Jsmc-10381

NORMATIVE DATA OF NERVE CONDUCTION STUDY OF UPPER LIMB NERVES AMONG ADULTS IN SULAIMANI PROVINCE: A CROSS-SECTIONAL STUDY

Hiwa S. Namiq a, and Talar Hamaali b

a Dep. of Pharmacology, College of Pharmacy, University of Sulaimani, Kurdistan Region, Iraq. 

b Department of Physiology, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

Submitted: 27/5/2022; Accepted: 21/10/2022; Published: 21/12/2022

DOI Link: https://doi.org/10.17656/jsmc.10381 

ABSTRACT 

Background 

Electrodiagnostic studies, which serve as an extension of clinical examination, play an important role in evaluating patients with neuromuscular disorders. Therefore, each electromyography laboratory must have normative data for its population to establish reference values for nerve conduction study (NCS) parameters, and many carefully screened healthy subjects are required.

Objectives 

To provide the normative data for a nerve conduction study among adults in Sulaimani province. And evaluate the impact of age, gender, and anthropometric measures on NCS parameters.

Patients and Methods

A cross-sectional study was conducted at the electromyography unit of Shahid Dr. Aso Hospital in Sulaimani, Iraq. The study involved 300 healthy participants with an approximately equal proportion of the two genders. Their age ranged from 20 to 60 years. The subjects were enrolled in the study according to specific inclusion criteria after history checking and undergoing neurological examination.

Results

The study included 144 (48%) male and 156 (52%) female participants. The DMLs and DSLs of all the tested nerves turned out to be significantly shorter in females. CMAP-As and SNAP-As were considerably higher in females. The MCVs and SCVs of all nerves were markedly faster in females. Also, the median and ulnar FMINLAT results showed to be significantly shorter in females. Aging has led to a significant prolongation of median DML and DSL, reduction in CMAP-A and SNAP-A, and slowing of MCV and SCV. Similar results were obtained for ulnar and radial nerves with different levels of statistical significance. Using Pearson’s correlation, the DML, DSL, and FMINLATs of all the tested nerves showed a significant positive linear correlation with height. 

Conclusion

Age and BMI did not show a systematic pattern of influence on any of the NCS parameters, demonstrating variable effects with variable levels of significance. In NCS, applying universally standardized techniques may result in different NCS data to the existing literature regarding latencies, amplitudes, nerve conduction velocities, and F-wave data.

KEYWORDS

Nerve conduction study, normative data, median, and ulnar nerve reference values.

References 

1. Mallik A, Weir A. Nerve conduction studies: essentials and pitfalls in practice. Journal of Neurology, Neurosurgery & Psychiatry. 2005, 1;76:23-31.

2. Rayegani SM, editor. Electrodiagnostic medicine consultation in peripheral nerve disorders. In: Basic Principles of Peripheral Nerve Disorders; 2012, pages 17018. 

3. Preston DC, Shapiro BE. Basic nerve conduction studies. In: Electromyography and neuromuscular disorders: clinical-electrophysiologic correlations. Elsevier Health Sciences; 2005, p 25.

4. Buschbacher RM. Median nerve motor conduction to the abductor pollicis Brevis. American journal of physical medicine & rehabilitation. 1999, 78(6), 1-8.

5. Buschbacher RM, Koch J. Race effect on nerve conduction studies: a comparison between 50 blacks and 50 whites. Archives of physical medicine and rehabilitation. 1999, 80(5):536-9.

6. Garg, R, Bansal, N, Kaur, H & Arora, KS. Nerve conduction studies in the upper limb in Malwa region- Normative data. Journal of Clinical and diagnostic research. 2013, 7(2), 201-204.

7. Shehab DK. Normative data of nerve conduction studies in the upper limb in Kuwait: Are they different from the western data? Medical principles and practice. 1998, 7(3), 203-8. 

8. Huang CR, Chang WN, Chang HW, Tsai NW, Lu CH. Effects of age, gender, height, and weight on late responses and nerve conduction study parameters. Acta Neurol Taiwan. 2009, 18(4), 242-9.

9. Gakhar M, Verma SK, Lehri A. A comparison of nerve conduction properties in males and females of 20 to 30 years of age group. Journal of Exercise Science and Physiotherapy. 2014, 10(1), 16.

10 Thakur D, Paudel BH, Bajaj BK, Jha CB. Nerve conduction study in healthy individuals: a gender-based study. Health Renaissance. 2010, 8(3), 169-75.

11. Puksa L, Stålberg E, Falck B. Reference values of F wave parameters in healthy subjects. Clinical Neurophysiology. 2003, 114(6), 1079-90.

12. Kumar A, Roohi F, Prasad A. Study of nerve conduction velocity in the median nerve of healthy males and females of different age groups. Int J Recent Sci Res. 2014, 5(12), 2250–5.

13. McHugh JC, Reilly RB, Connolly S. Examining the effects of age, sex, and body mass index on normative median motor nerve excitability measurements. Clinical Neurophysiology. 2011, 122(10), 2081-8.

14. Stetson DS, Albers JW, Silverstein BA, Wolfe RA. Effects of age, sex, and anthropometric factors on nerve conduction measures. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 1992, 15(10), 1095-104.

15. Kimura J. Height and Other Factors, Principles of Nerve Conduction Studies. In: Electrodiagnosis in diseases of nerve and muscle: Principles and Practice. Oxford university press. 2013.P. 91-92

16. Bolton CF, Carter KM. Human sensory nerve compound action potential amplitude: variation with sex and finger circumference. Journal of Neurology, Neurosurgery & Psychiatry. 1980, 43(10), 925-8.

17. Shehab DK, Khuraibet AJ, Butinar D, Abraham MP, Jabre JF. Effect of gender on orthodromic sensory nerve action potential amplitude. American journal of physical medicine & rehabilitation. 2001, 80(10), 718-20.

18 Buschbacher RM. Body mass index effect on common nerve conduction study measurements. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 1998, 21(11), 1398-404. 

19. Awang MS, Abdullah JM, Abdullah MR, Tharakan J, Prasad A, Husin ZA, et al. Nerve conduction study among healthy Malays. The influence of age, height, and body mass index on the median, ulnar, common peroneal, and sural nerves. The Malaysian journal of medical sciences: MJMS. 2006, 13(2), 19. 

20. Jagga M, Lehri A, Verma SK. Effect of aging and anthropometric measurements on nerve conduction properties-A review. Journal of exercise science and physiotherapy. 2011, 7(1), 1.

21. Pawar SM, Taksande AB, Singh R. Effect of body mass index on parameters of nerve conduction study in Indian population. Indian J Physiol Pharmacol. 2012, 56(1), 88–93.

22. Naik BM, Pal P, Pal GK, Balakumar B, Dutta TK. Assessment of motor nerve conduction in healthy obese Indian population. International Journal of Clinical and Experimental Physiology. 2014, 1(4), 277-82.

23. Becker J, Nora DB, Gomes I, Stringari FF, Seitensus R, Panosso JS, et al. An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome. Clinical Neurophysiology. 2002, 113(9), 1429-34. 

24. Werner RA, Jacobson JA, Jamadar DA. Influence of body mass index on median nerve function, carpal canal pressure, and median nerve cross-sectional area. Muscle & nerve. 2004, 30(4), 481-5.

25. Rivner MH, Swift TR, Malik K. Influence of age and height on nerve conduction. Muscle & nerve. 2001, 24(9), 1134-41. 

26. Tong HC, Werner RA, Franzblau A. Effect of aging on sensory nerve conduction study parameters. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2004, 29(5), 716-20. 

27. Thakur D, Paudel BH, Jha CB. Nerve Conduction study in healthy individuals, a preliminary age-based study. Kathmandu University Medical Journal. 2010, 8(3), 311-6.

28. Verdú E, Ceballos D, Vilches JJ, Navarro X. Age’s influence on peripheral nerve function and regeneration. Journal of the Peripheral Nervous System. 2000, 5(4), 191-208.

29. Bhorania ds, Ichaporia dr. Study of sensory nerve conduction of median and ulnar nerves in the upper limbs: effect of age, gender, and BMI. Indian Journal of Applied Basic Medical Sciences. 2014, 16(23), 10-5. 

30. Fujimaki Y, Kuwabara S, Sato Y, Isose S, Shibuya K, Sekiguchi Y, et al. The effects of age, gender, and body mass index on the amplitude of sensory nerve action potentials: multivariate analyses. Clinical Neurophysiology. 2009, 120(9), 1683-6.

31. Thakur D, Jha S, Pandey NK, Jha CB, Bajaj BK, Paudel BH. Influence of height on the nerve conduction study parameters of the peripheral nerves. J Clin Diagn Res. 2011, 5(2), 260-3. 

32. Patel A, Sanghavi S, Joshi R, Patel B, Harkhani J, Joshi S. Study of the relationship between motor nerve conduction velocity and height in healthy individuals. Hand. 2013, 171(18), 62-91.

33. Mohsen SS, Hamdan FB, Mohammed NH. Measuring F wave components in a sample of healthy Iraqis: Normative data. Saudi Journal for Health Sciences. 2013, 2(3), 194.

34. Ghugare BW, Ramavat MR, Joshi MU, Singh R. The impact of age, height, weight, and body mass index on sural sensory and soleus H-reflex study measures in the healthy central Indian population. Health. 2013, 1(1).

Full Text

 © The Authors, published by University of Sulaimani, College of Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.