individually. RESULTS: The mean values of the threshold for perception evoked by 250 Hz were 0.30 mA in left and 0.31 mA in right, 0.17 mA in left and 0.14 mA in right at 5 Hz respectively. The mean values of the nociception threshold were 0.52 mA in both site at 250 Hz and from 0.35 mA to 0.32 mA at 5 Hz (Table 1). There were no differences between left and right wrist (Fig. 1). Also a significant positive correlation between current perception and nociception thresholds was found (p<0.05) (Fig. 2, 3). There appeared to be different between genders in perception threshold evoked by 250 Hz and nociception threshold evoked by 5 Hz in left (p<0.05) (Table 2). CONCLUSIONS: There exists a meaningful correlation between both sensations of non-pain and pain perception thresholds obtained from all subjects. The measurement of the current perception threshold is considered to be a unique and valuable resource in evaluation of patient with neurologic condition, as well as in serial evaluation of patient to assess the outcome of therapeutic intervention.