Electrophysiological Changes Based on the Palmaris Longus

Electrophysiological Changes in the Median Nerve in the Presence and Absence of the Palmaris Longus

One of the most important causes of carpal tunnel syndrome is increased pressure in the canal. With the loading of the palmaris longus at 20 degrees of wrist extension, the pressure within the canal increases more than the load exerted on other flexor tendons. Several studies have shown the association of carpal tunnel syndrome with the presence of palmaris longus. In this study, our aim is to investigate how the presence or absence of palmaris longus changes EMG measurements in the median nerve. Individuals with a diagnosis of carpal tunnel syndrome or entrapment neuropathy will be given the Schaffer test, a standardized test to test the presence of the palmaris longus muscle. The result will be noted, EMG examination will be requested and the electrophysiological properties of the median nerve will be recorded.

Study Overview

• Status: Unknown
• Conditions: Carpal Tunnel Syndrome; Palmaris Longus Muscle, Absence of; EMG Syndrome
• Intervention / Treatment: Diagnostic test: EMG; Diagnostic test: Palmaris Longus Test

Detailed Description

One of the most important causes of carpal tunnel syndrome(CTS) is the pressure increase in the canal. With the loading of the palmaris longus at 20 degrees of wrist extension, the pressure within the canal increases more than the load exerted on other flexor tendons. Several studies have shown the association of carpal tunnel syndrome with the presence of palmaris longus. Our aim in this study is to investigate how the presence or absence of the palmaris longus changes the EMG measurements in the median nerve. Individuals with a diagnosis of carpal tunnel syndrome or entrapment neuropathy will be given the Schaffer test, a standardized test to test the presence of the palmaris longus muscle. The result will be noted, EMG examination will be requested, and the electrophysiological properties of the median nerve will be recorded. If the Schaffer test that detects the presence of palmaris longus is negative, 4 different tests that will prove the absence of palmaris longus will be performed by the same practitioner. These 4 tests are Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's "two-finger sign" method. Routine median nerve conduction studies are valuable in CTS. Prolonged distal latency in motor and sensory nerves can be found in most cases of CTS. If routine studies are insufficient, more sensitive methods are needed. These; Comparison of mixed latencies in the wrist recording of the sensory responses of the median and ulnar nerves with palmar stimulation, median and ulnar sensory latencies with orthodromic or antidromic recording from the 4th finger, median and ulnar motor latencies with recording from the second lumbrical and second interosseous muscle, median and radial sensory latencies with thumb recording It is based on determining the compression point by centrifugation method by performing segmental sensory nerve conduction examination.

• Study Type: Interventional
• Enrollment (Anticipated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Gizem Ergezen, MSc; Phone Number: +905347098414; Email: gergezen@medipol.edu.tr

Study Locations

• Turkey
  • Beykoz
    • Istanbul, Beykoz, Turkey, 34815
      • Istanbul Medipol University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 45 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Applying to the electrophysiology laboratory for an EMG examination for entrapment neuropathy. The examination should be requested by a doctor.

Exclusion Criteria:

• Having a disease affecting the orthopedic, neurological or rheumatological skeletal and neurological system;
• Those who do physical activity so heavy that they cause muscle pain or neurological damage;
• Those who have an operation in the area to be evaluated

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: palmaris longus and carpal tunnel; EMG measurements of median and ulnar nerves will be made in patients with palmaris longus muscle.	Diagnostic test: EMG; Electromyography (EMG) is an electrodiagnostic medicine technique for evaluating and recording the electrical activity produced by skeletal muscles.; Diagnostic test: Palmaris Longus Test; Schaffer test will be done to understand the presence of palmaris longus. 4 different tests will be done to prove its absence.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Median Nerve Conduction Velocity	right and left median nerve conduction velocity will be assessed with EMG, (m/s)	1st day
Median Nerve Peak Latency	right and left median nerve peak latency will be assessed with EMG,0 (ms)	1st day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ulnar Nerve Conduction Velocity	right and left ulnar nerve conduction velocity will be assessed with EMG, (m/s)	1st day
Ulnar Nerve Peak Latency	right and left ulnar nerve peak latency will be assessed with EMG,0 (ms)	1st day

Collaborators and Investigators

• Sponsor: Istanbul Medipol University Hospital
• Investigators: Study Chair: Mustafa Sahin, PhD, Medipol University

Study record dates

Study Major Dates

• Study Start (Anticipated): November 5, 2020
• Primary Completion (Anticipated): December 19, 2020
• Study Completion (Anticipated): December 31, 2020

Study Registration Dates

• First Submitted: November 3, 2020
• First Submitted That Met QC Criteria: November 5, 2020
• First Posted (Actual): November 6, 2020

Study Record Updates

• Last Update Posted (Actual): November 6, 2020
• Last Update Submitted That Met QC Criteria: November 5, 2020
• Last Verified: November 1, 2020

More Information

Terms related to this study

• Keywords: carpal tunnel syndrome; median nerve; carpal tunnel; palmaris longus
• Additional Relevant MeSH Terms: Pathologic Processes; Nervous System Diseases; Wounds and Injuries; Disease; Congenital Abnormalities; Genetic Diseases, Inborn; Neuromuscular Diseases; Mononeuropathies; Peripheral Nervous System Diseases; Median Neuropathy; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Abnormalities, Multiple; Chromosome Disorders; Syndrome; Carpal Tunnel Syndrome; Beckwith-Wiedemann Syndrome
• Other Study ID Numbers: 10840098-722.02-E.342196

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No