Blood flow velocity but not tendon mechanics relates to nerve function in carpal tunnel syndrome patients

Carpal tunnel syndrome (CTS) develops from chronic compression of the median nerve. Chronic compression results in a number of vascular, structural and functional changes to the carpal tunnel tissues which ultimately manifest in the characteristic symptoms of CTS. The purpose of this study was to in...

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Bibliographic Details
Published in:Journal of the neurological sciences 2020-04, Vol.411, p.116694-116694, Article 116694
Main Authors: Farias Zuniga, Amanda, Ghavanini, Amer A., Israelian, Gaspar, Keir, Peter J.
Format: Article
Language:English
Subjects:
Blood Flow Velocity
Carpal tunnel syndrome
Carpal Tunnel Syndrome - diagnostic imaging
Connective Tissue
Humans
Intraneural blood flow
Median nerve
Median Nerve - diagnostic imaging
Nerve conduction studies
Subsynovial connective tissue
Tendons - diagnostic imaging
Ultrasound
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Summary:Carpal tunnel syndrome (CTS) develops from chronic compression of the median nerve. Chronic compression results in a number of vascular, structural and functional changes to the carpal tunnel tissues which ultimately manifest in the characteristic symptoms of CTS. The purpose of this study was to investigate the interplay of median nerve function, median nerve hemodynamics, and finger flexor tendon and subsynovial connective tissue (SSCT) mechanics in CTS patients. Thirty-five patients were recruited following nerve conduction study for this double-blinded imaging study. Ultrasound B-mode, pulse-wave Doppler, and colour Doppler images and videos were collected at the proximal carpal tunnel to quantify: (1) median nerve cross-sectional area, (2) intraneural blood flow velocity in 3 wrist postures (neutral (0°), flexion (15°), extension (30°)), and (3) flexor digitorum superficialis and SSCT displacement. Results demonstrate that intraneural blood flow velocity is dependent on median nerve function and wrist posture such that patients with mild CTS are more susceptible to the effects of non-neutral wrist postures. Tendon-SSCT mechanics do not appear to differ based on severity. This study stresses the importance of limiting exposure to non-neutral wrist postures in patients with early signs of the condition. •CTS patients have altered nerve vascular dynamics and tissue mechanics.•Effect of wrist posture on intraneural blood flow velocity is dependent on severity.•Tendon-connective tissue mechanics do not differ with nerve function in CTS patients.•Median nerve cross-sectional area may generally distinguish CTS severity.•Ultrasound may serve as a supplementary diagnosis tool in CTS.
ISSN:0022-510X
1878-5883
DOI:10.1016/j.jns.2020.116694