Επίδραση της θερμοκρασίας στην αγωγιμότητα των περιφερικών νεύρων σε φυσιολογικές και παθολογικές συνθήκες

• Main Authors: Gkavanozi, Evangelia, Γκαβανόζη, Ευαγγελία
• Format: Doctoral or Postdoctoral Thesis
• Language: Greek
• Published: University of Patras 2022
• Subjects: Θερμοκρασία; Σύνδρομο καρπιαίου σωλήνα; ΣΥΝΤΕΛΕΣΤΕΣ ΔΙΟΡΘΩΣΗΣ; Μέσο νεύρο; Ωλένιο νεύρο; Σακχαρώδης διαβήτης; Temperature; Carpal tunnel syndrome; Diabetes mellitus; Median nerve; Ulnar nerve; Correction Factors; Άλλες Ιατρικές Επιστήμες; Ιατρική και Επιστήμες Υγείας; Ιατρική; άλλοι τομείς; Κλινική Ιατρική; Κλινική νευρολογία; Other Medical Sciences; Medical and Health Sciences; Medicine; miscellaneous; Clinical Medicine; Clinical Neurology; DML
• Online Access: http://hdl.handle.net/10442/hedi/52553; https://doi.org/10.12681/eadd/52553

AIM: To assess the influence of temperature on sensory and motor nerve conduction parameters in healthy and diseased nerves.METHODS: Fifty two subjects with carpal tunnel syndrome (CTS) with 52 matched healthy controls, and 32 patients with diabetes mellitus (DM) type 2 with 32 matched healthy controls participated in this study. Sensory and motor nerve conduction studies were performed in the median and ulnar nerves. The following parameters were evaluated including distal motor latency, compound muscle action potential (CMAP) amplitude and duration, sensory nerve action potential (SNAP) amplitude and sensory conduction velocity (SCV). These parameters were measured at environmental skin temperature, after heating the upper limb for 15 minutes in hot water (40 °C) and after cooling it in cold water (20 °C). Their absolute and relative changes were calculated and compared within the groups and between the two nerves. RESULTS: In the hot condition, group comparisons for the median nerve showed a similar rate of distal motor latency (DML) reduction and sensory conduction velocity (SCV) increase in CTS, DM and controls. With cold, the rate of change was smaller in the CTS group: DML mean increase was 5%/°C (7% for controls) and SCV mean decrease was 2.5%/°C (3.2% for controls). Individual CTS analysis revealed fewer abnormal median DML and SCV values at hot or at cold, compared to environmental temperature. This finding was not observed in individual DM analysis. There were no consistent differences in SNAP and CMAP amplitudes for both nerves, in all study groups. CONCLUSION: In CTS, conduction adjustments for low hand temperatures based on healthy measurements resulted in overcorrection and therefore underdiagnosis. Alternatively, at excessive hand warming the convergence of patient and healthy measurements also lead to underdiagnosis. In DM participants, the effect of skin temperature changes on nerve conduction was similar to healthy controls. Maintenance of skin temperature at 32–33 °C, corresponding to normal ...