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  • 1
    Electronic Resource
    Electronic Resource
    Usefulness of segmental and comparative tests in the electrodiagnosis of carpal tunnel syndrome: the Italian multicenter study (1999)
    Springer
    Italian journal of neurological sciences 20 (1999), S. 315-320 
    Details
    ISSN: 1126-5442
    Keywords: Key words Carpal tunnel syndrome ; Symptom ; Hand function ; Multicenter ; Patient-oriented ; Classification ; Neurophysiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The Italian CTS Study Group performed a wide multicentric and multiparametric study to quantify the increase of electrodiagnostic sensitivity using an extended neurophysiological protocol and particularly segmental and comparative tests. The study also evaluated the clinical features of carpal tunnel syndrome (CTS) diagnosed by these tests, using validated physician- and patient-oriented measurements. The study group was composed of 740 patients for a total of 1123 idiopathic CTS hands. Overall, the sensitivity of standard tests (median digit-wrist sensory conduction velocity and wrist-thenar distal motor latency) was 83.5%. Comparative/segmental tests disclosed abnormal findings in a further 11.4% of cases, providing CTS electrodiagnosis in about 7 of 10 “standard negative” cases. The overall sensitivity of the electrodiagnostic protocol was 94.9%. The CTS population diagnosed by segmental/comparative tests had a clinical picture characterized by a high percentage of pain, and severe discomfort but no limitation in functional daily activity. Our data confirm the usefulness of a complete neurophysiological assessment by using segmental/comparative tests when standard tests yield normal results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100720050047
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Italian multicentre study of carpal tunnel syndrome: clinical-neurophysiological picture and diagnostic pathway in 461 patients and differences between the populations enrolled in the northern, central and southern centres (1999)
    Springer
    Italian journal of neurological sciences 20 (1999), S. 309-313 
    Details
    ISSN: 1126-5442
    Keywords: Key words Carpal tunnel syndrome ; Multicentre ; Neurophysiology ; Cost ; Schooling ; Italy ; Diagnosis ; Patient-oriented ; Italian CTS Study Group
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The economic trend in our country, as in other countries, now requires us to pay more attention to the social and economic aspects of health. Therefore, it is important to evaluate the diagnostic pathway and the socio-economic aspects of pathologies. The Italian CTS Study Group performed a wide multicentre and multidimensional study (through a patient-, physician- and neurophysiologically oriented evaluation) on 461 idiopathic CTS patients to evaluate the clinical-neurophysiological picture and the diagnostic pathway. The whole population and the differences between the populations enrolled in the neurophysiological centres of the northern, central and southern parts of Italy were analysed. This study provided new and interesting information. As concerns the whole population, we observed different diagnostic pathways in relation to the level of schooling. As concerns the comparison of the populations, the southern centres have a population of CTS patients with higher frequency of hand stress and more severe nerve impairment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100720050046
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Intracortical origin of the short latency facilitation produced by pairs of threshold magnetic stimuli applied to human motor cortex (1999)
    Springer
    Experimental brain research 129 (1999), S. 494-499 
    Details
    ISSN: 1432-1106
    Keywords: Key words Intracortical excitatory circuits ; Brain stimulation ; Motor cortex ; Descending volleys ; Magnetic stimulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Under certain conditions, EMG responses evoked by pairs of transcranial magnetic stimuli over the motor cortex are larger than the sum of the responses to each stimulus given alone. This occurs with interstimulus intervals of around 1.3, 2.5 and 4.3 ms and could be due to interaction between the responses to each stimulus at either the cortex or spinal cord. We recorded the descending volleys set up by such pairs of stimuli from the cervical epidural space of five patients implanted with chronic stimulators for pain control. Interstimulus intervals of 1, 1.2, 1.4 and 2 ms were used to investigate the first peak of facilitation. Enhanced EMG responses occurred after pairs of stimuli at 1, 1.2 and 1.4 ms, and these were accompanied by larger and more numerous descending volleys than expected from the sum of each stimulus alone. We conclude that facilitatory interaction between the stimuli can occur within the cerebral cortex. This may involve elements that produce repetitive I-wave activity in response to a single stimulus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002210050919
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Direct demonstration of interhemispheric inhibition of the human motor cortex produced by transcranial magnetic stimulation (1999)
    Springer
    Experimental brain research 124 (1999), S. 520-524 
    Details
    ISSN: 1432-1106
    Keywords: Key words Magnetic stimulation ; Motor cortex ; Corpus callosum ; Descending volleys ; Interhemispheric inhibition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Electromyographic (EMG) responses evoked in hand muscles by a magnetic test stimulus over the motor cortex can be suppressed if a conditioning stimulus is applied to the opposite hemisphere 6–30 ms earlier. In order to define the mechanism and the site of action of this inhibitory phenomenon, we recorded descending volleys produced by the test stimulus through high cervical, epidural electrodes implanted for pain relief in three conscious subjects. These could be compared with simultaneously recorded EMG responses in hand muscles. When the test stimulus was given on its own it evoked three waves of activity (I-waves) in the spinal cord, and a small EMG response in the hand. A prior conditioning stimulus to the other hemisphere suppressed the size of both the descending spinal cord volleys and the EMG responses evoked by the test stimulus when the interstimulus interval was greater than 6 ms. In the spinal recordings, the effect was most marked for the last I-wave (I3), whereas the second I2-wave was only slightly inhibited, and the first I-wave (I1) was not inhibited at all. We conclude that transcranial stimulation over the lateral part of the motor cortex of one hemisphere can suppress the excitability of the contralateral motor cortex.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002210050648
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Effects of voluntary contraction on descending volleys evoked by transcranial electrical stimulation over the motor cortex hand area in conscious humans (1999)
    Springer
    Experimental brain research 124 (1999), S. 525-528 
    Details
    ISSN: 1432-1106
    Keywords: Key words Brain stimulation ; Electrical stimulation ; Motor cortex ; Descending volleys
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The spinal volleys evoked by electric anodal and cathodal stimulation over the cerebral motor cortex hand area were recorded from a bipolar electrode inserted into the cervical epidural space of two conscious human subjects. We measured the size of volleys elicited by electric stimulation at active motor threshold and at 3% of maximum stimulator output above this value with subjects at rest and during maximum voluntary contraction of the contralateral first dorsal interosseous muscle. Surface EMG activity was recorded at the same time. Electrical anodal stimulation evoked a single negative wave that we termed D-wave in analogy with data in experimental animals. Cathodal stimulation evoked a single negative wave with a latency of 0.2 ms longer than the D-wave recruited by anodal stimulation. At both intensities tested, voluntary contraction did not modify the amplitude of the descending waves. We conclude that changes in cortical excitability induced by voluntary activity do not modify the corticospinal volley evoked by electric stimulation and that the D-waves evoked by both anodal and cathodal electric stimulation are probably initiated several nodes distant to the cell body.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002210050649
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    Paper (German National Licenses)
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