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OBJECTIVE: Endogenous carbonyl stress leads to the formation of advanced glycation end products (AGEs). AGEs represent a potential target to prevent or treat diabetic sensorimotor polyneuropathy (DSPN). The current study aimed to characterize cutaneous carbonyl stress, oxidative stress, immune cells, and endothelial cell damage in early type 2 diabetes compared with normal glucose tolerance (NGT) using novel cutaneous biomarkers. RESEARCH DESIGN AND METHODS: Included were 160 individuals recently (£12 months) diagnosed with type 2 diabetes and 144 with NGT from the German Diabetes Study baseline cohort. Nerve function was assessed using electrophysiological, quantitative sensory, and clinical testing. Skin biopsies were obtained to analyze intraepidermal nerve fiber density, AGE autofluorescence, argpyrimidine area, and endothelial cell area. In addition, skin autofluorescence was measured noninvasively using the AGE reader. A subgroup with type 2 diabetes (n = 80) was reassessed 5 years later. RESULTS: After adjustment for sex, age, HbA1c, LDL cholesterol, and BMI, argpyrimidine area (17.5 ± 18.8 vs. 11.7 ± 12.7%) was higher in recent-onset type 2 diabetes than in NGT (P < 0.05). AGE autofluorescence was inversely correlated with nerve conduction (e.g., peroneal motor nerve conduction velocity: r = 20.346) and positively with AGE reader measurements in type 2 diabetes (r = 0.358, all P < 0.05), but not in NGT. Higher baseline AGE autofluorescence and lower endothelial cell area predicted the deterioration of clinical and neurophysiological measures after 5 years. CONCLUSIONS: Cutaneous AGE markers were associated with neurophysiological deficits in recent-onset type 2 diabetes and predicted their progression after 5 years, substantiating the role of carbonyl stress in the development of early DSPN. [ABSTRACT FROM AUTHOR]

The long-term effect of fluoridated water consumption during development on the velocity of nerve impulse conduction in the sciatic nerve of rats was assessed. Thirty male Wistar rats, 21 days old, were randomly assigned to five groups. Three groups were given fluoridated water ad libitum (as the only source) at different concentrations (10, 100, and 150 ppm), designated as groups F10, F100, and F150, respectively. The study included a control group (C) that received fluoridated water at the maximum level established by the World Health Organization (1.5 ppm of fluorides) and another group that received deionized water (DW). The animals were treated until they reached 90 days of age. Electrophysiological recordings were performed on the rats' sciatic nerves to determine nerve conduction velocity, and blood plasma was extracted for fluoride concentration analysis. The study found that the F150 group had a lower nerve impulse conduction velocity in the sciatic nerve compared to the C group (P = 0.0015). Additionally, there was a negative correlation between the concentration of fluorides in plasma and the nerve conduction velocity (r = −0.5132, P = 0.0037). These findings indicate that chronic consumption of high concentrations of fluoride leads to a decrease in nerve conduction velocity. This, in conjunction with potential alterations in the central nervous system, may explain the deficits in learning and memory tests that have been documented in numerous studies evaluating individuals exposed to fluoride consumption. These results provide valuable information for understanding the effects and action mechanisms of fluoride in exposed individuals. [ABSTRACT FROM AUTHOR]

Pathogenic variants in the SMC1A gene are often dominant-negative and cause an X-linked form of Cornelia de Lange syndrome (CdLS) with growth retardation and typical facial features. However, rare SMC1A variants cause a developmental and epileptic encephalopathy (DEE) with intractable early-onset epilepsy that is absent in CdLS. Here we describe an 11-year-old girl with epilepsy, walking disorder, and neurodevelopmental disorder. A neurophysiological examination of nerve conduction velocity showed a mixed, sensory–motor, chronic 4-limb polyneuropathy. Whole-exome sequencing identified the variant c.3145C > T p.(Arg1049*) in SMC1A (NM_006306.3), which can be classified as pathogenic. To the best of our knowledge, among 79 individuals with SMC1A -related DEE reported in the literature, altered peripheral nerve conduction has never been described. In this article, we propose that severe sensory–motor polyneuropathy could be an expansion of the SMC1A -related phenotype. [ABSTRACT FROM AUTHOR]

Background: Increased glucagon levels are now recognized as a pathophysiological adaptation to counteract overnutrition in type 2 diabetes (T2D). This study aimed to elucidate the role of glucagon in peripheral nerve function in patients with T2D with different body mass indices (BMIs). Methods: We consecutively enrolled 174 individuals with T2D and obesity (T2D/OB, BMI ≥ 28 kg/m2), and 480 individuals with T2D and nonobesity (T2D/non-OB, BMI < 28 kg/m2), all of whom underwent oral glucose tolerance tests to determine the area under the curve for glucagon (AUCgla). Electromyography was utilized to assess overall composite Z-scores for latency, amplitude, and nerve conduction velocity (NCV) across all peripheral nerves, specifically examining the median, ulnar, common peroneal, posterior tibial, superficial peroneal, and sural nerves. Results: In the T2D/OB group, the AUCgla exhibited a significant correlation with the latency, amplitude and NCV of each peripheral nerve, as well as with the overall composite Z-scores for latency (r = –0.283, p < 0.001), amplitude (r = 0.295, p < 0.001), and NCV (r = 0.362, p < 0.001). In contrast, the T2D/non-OB group did not exhibit obvious correlations between the AUCgla and the overall composite Z-scores for latency (r = –0.088, p = 0.056), amplitude (r = 0.054, p = 0.251), and NCV (r = 0.116, p = 0.012). Furthermore, multivariate linear regression analyses indicated that elevated AUCgla was independently associated with a lower overall composite Z-score for latency (β = –0.304, t = –3.391, p = 0.001), as well as higher overall composite Z-scores for amplitude (β = 0.256, t = 2.630, p = 0.010) and NCV (β = 0.286, t = 3.503, p = 0.001), after adjusting for other clinical covariates within the T2D/OB group. Conclusion: Increased glucagon levels may be a potential protective factor against peripheral nerve compromise in patients with T2D and obesity. [ABSTRACT FROM AUTHOR]

Introduction: Joint positioning can impact nerve function. Few studies have explored the effects of ankle positions on deep peroneal nerve conduction. This cross-sectional study investigated the influence of different ankle joint positions on the deep peroneal nerve's distal motor and sensory onset latencies. Materials and Methods: A total of 31 healthy adults (23.4±3.9 years old) underwent a deep peroneal nerve conduction study. Distal motor and sensory onset latencies were measured at neutral (0°), dorsiflexion (20°) and plantar flexion (40°) ankle positions. Results: Changing ankle position significantly affected distal motor (P=0.001) and sensory onset latencies (P=0.001). Latencies were shortest in dorsiflexion (motor: 3.8±0.46; sensory: 2.4±0.2 ms), followed by neutral (motor: 4.2±0.5; sensory: 2.6±0.3 ms) and most prolonged in plantar flexion (motor: 5±0.6; sensory: 3.3±0.2 ms). Conclusion: Ankle position impacts deep peroneal nerve conduction. Dorsiflexion and neutral positions reduced distal motor and sensory latencies compared to plantar flexion. These findings provide preliminary evidence that may help optimize ankle positioning in electrodiagnostic testing. Further blinded research with larger, more diverse samples is warranted. [ABSTRACT FROM AUTHOR]

Objective: Identifying individuals at ultra-high risk for psychosis (UHRP) is crucial for early intervention and prevention strategies. Neurocognitive deficits have been increasingly recognized as potential predictors of psychosis onset. This overview aims to consolidate current evidence and elucidate the role of neurocognitive predictors in identifying UHRP individuals. Method: we systematically searched three scientific databases, i.e., PubMed, Scopus, and Google Scholar using predefined keywords related to predictive neurocognitive markers and ultra-high risk psychosis. By following the PRISMA procedure, we included all relevant systematic-reviews and meta-analyses in our data-synthesis. Results: Neurocognitive deficits, including impairments in working memory, attentional control, verbal learning, and executive functions, have been consistently identified as predictors of psychosis conversion in individuals at UHRP. Structural and functional neuroimaging studies have further revealed aberrant brain connectivity, reduced gray matter volume, and altered neural activation patterns in key brain regions to be involved in psychosis. Moreover, the combination of neurocognitive and clinical risk factors has been shown to enhance the accuracy of predicting psychosis onset and inform personalized intervention strategies. Conclusion: Neurocognitive deficits serve as valuable predictors of the risk of psychosis in individuals with UHRP, offering insights into the underlying neurobiological mechanisms and potential targets for early intervention. Future research should focus on refining predictive models, elucidating the neurodevelopmental trajectories, and evaluating the efficacy of targeted interventions in mitigating the psychosis risk. [ABSTRACT FROM AUTHOR]

Objectives: The increase of bilateral cochlear implantation (CI) in recent years has made it essential to comprehend the effects of CI on otolith function. This study aimed to investigate the development of gross motor and otolith function in patients with inner ear malformations (IEMs) using vestibular‐evoked myogenic potentials (VEMPs). Materials and Methods: Overall, 78 patients with sensorineural hearing loss (SNHL) (age 5.7 ± 4.1 years) were divided into two groups based on the presence (IEM group, n = 39) or absence (control group, n = 39) of IEMs. VEMP testing was performed both before and 1–3 months after CI, and the evaluation of gross motor development was carried out. Results: The mean ages for achieving head control and independent walking were delayed in the IEM group compared with the control group (p = 0.02). The preoperative cervical VEMP (cVEMP) and ocular VEMP (oVEMP) response rates were higher in the control group (60% and 86.95%) than in the IEM group (57.69% and 74.35%) (p < 0.05). Additionally, abnormal cVEMP was associated with delayed acquisition of independent walking (p = 0.017). Saccular and utricular functions after CI were lost by 40% and 31.75%, respectively, in patients who elicited preoperative VEMPs waveform (n = 25). Conclusions: Among SNHL patients, balance development is more delayed in patients of IEMs than in patients without IEMs. The cVEMP and oVEMP waveforms differed greatly between the two groups. The otolith‐vestibular nerve conduction pathway can be affected by CI, potentially leading to otolith function impairment. Therefore, it is essential to assess otolith and balance functions before CI, and this evaluation should be considered an integral part of clinical practice. [ABSTRACT FROM AUTHOR]

The article discusses the case of an 18-year-old male who sustained a severe traumatic brain injury (TBI) and multiple fractures in a motor vehicle accident. Initially, he presented with a Glasgow Coma Scale of 7, left temporal subdural hematoma, bifrontal intraparenchymal hemorrhagic contusions, and fractures in the left upper extremity (LUE), requiring decompressive craniectomy, hematoma evacuation, and surgical fixation of fractures.

Neurogenic thoracic outlet syndrome is a chronic, focal lesion of the lower trunk of the brachial plexus or of the T1 and C8 anterior primary rami, often arising due to distortion of neural structures by a fibrous congenital band extending from a C7 transverse process or cervical rib. Accordingly, patients present with chronic weakness or atrophy of the hand, most prominently of the thenar eminence, which receives most innervation from the T1 root. We present clinical, electrophysiologic, and imaging findings in a case of neurogenic thoracic outlet syndrome presenting in an adult with a history most suggestive of congenital brachial plexus palsy, another pathology sharing the mechanism of nerve compression or injury within the supracostoclavicular space. The patient had new right thenar eminence atrophy and a lifelong history of medial forearm sensory deficit and she improved after first rib resection. The convergence of two disorders in the same patient arising in different phases of life illustrates how anatomic or structural variation in this space can predispose to lower brachial plexus injury. [ABSTRACT FROM AUTHOR]

The article focuses on the clinical presentation and diagnostic features of monotruncular (monomelic) onset in chronic inflammatory demyelinating polyneuropathy (CIDP). Topics include the frequency and clinical features of CIDP with monotruncular onset, electrodiagnostic and MRI findings, and the evolution of the disease in affected patients.

Objective: To assess the protective effects of trigonelline against spinal cord injury (SCI) in rats. Methods: Rats (Sprague-Dawley, male) were randomly assigned to seven groups (n =15 per group): normal, sham, SCI control (1% DMSO), methylprednisolone (30 mg/kg), and trigonelline (50, 100, and 200 mg/kg). Rats received respective treatment daily for 28 days. SCI was induced by using a temporary aneurysm clip. Behavioral, biochemical, and histological analyses were performed to investigate the neuroprotective effect of trigonelline. Results: Trigonelline (100 and 200 mg/kg) treatment effectively (P <0.05) mitigated SCI-induced changes in mechano-tactile sensation, allodynia, hyperalgesia, and motor nerve conduction velocity. It notably (P <0.05) downregulated apoptotic (Bax and caspase-3) and inflammatory (COX-II) markers, while upregulating Bcl-2 and BDNF mRNA expression in the spinal cord (P <0.05). Furthermore, trigonelline effectively alleviated (P <0.05) SCI-induced alterations in mitochondrial complex levels, resulting in enhanced nicotinamide adenine dinucleotide dehydrogenase, succinate dehydrogenase, redox activity, and cytochrome-C levels. Histological examination of spinal cord tissue indicated that trigonelline significantly (P <0.05) ameliorated the histological damage caused by SCI, thereby improving neuronal degeneration, inflammatory cell infiltration, and necrosis. Conclusions: Trigonelline shows neuroprotective properties in SCI rats by reducing allodynia, hyperalgesia, and inflammation, stabilizing mitochondrial enzyme complexes, and modulating apoptotic and neurotrophic factors. Thus, trigonelline holds promise as a potential neuroprotective agent. [ABSTRACT FROM AUTHOR]

Diabetic neuropathy (DN) is a common complication of chronic diabetes mellitus, which is prevalent worldwide. We intend to measure the result of class IV LASER therapy (LT) and sensory re-education (SR) in improving sensory levels in patients with DN. The neurological physiotherapist assessed the nerve conduction velocity (NCV) of the tibial and peroneal nerves on the 50-year-old female patient, who had been diagnosed with DN by her primary care neurologist. Monofilament testing was conducted on 10 locations on the dorsal and plantar aspects of both feet. Following that, class IV LT was administered to the right leg and SR was applied to the left. After the treatment procedure, again monofilament testing was performed, and NCV was also carried out. Baseline data of monofilament testing was 8/10 points on the bilateral leg and post-intervention was 10/10 points on the right leg and 9/10 points on the left leg. Pre- and post-intervention changes in electrophysiological parameters of the tibial and peroneal nerve were recorded. This case report emphasizes the role of class IV LASER and SR in patients with DN and SR, which improve the sensory function of the lower limb. Class IV LT and SR provide an effective treatment protocol for treating symptoms in patients with DN as well as to regain sensation of lower limbs in patients with DN. [ABSTRACT FROM AUTHOR]

Introduction: China has the largest population of individuals with diabetes, and the prevalence of various complications among patients with type 2 diabetes remains high. Diabetic nephropathy affects approximately 20% to 40% of diabetic patients, becoming a major cause of chronic kidney disease and end-stage renal disease. Furthermore, around 50% of patients develop diabetic peripheral neuropathy (DPN), which is closely associated with physical disability, increased healthcare costs, and reduced work productivity. There is an urgent need for novel strategies in prevention, diagnosis, and treatment to improve patient outcomes. Methods: In this study, 163 patients with type 2 diabetes were selected as the observation group and further divided into three subgroups based on homocysteine (HCY) levels. The study measured several clinical parameters, including homocysteine, blood glucose, blood lipids, glycated hemoglobin, urinary microalbumin, urinary albumin-to-creatinine ratio (ACR), electromyography, and highly-sensitive C-reactive protein (CRP), among others. The levels of these indicators were analyzed and compared across the subgroups. Results: The results revealed significant differences in uric acid, creatinine, urinary microalbumin, urinary ACR, and nerve conduction velocity (right tibial nerve sensory conduction) among different HCY levels in patients with type 2 diabetes (P < 0.05). Linear regression analysis indicated that homocysteine levels were associated with systolic blood pressure, glycated hemoglobin, fasting C-peptide, uric acid, creatinine, urinary microalbumin, and nerve conduction velocity (including motor conduction velocity of the ulnar nerve and sensory conduction velocity of the sural nerve). Discussion: The clinical assessment of homocysteine in diabetic patients holds significant importance in the prevention of microvascular complications. Lowering HCY levels may offer a promising therapeutic approach for managing microvascular disease in diabetes. [ABSTRACT FROM AUTHOR]

Cognitive impairment is a critical non-motor symptom of Parkinson's Disease (PD) that profoundly affects patients' quality of life. Magnetic Resonance Imaging (MRI) has emerged as a valuable tool for investigating the structural and functional brain changes associated with cognitive impairment in PD (PD-CI). MRI techniques enable the precise identification and monitoring of the onset and progression of cognitive deficits in PD. This review synthesizes recent literature on the use of MRI-based techniques, including voxel-based morphometry, diffusion tensor imaging, and functional MRI, in the study of PD-CI. By examining these imaging modalities, the article aims to elucidate the patterns of brain structural and functional alterations in PD-CI, offering critical insights that can inform clinical management and therapeutic strategies. In particular, this review provides a novel synthesis of recent advancements in understanding how specific MRI metrics, such as amplitude of low-frequency fluctuations, regional homogeneity, and functional connectivity, contribute to early detection and personalized treatment approaches for PD-CI. The integration of findings from these studies enhances our understanding of the neural mechanisms underlying cognitive impairment in PD and highlights the potential of MRI as a supportive tool in the clinical assessment and treatment of PD-CI. [ABSTRACT FROM AUTHOR]

ABSTRACT Electrical Interference (EI: radiated electromagnetic and/or power line interference) is a common problem in clinical neurophysiology with many causes and thus various conceivable solutions. Although newer digitized electrodiagnostic (EDX) systems have markedly reduced EI issues, it remains a possible impediment in achieving high quality studies. So that the electrodiagnostic medicine consultant (EMC) can problem solve EI, this monograph details the fundamental functional concepts and terminology of electronic amplification and recording electrodes from a practical perspective. This information is then utilized in a proposed standard operating protocol (SOP) to help the EMC address a wide variety of EI sources. Three major EI sources are considered: the EDX system/operator error, the environment, and the patient. The first is a thorough assessment of the recording electrodes from the perspective of clean electrodes, security of attachment, appropriate gel application, proper lead connections to both the patient and instrument, and similarity of electrode composition. Second is how adverse environmental conditions are mitigated through isolating the EDX instrument from nearby large generator sources, unplugging unnecessary equipment, keeping the amplifier close to the patient along with short and braided electrode leads, and utilize filtering (both 60 Hz and total bandwidth) with appropriate caution to avoid unwanted signal distortion. Third, the patient and EMC interaction must be considered. Specifically, all electronic devices that can be removed should be powered down and relocated as far as feasible from the EDX system, including digital watches, cell phones, TENS units, and other such devices. A systematic application of the above proposed protocol should solve the majority of EI issues. [ABSTRACT FROM AUTHOR]

Objectives: Electroencephalograms (EEGs) or multi-unit activities (MUAs) of tonic–clonic seizures typically exhibit a distinct structure. After a preliminary phase (DC shift, spikes), the tonic phase is characterized by synchronized activity of numerous neurons, followed by the clonic phase, marked by a periodic sequence of spikes. However, the mechanisms underlying the transition from tonic to clonic phases remain poorly understood. Methods: We employ a simple two-dimensional cellular automaton model to simulate seizure activity, specifically focusing on replicating the tonic–clonic transition. This model effectively illustrates the physical processes during the ictal phase and, more importantly, differentiates the roles of neurons' activity, identifying their origin as either synaptic or ephaptic. Results: Our model reveals an intriguing interaction between the synaptic and ephaptic modes of action potential wave conduction. By replicating the EEG and multi-unit activity (MUA) structure of a tonic–clonic seizure and comparing it with real MUA data, we validate the model's underlying assumption: the transition from tonic to clonic phases is driven by a shift in dominance from synaptic to ephaptic conduction. During synaptic-mode control, neural conduction occurs through synaptic transmission involving chemical substances, while in the ephaptic mode, information transfer occurs through direct Ohmic conduction. Significance: Gaining a deeper understanding of the neuronal electrical conduction transitions during tonic–clonic seizures is crucial for improving the treatment of this debilitating condition. [ABSTRACT FROM AUTHOR]

Introduction: We present a case of autosomal dominant Charcot–Marie–Tooth disease type 4B3 (CMT4B3) in a family caused by a novel SBF1 missense mutation. Methods: Two patients, a mother and daughter, were recruited from our hospital. Both exhibited early-onset symptoms, including distal muscle atrophy of the limbs, without cranial nerve involvement. Electromyography was performed to assess nerve amplitudes and conduction velocities. Whole-exome sequencing (WES) and Sanger sequencing were performed to identify genetic mutations. Results: Electromyography revealed a significant decline in nerve amplitudes, while the nerve conduction velocities (NCVs) remained normal in the extremities. Sequencing identified a novel missense mutation (c.1398C > A, p.H466Q) in exon 13 of the SET binding factor 1 (SBF1) gene in both patients, indicating an autosomal dominant inheritance pattern. Discussion: Pathogenicity and protein predictions suggest that the myotubularin-related protein 5 (MTMR5), encoded by the mutated SBF1 , may possess an altered structure, resulting in disease. These findings will help expand the phenotypic and genetic spectrum of CMT4B3. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal shock wave therapy (ESWT), as a non-invasive physical agent modality, was effective in relieving spasticity, reducing pain, and improving dysfunction. This systematic review and meta-analysis aimed to investigate the effect of ESWT on nerve conduction, and to find out whether the ESWT group is superior to the control or other comparison groups, thus providing support for guiding the rehabilitation of peripheral nerve injury in clinical work. Methods: PubMed, Web of Science, the Cochrane Library, and Embase were searched from inception to August 20, 2024. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the PROSPERO database (registration number CRD42024500891). It aimed to compare (1) the ESWT group (ESWT) and baseline, and (2) subgroup analyses: ESWT and the control group (Control), ESWT and the local corticosteroid injection group (LCI), ESWT combined with physical therapy (ESWT + PT) and PT alone, and ESWT and PT. Outcome indicators extracted were nerve conduction study results: sensory nerve action potential (SNAP) amplitude, SNAP distal latency, sensory nerve conduction velocity (SNCV), compound muscle action potential (CMAP) amplitude, motor nerve distal latency (MNDL), motor nerve conduction velocity (MNCV), H/M ratio and H-reflex latency. Results: A total of 879 papers were identified through the database searches. Twenty-four trials were included in the systematic review, and 22 trials were included in the meta-analysis. The results showed that: (1) compared to the baseline, ESWT reduced SNAP distal latency mid-term (MD, −0.39; 95% CI: −0.52, −0.26; I 2 = 85%), and improved SNCV both short-term (MD, 4.36; 95% CI: 1.23, 7.49; I 2 = 91%) and mid-term (MD, 2.65; 95% CI: 1.79, 3.51; I 2 = 61%). At the same time, it reduced MNDL short-term (MD, −0.61; 95% CI: −0.91, −0.30; I 2 = 92%), but had no significant effect on MNCV. (2) Subgroup analyses showed that ESWT was superior to Control but not significantly better than LCI, especially in SNCV. The excitatory effect of ESWT + PT on the sensory and motor nerves was significantly better than that of PT alone. Conclusion: ESWT had some excitatory effect on peripheral nerves, especially on sensory nerve studies. Although the efficacy of this treatment was superior to that of the control group, and the combined treatment with PT was more effective than PT alone, its efficacy might not exceed that of LCI. Systematic review registration: Unique identifier: PROSPERO (CRD42024500891). [ABSTRACT FROM AUTHOR]

Introduction: Nerve Conduction Study (NCS) is a widely used electrodiagnostic tool to evaluate the health of the peripheral nervous system. First-year medical students, due to extensive use of Information and Communications Technology (ICT) and academic pressure, often have limited time for physical activity, potentially influencing nerve conduction. Understanding the influence of anthropometric factors on nerve conduction in this population can help suggest preventive strategies to maintain nerve health. Aim: To examine the association between various anthropometric variables with median nerve sensory conduction parameters like latency, amplitude, and Nerve Conduction Velocity (NCV) in first-year medical students. Materials and Methods: A cross-sectional study was conducted in the Department of Physiology at Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India from January 2019 to December 2019. Out of the total population, 110 students were selected through simple random sampling after applying inclusion and exclusion criteria. Anthropometric measurements, including height, weight, Body Mass Index (BMI), Waist-hip Ratio (WHR), and skinfold thickness, were recorded. Median nerve sensory conduction was assessed at the wrist in both hands. Data were analysed using Statistical Packages for Social Sciences (SPSS) software version 20.0, and associations between BMI, WHR, skinfold thickness and nerve conduction parameters were evaluated using Student's t-test. Results: For height, no statistically significant differences were found for latency (p=0.15) and amplitude (p=0.65), although shorter individuals had slightly lower NCV compared to those of normal height (p<0.01). BMI categories showed no significant differences in latency, amplitude, or NCV, though underweight individuals had slightly higher NCVs (54.60 m/s) than those of normal weight (51.96 m/s, p=0.54). A WHR ≤0.9 was associated with significantly higher right-hand amplitude (37.63 μV vs. 28.20 μV, p=0.013) and lower left-hand NCV (51.51 m/s vs. 55.02 m/s, p=0.03). Skinfold thickness showed no significant correlation with nerve conduction parameters (p>0.05). These findings suggest that height and WHR may impact specific aspects of nerve conduction, with potential implications for clinical assessments. Conclusion: This study demonstrates that anthropometric variables, including height, weight, and WHR, significantly influence median nerve sensory conduction parameters. These findings highlight the importance of considering body composition when interpreting Nerve Conduction Studies (NCS), particularly in populations with lifestyle constraints like medical students. [ABSTRACT FROM AUTHOR]

Nociceptive information is transmitted by action potentials (APs) through primary afferent neurons from the periphery to the central nervous system. Voltage-gated Na+ channels are involved in this AP production, while transient receptor potential (TRP) channels, which are non-selective cation channels, are involved in receiving and transmitting nociceptive stimuli in the peripheral and central terminals of the primary afferent neurons. Peripheral terminal TRP vanilloid-1 (TRPV1), ankylin-1 (TRPA1) and melastatin-8 (TRPM8) activation produces APs, while central terminal TRP activation enhances the spontaneous release of L-glutamate from the terminal to spinal cord and brain stem lamina II neurons that play a pivotal role in modulating nociceptive transmission. There is much evidence demonstrating that chemical compounds involved in Na+ channel (or nerve AP conduction) inhibition modify TRP channel functions. Among these compounds are local anesthetics, anti-epileptics, α2-adrenoceptor agonists, antidepressants (all of which are used as analgesic adjuvants), general anesthetics, opioids, non-steroidal anti-inflammatory drugs and plant-derived compounds, many of which are involved in antinociception. This review mentions the modulation of Na+ channels and TRP channels including TRPV1, TRPA1 and TRPM8, both of which modulations are produced by pain-related compounds. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the efficacy of epalrestat combined with Sulodexide in the treatment of diabetic peripheral neuropathy in type 2 diabetes. Methods: A total of 140 patients with type 2 diabetic peripheral neuropathy, who were treated at the Zhanjiang Central People's Hospital between February 2022 and February 2023, were selected as subjects. They were randomly divided into two groups using a computer-generated random number table. The control group (n = 70) received epalrestat treatment, while the study group (n = 70) was treated with a combination of epalrestat and Sulodexide11. Efficacy, nerve conduction velocity, levels of inflammatory factors and oxidative stress markers were compared between groups. Results: After treatment, total effective rate in study group was 97.14 %, which was higher than that of control group (85.71 %; p < 0.05). Sensory nerve conduction velocity (SCV) and motor nerve conduction velocity (MCV) of the common peroneal nerve and median nerve in study group were significantly faster than those in control group (p < 0.05). Levels of serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), procalcitonin (PCT) and tumor necrosis factor-α (TNF-α) in study group were significantly lower than those in control group (p < 0.05). Total antioxidant capacity (T-AOC) and superoxide dismutase (SOD) levels in study group were higher than those in control group, while malondialdehyde (MDA) level was lower than control group (p < 0.05). Conclusions: Epalrestat combined with Sulodexide in treatment of diabetic peripheral neuropathy in type 2 diabetes improves efficacy, accelerates nerve conduction velocity, reduces inflammatory factor levels and decreases oxidative stress response. Further studies are necessary to accurately verify the combination therapy value using epalrestat and Sulodexide in treating peripheral neuropathy associated with type 2 diabetes. [ABSTRACT FROM AUTHOR]

The standard conception of cardiac conduction is based on the cable theory of nerve conduction, which treats cardiac tissue as a continuous syncytium described by the Hodgkin–Huxley equations. However, cardiac tissue is composed of discretized cells with microscopic and macroscopic heterogeneities and discontinuities, such as subcellular localizations of sodium channels and connexins. In addition to this, there are heterogeneities in the distribution of sympathetic and parasympathetic nerves, which powerfully regulate impulse propagation. In the continuous models, the ultrastructural details, i.e. the microscopic heterogeneities and discontinuities, are ignored by ‘coarse graining’ or ‘smoothing’. However, these ultrastructural components may play crucial roles in cardiac conduction and arrhythmogenesis, particularly in disease states. We discuss the current progress of modelling the effects of ultrastructural components on electrical conduction, the issues and challenges faced by the cardiac modelling community, and how to scale up conduction properties at the subcellular (microscopic) scale to the tissue and whole‐heart (macroscopic) scale in future modelling and experimental studies, i.e. how to link the ultrastructure at different scales to impulse conduction and arrhythmogenesis in the heart. [ABSTRACT FROM AUTHOR]

Background and purpose Methods Results Conclusions X‐linked Charcot‐Marie‐Tooth disease type 1 (CMTX1) ranks as the second most prevalent hereditary neuropathy and, currently, has no definitive cure. Emerging preclinical trials offer hope for potential clinical studies in the near future. While it is widely accepted that experimental groups in these trials should be balanced for age and gender, there is a current shortfall in data regarding phenotype–genotype correlations. Our aim was to provide a more detailed understanding of these correlations to facilitate the formation of well‐matched patient groups in upcoming clinical trials.We conducted a retrospective evaluation of CMTX1 patients from 13 designated reference centers in France. Data on genetics, clinical features, and nerve conduction were systematically gathered.We analyzed the genotype–phenotype correlations in 275 CMTX1 patients belonging to 162 families and carrying 87 distinct variants. Patients with variants affecting the transmembrane domains demonstrated significantly greater severity, as evidenced by a Charcot‐Marie‐Tooth Examination Score of 10.5, compared to 7.1 for those with intracellular domain variants and 8.7 for extracellular domain variants (p < 0.000). These patients also experienced an earlier age of onset, showed slower ulnar nerve conduction velocities and had more substantial loss of motor amplitude.This study confirms the presence of a correlation between the mutated protein domain and the clinical phenotype. Patients with a variant in the transmembrane domains demonstrated a more severe clinical and electrophysiological profile. Consequently, the genotype could play a prognostic role in addition to its diagnostic role, and it will be essential to consider this in future clinical trials. [ABSTRACT FROM AUTHOR]

Objective: To assess the effects of neural mobilisation on nerve function and nerve structure of patients with peripheral neuropathic pain. Methods: A systematic review with meta-analysis was conducted. Medline, Embase, CINAHL, Cochrane Library, and World Health Organization International Clinical Trials Registry Platform were searched without restrictions. Eligibility criteria included controlled trials or quasi-experimental studies comparing neural mobilisation versus sham, active or inactive control in adults with peripheral neuropathic pain. Primary outcomes were the change in peripheral nerve cross-sectional area. Secondary outcomes included nerve echogenicity, nerve excursion and nerve conduction. Random effects meta-analysis was conducted. Risk of bias was assessed with the Cochrane Collaboration tool, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Results: Eleven randomised controlled trials and four quasi-experimental studies (total sample = 722 participants) were included. Thirteen studies included participants with carpal tunnel syndrome. Two studies examined the cross-sectional area, revealing improvements (i.e., a reduction) in the cross-sectional area after the neural mobilisation. Neural mobilisation improved motor [mean difference = 2.95 (95%CI 1.67 to 4.22)] and sensory conduction velocity in short-term [mean difference = 11.74 (95%CI 7.06 to 16.43)], compared to control. Neural mobilisation did not alter distal motor or sensory latency. Conclusion: Neural mobilisation seems to improve (i.e., a reduced) the cross-sectional area (very low-quality evidence) and sensory conduction velocity (very low-quality evidence). Neural mobilisation was superior to control in improving motor conduction velocity in patients with peripheral neuropathic pain with moderate quality evidence. Distal motor or sensory latency presented similar results compared to other interventions. Our findings should be interpreted cautiously since most studies included patients with carpal tunnel syndrome. [ABSTRACT FROM AUTHOR]

Vestibular evoked myogenic potentials (VEMPs) are a tool to assess otolith function and a component of sensor specific vestibular diagnostics. The aim of the present study was to measure VEMP trough bone conducted (BC) stimulation using the B250 prototype and to report amplitudes, latencies and threshold levels for patients before resection of a sporadic unilateral vestibular schwannoma (VS) in order to assess function regarding to the reported nerve of origin. Twenty-seven participants (9 male/18 female) with a mean age of 55.9 years (SD: 10.8) were included for the analysis. In the side contralateral to the tumor, in 24 (89%) of the patients cVEMP could be measured, while oVEMP were recordable in 20 patients (74%). For patients with inferior vestibular nerve of origin (n = 11), cVEMP amplitudes of the affected side were significantly lower as compared to the non-affected side, while the force threshold level was increased. No statistically significant differences were observed for neither, oVEMP amplitudes nor threshold levels in the group with superior vestibular nerve of origin (n = 7). Across groups, p13 latency was significantly increased in the affected ear while all other VEMP latencies were not different between the ears. The B250 transducer was applicable to all participants of the clinical cohort. The sample size, however, was too low for a reliable statistical analysis and only allowed for exploratory analysis. [ABSTRACT FROM AUTHOR]

Background In contemporary neuroimaging studies, it has been observed that patients with major depressive disorder (MDD) exhibit aberrant spontaneous neural activity, commonly quantified through the amplitude of low-frequency fluctuations (ALFF). However, the substantial individual heterogeneity among patients poses a challenge to reaching a unified conclusion. Methods To address this variability, our study adopts a novel framework to parse individualized ALFF abnormalities. We hypothesize that individualized ALFF abnormalities can be portrayed as a unique linear combination of shared differential factors. Our study involved two large multi-center datasets, comprising 2424 patients with MDD and 2183 healthy controls. In patients, individualized ALFF abnormalities were derived through normative modeling and further deconstructed into differential factors using non-negative matrix factorization. Results Two positive and two negative factors were identified. These factors were closely linked to clinical characteristics and explained group-level ALFF abnormalities in the two datasets. Moreover, these factors exhibited distinct associations with the distribution of neurotransmitter receptors/transporters, transcriptional profiles of inflammation-related genes, and connectome-informed epicenters, underscoring their neurobiological relevance. Additionally, factor compositions facilitated the identification of four distinct depressive subtypes, each characterized by unique abnormal ALFF patterns and clinical features. Importantly, these findings were successfully replicated in another dataset with different acquisition equipment, protocols, preprocessing strategies, and medication statuses, validating their robustness and generalizability. Conclusions This research identifies shared differential factors underlying individual spontaneous neural activity abnormalities in MDD and contributes novel insights into the heterogeneity of spontaneous neural activity abnormalities in MDD. [ABSTRACT FROM AUTHOR]

Objective: Exploring novel therapeutic approaches for diabetic neuropathy (DN) is crucial, and Ficus carica seed oil (FCSO) emerges as a promising candidate due to its rich composition of fatty acids, phenolics, antioxidants, and anti-inflammatory compounds. This study aimed to investigate the effects of FCSO treatment on the progression of DN. Materials and Methods: Adult male Wistar rats were randomly assigned to control, untreated diabetic, and FCSO-treated diabetic groups. Diabetes was induced by a single intraperitoneal injection of streptozotocin (STZ) at a dose of 50 mg/kg, confirmed by hyperglycemia (>250 mg/ dL). The treatment group received FCSO orally at a dose of 4 mL/kg/day for 5 weeks. Blood glucose was monitored at the initiation and conclusion of the treatment, while insulin and glycated hemoglobin (HbA1c) were assessed at the study’s endpoint. The hot plate test was conducted at the 3rd and 5th weeks of treatment. Sciatic nerve electrophysiology was performed, followed by biochemical analyses for markers of inflammation and oxidative stress. Results: Diabetes resulted in elevated blood glucose and HbA1c levels, along with decreased insulin levels, indicative of diabetic conditions. Increased oxidative stress and inflammation were observed, alongside reductions in nociceptive response and nerve conduction velocity, indicating DN progression. However, FCSO treatment mitigated these effects, restoring markers to levels comparable to those of normal controls. Conclusion: Early intervention with FCSO appears to counteract the mechanisms leading to DN, exerting neuroprotective and preventive effects. These findings underscore the therapeutic potential of FCSO and highlights its role as a promising treatment against DN. [ABSTRACT FROM AUTHOR]

Cerebrotendinous xanthomatosis (CTX) is a rare metabolic disorder caused by mutations in the CYP27A1 gene, leading to cholestanol accumulation in various tissues, including peripheral nerves. Polyneuropathy is an underrecognized feature with considerable variability in clinical presentation and neurophysiological findings in CTX. This review assesses the prevalence, clinical manifestations, and diagnostic methodologies of polyneuropathy in CTX, exploring its underlying mechanisms and potential treatment outcomes. A literature review was conducted using PubMed, Embase, and the Virtual Health Library databases with search terms related to CTX and polyneuropathy. A total of 892 articles were initially identified, with 59 selected for in-depth analysis. The review focused on studies examining peripheral nerve involvement in CTX, including nerve conduction studies, electromyography, and nerve ultrasound. Polyneuropathy in CTX was observed in 50% to 77.7% of patients across multiple case series. Neurophysiological findings varied, with reports of axonal, demyelinating, and mixed polyneuropathies. Clinical presentation included lower limb atrophy, pes cavus, and distal weakness, with sensory symptoms less frequently reported. Treatment with chenodeoxycholic acid (CDCA) showed potential in improving nerve conduction parameters, although the response was variable and dependent on the timing of intervention. Polyneuropathy in CTX presents significant diagnostic challenges due to its heterogeneous presentation and varying neurophysiological findings. Early recognition and intervention are crucial for improving patient outcomes. Peripheral nerve ultrasound is a promising diagnostic tool, complementing traditional neurophysiological assessments. Further research is needed to standardize protocols and explore the full therapeutic potential of CDCA in managing CTX-related polyneuropathy. [ABSTRACT FROM AUTHOR]

Objective: To provide a strong foundation for the use of high-intensity laser therapy in carpel tunnel syndrome, we conducted a systematic review and meta-analysis to investigate the outcomes of short- and long-term follow-up studies. Design: This is a systematic review and meta-analysis. Results: Sample sizes of included studies ranged from 16 to 98 patients (N = 308). Overall, a significant difference between the treatment and control groups were found across majority of the measures. Studies using a 4-wk follow-up period, however, only found significantly greater benefits for high-intensity laser therapy in visual analog scale compared with placebo (P = 0.0191), transcutaneous electrical nerve stimulation (P = 0.0026), and low-intensity laser therapy 20 J/cm2 (P < 0.0002), and exercise (P < 0.0001). For improvement in visual analog scale score over a long treatment period, high-intensity laser therapy was also preferred over control group (P < 0.0071). Insufficient evidence exists to determine effect of high-intensity laser therapy on nerve conduction examinations. The only statistically significant differences observed in examinations were in relation to sensory nerve action potential (P = 0.0083) and sensory nerve conduction velocity (P = 0.0468). Conclusions: Moderate evidence exists regarding efficacy of high-intensity laser therapy compared with placebo, high-intensity laser therapy + wrist splint, and exercise in a short period of follow-up time but evidence on long-term follow-up is limited. [ABSTRACT FROM AUTHOR]

Introduction: Athletic training requires both challenging stimuli for adaptation and sufficient recovery for improved performance. While cold water immersion (CWI) is already a popular recovery method, handheld percussive massage (PM) devices have also gained popularity in recent years. This study aims to assess the effects of CWI and PM on performance recovery after strenuous eccentric exercises compared to a passive rest (PR) control condition. Methods: Thirty-four healthy physically active participants (9 females, 25 males) were randomly divided into three groups: CWI (n = 11), PM (n = 11), and passive rest (PR) (n = 12). They underwent an exhausting eccentric exercise protocol and different measurements at six time points (baseline, POST1, POST2, POST24, POST48, and POST72) over the time course of 72 h. These included subjective assessments of muscle soreness and perceived stiffness as well as measures of skin temperature, leg volume, creatine kinase activity, and three different jump tests. The eccentric exercise protocol consisted of 15 min downhill running (slope: 12%, speed: 10 km/h) and 3 sets of successive depth jumps (dropping height: 0.5 m) until individual exhaustion. After POST1 measurements, participants received 12 min of either CWI (11 ± 0.5°C), PM (40 Hz) or PR (supine posture). Results: No significant group effects were found for the number of depth jumps performed during the exhaustion protocol. All jump tests displayed a significant group × time interaction effect. Post-hoc analysis indicated significant lower jump heights in ΔPOST2 between CWI and both PM and PR. No other significant group effects were observed at any time point. No significant group × time interaction effects were noted for CK, leg volume, and soreness. The perceived stiffness showed a significant group × time interaction effect. Post-hoc analysis revealed a significant decrease in stiffness for PM compared to PR at ΔPOST2. Conclusion: Neither CWI nor PM showed any significant improvement in performance recovery over the 72-h period following strenuous eccentric exercise compared to PR. CWI showed an immediate performance decline which may be attributed to a cold-related reduction in motor nerve conduction velocity. [ABSTRACT FROM AUTHOR]

Objective: The study attempted to evaluate the meta-analyses (MAs) of the acupuncture treatment of diabetic peripheral neuropathy (DPN) to provide a basis for clinical decision-making. Methods: Eight databases, such as PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, CQVIP, and CBM, were searched from database creation to December 22, 2023. The MAs of DPN treatment using acupuncture or acupuncture combined with conventional Western medicine were included. AMSTAR-2 and PRISMA 2020 helped evaluate the methodological and reporting quality of the included studies. The GRADE methodology helped assess the evidence quality of outcome indicators. Evidence mapping was performed to display evaluation results. Results: A total of 18 MAs involving 23,240 DPN patients were included. Based on the methodological quality evaluation, four MAs were of "moderate" quality, seven had a quality grade of "low," and another seven were of "critically low" quality. The evidence quality evaluation showed that among studies of acupuncture vs. conventional Western medicine, four had an evidence quality of "moderate," 18 had an evidence quality of "low," and 17 had an evidence quality of "critically low" and that among studies of acupuncture + conventional Western medicine vs. conventional Western medicine, 12 had an evidence quality of "moderate," 29 had an evidence quality of "low," and 33 had an evidence quality of "critically low." Compared with conventional Western medicine, simple acupuncture and acupuncture + conventional Western medicine significantly improved total effective rate (TER) and nerve conduction velocity (NCV). Conclusion: Acupuncture treatment of DPN significantly improves TER and NCV with proven safety. However, the MAs of the acupuncture treatment of DPN must strictly refer to relevant standards and specifications regarding methodological and reporting quality, along with the design, execution, and reporting of primary randomized controlled trials (RCTs). [ABSTRACT FROM AUTHOR]

A network meta-analysis of randomized controlled trials compared the effectiveness of corticosteroid injections with placebo injections and wrist splints for carpal tunnel syndrome, focusing on symptom relief and median nerve conduction velocity. Within 3 months of the corticosteroid injection, there was a modest statistically significant difference in symptom relief compared to placebo injections and wrist splints, as measured by the Symptom Severity Subscore of the Boston Carpal Tunnel Questionnaire; however, this did not meet the minimum clinically important difference. Pain reduction with corticosteroids was slightly better than with wrist splints, but it also failed to reach clinical significance. Electrodiagnostic assessments showed transient changes in distal motor and sensory latencies in favour of corticosteroids at 3 months, but these changes were not evident at 6 months. The best current evidence suggests that corticosteroid injections provide minimal transient improvement in nerve conduction and symptomatology compared with placebo or wrist splints. [ABSTRACT FROM AUTHOR]

Copper is an important trace element for maintaining key biological functions such as cellular respiration, nerve conduction, and antioxidant defense. Maintaining copper homeostasis is critical for human health, and its imbalance has been linked to various diseases, especially cancer. Cuproptosis, a novel mechanism of copper-induced cell death, provides new therapeutic opportunities for metal ion regulation to interact with cell fate. This review provides insights into the complex mechanisms of copper metabolism, the molecular basis of cuproptosis, and its association with cancer development. We assess the role of cuproptosis-related genes (CRGs) associated with tumorigenesis, their importance as prognostic indicators and therapeutic targets, and the impact of copper homeostasis on the tumor microenvironment (TME) and immune response. Ultimately, this review highlights the complex interplay between copper, cuproptosis, and cancer immunotherapy. [ABSTRACT FROM AUTHOR]

Previous researches found that glucagon‐like peptide 1 receptor agonists (GLP‐1RA) offer benefits beyond their anti‐diabetic properties, including weight loss and cardiovascular disease prevention. However, the effects of GLP‐1RA on diabetic peripheral neuropathy (DPN) remain unclear. This meta‐analysis aims to assess the potential benefits of GLP‐1RA treatment in DPN patients by evaluating peripheral neural function. Following the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, we conducted a meta‐analysis of the clinical trials investigating the impact of GLP‐1RA treatment on peripheral neural function in patients with DPN. Outcomes were measured using electrophysiological tests, including nerve conduction velocity (NCV) and action potential amplitude. Our meta‐analysis included six studies with 271 participants. Following GLP‐1RA treatment, NCV significantly improved compared to the control group (MD 1.74; 95% CI 1.16 to 2.33; p < 0.001) and before treatment (MD 2.16; 95% CI 1.04 to 3.27; p < 0.001). Despite the improvement in NCV, blood glucose levels did not change significantly (MD −0.20 95% CI −0.87 to 0.46, p = 0.55) indicating that GLP‐1RA enhances NCV through mechanisms other than glucose lowering. Nonetheless, as a result of the limited population studied, further research is needed to strengthen the reliability of these findings. [ABSTRACT FROM AUTHOR]

Objective: The study attempted to evaluate the meta-analyses (MAs) of the acupuncture treatment of diabetic peripheral neuropathy (DPN) to provide a basis for clinical decision-making. Methods: Eight databases, such as PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, CQVIP, and CBM, were searched from database creation to December 22, 2023. The MAs of DPN treatment using acupuncture or acupuncture combined with conventional Western medicine were included. AMSTAR-2 and PRISMA 2020 helped evaluate the methodological and reporting quality of the included studies. The GRADE methodology helped assess the evidence quality of outcome indicators. Evidence mapping was performed to display evaluation results. Results: A total of 18 MAs involving 23,240 DPN patients were included. Based on the methodological quality evaluation, four MAs were of "moderate" quality, seven had a quality grade of "low," and another seven were of "critically low" quality. The evidence quality evaluation showed that among studies of acupuncture vs. conventional Western medicine, four had an evidence quality of "moderate," 18 had an evidence quality of "low," and 17 had an evidence quality of "critically low" and that among studies of acupuncture + conventional Western medicine vs. conventional Western medicine, 12 had an evidence quality of "moderate," 29 had an evidence quality of "low," and 33 had an evidence quality of "critically low." Compared with conventional Western medicine, simple acupuncture and acupuncture + conventional Western medicine significantly improved total effective rate (TER) and nerve conduction velocity (NCV). Conclusion: Acupuncture treatment of DPN significantly improves TER and NCV with proven safety. However, the MAs of the acupuncture treatment of DPN must strictly refer to relevant standards and specifications regarding methodological and reporting quality, along with the design, execution, and reporting of primary randomized controlled trials (RCTs). [ABSTRACT FROM AUTHOR]

Background: Electrodiagnosis is a localizing, diagnostic, and prognostic tool for individuals with suspected neuromuscular diseases. In addition to detailed history taking and thorough clinical examination, correct execution and interpretation of these tests can provide vital insights into the underlying neuromuscular disorders and frequently guide the need for proper management decision. The request for an electrodiagnosis examination should include brief clinical information and a provisional clinical diagnosis; this enhances the efficient easy performance of the test. The current study aims to detect the pattern of neuromuscular diseases in the Alexandria Main University Hospital, Egypt, and to evaluate the quality of the referral system to the electrodiagnosis unit. Results: The study included 371 patients, out of which, 65% were referred from the Governmental Specialized Medical Councils and the Neurosurgery department. Although sensory complaints were the main reason for referral, yet 28.8% of patients did not show any electrodiagnosis abnormality. A compatible referral note led to shorter test times and fewer electromyography needle insertions. Conclusion: Disorders of the peripheral nerves are the most frequent neuromuscular diseases referred to the electrodiagnosis unit with carpal tunnel syndrome being the most common disorder. A compatible referral letter is necessary when requesting an electrodiagnosis test, to save the physician time and focus on targeted procedures. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to evaluate the clinical efficacy of a 4D digital strabismus and amblyopia visual function correction system (4D-DSAAVFCS) in combination with conventional modalities compared with conventional modalities alone in children with anisometropic amblyopia. Methods: This nonrandomized controlled study collected data on best-corrected visual acuity (BCVA), simultaneous vision, fusion vision, near stereoscopic vision, the amplitude of P100 wave (graphic evoked visual potentials), and the latency of P100 wave from both eyes at the beginning of the treatment and one year later. The Mann‒Whitney U test was used to compare BCVA contrasts in different subgroups, and the independent samples t test was used to compare the amplitude and latency of P100 wave contrasts in different subgroups. The basic cure rate, simultaneous vision recovery rate, fusion vision recovery rate, and near stereoscopic vision recovery rate contrasts in different subgroups were compared via the chi-square test. Results: This study included 393 children (217 boys and 176 girls) aged 3 to 12 years with anisometropic amblyopia who were treated at the Aier Eye Hospital of Wuhan University from January 2020 to December 2022. The children were divided into two groups, the 4D group (263 cases) and the traditional group (130 cases), on the basis of the treatment modality. The children in the traditional group received treatment through the conventional method of occlusion and regular training. Meanwhile, the children in the 4D group received treatment through the traditional method and the 4D-DSAAVFCS. The 4D group was divided into two age groups: 3 ~ 6 years (161 cases) and 6 ~ 12 years (102 cases). The basic cure rate of the 4D group was significantly better than that of the traditional group (χ2 = 4.318, P < 0.05). There were no statistically significant differences in the BCVA, the latency of P100 wave, or the amplitude of P100 wave between the 4D group and the traditional group before treatment (U=-0.117, t=-0.05, all P > 0.05). After one year of treatment, a statistically significant difference was observed between the 4D group and the conventional group in terms of BCVA, the latency of P100 wave, and the amplitude of P100 wave (U=-1.243, t=-0.853, t=-1.546, all P < 0.05). These results suggest that the therapeutic effect was greater in the 4D group than in the conventional group. The recovery rates of simultaneous vision, convergent fusion, divergent fusion, and near stereoscopic vision were significantly greater in the 4D group than in the conventional group (χ2 = 4.344, 4.726, 5.123, and 2.036, respectively; all P < 0.05). Additionally, the basic cure rate of children aged 3 ~ 6 years in the 4D group was significantly greater than that of children aged 6 ~ 12 years (χ2 = 2.365, P < 0.05). In this study, BCVA was significantly lower in the 3 ~ 6-year-old group than in the 6 ~ 12-year-old group (U = -1.267, P < 0.05). Similarly, the amplitude of P100 wave was also significantly greater in the 3 ~ 6-year-old group than in the 6 ~ 12-year-old group (t = -1877, P < 0.05). The latency of P100 wave was lower in the 3 ~ 6-year-old group than in the 6 ~ 12-year-old group (t=-0.998, P < 0.05). Additionally, the recovery rate of near stereoscopic vision was significantly greater in the 3 ~ 6-year-old group than in the 6 ~ 12-year-old group (χ2 = 4.534, P < 0.05). Conclusion: The combination of the traditional method with the 4D-DSAAVFCS was more effective than the traditional method alone in treating amblyopic children. This approach was particularly helpful in improving the visual acuity of the children and restoring their optic nerve conduction function, simultaneous vision, fusion vision, and near stereoscopic vision. The combination of the traditional method and the 4D-DSAAVFCS is more effective for younger children. [ABSTRACT FROM AUTHOR]

The article discusses the significant impact of diabetic neuropathy on patients and explores potential therapeutic interventions. Topics include the role of nerve growth factor (NGF) in promoting neuronal health and regeneration, the current pharmacological treatments for managing diabetic neuropathy symptoms, and the study assessing the combined effects of carnosine and vitamin B complex on NGF levels and neuropathy outcomes over a 12-month trial.

ABSTRACT: Introduction: Diabetes mellitus (DM) poses a significant health burden globally, impacting millions due to its metabolic disruptions. Among its complications, diabetic peripheral neuropathy (DPN) is a prevalent concern, affecting sensory and motor nerves. While various diagnostic methods exist, discrepancies persist in prevalence estimates of DPN among diabetic populations. Objective: This meta-analysis aimed to assess the prevalence of DPN in individuals with DM, focusing on sural nerve conduction velocity (NCV) measurements. Additionally, the study explored how different evaluation techniques influenced prevalence estimates. Methods: A systematic literature search was conducted following PRISMA guidelines across multiple databases. Studies reporting sural nerve NCV measurements in diabetic patients were included. Data extraction, quality assessment, and statistical analyses were performed to synthesize findings. Results: Twenty-six studies met the inclusion criteria, providing insights into sural nerve NCV among diabetic individuals. Pooled analysis revealed a mean sural nerve NCV of 42.12 m/s (95% CI: 39.87-44.36), indicative of reduced conduction velocity in diabetic populations. Furthermore, sural nerve amplitude was significantly lower in diabetic individuals, with a pooled mean of 4.68 μV (95% CI: 3.11-6.25). Conclusion: Individuals with type 2 DM exhibit impaired sural nerve function, as evidenced by reduced NCV and amplitude measurements. Timely NCV assessment, alongside glycemic monitoring, is crucial for identifying and managing DPN to prevent further complications. Interventions addressing glycemic control, dietary regulation, and lifestyle modifications are recommended to mitigate the progression of neuropathy in diabetic populations. [ABSTRACT FROM AUTHOR]

Cubital tunnel syndrome (CBTS) impairs hand function, with limited conservative options often leading to surgery. Chitosan neuroregenerative effects delivered via phonophoresis provide a rationale for testing this emerging treatment approach. The primary goal of this research was to assess the impact of chitosan phonophoresis on the conductivity of the ulnar nerve, as well as its effects on pain levels and functional outcomes in individuals diagnosed with mild to moderate CBTS. Double-blind randomized controlled trial. This was a prospective, double-blinded, randomized controlled study. The participants consisted of 54 individuals aged between 20–35 years who were randomly assigned using block randomization. The control group (n = 27) received standard hand therapy alone, while the experimental group (n = 27) received both standard hand therapy and chitosan phonophoresis. Both groups underwent three treatment sessions per week, each lasting for 60–72 minutes, over a period of five weeks. Pre- and post-intervention evaluations included assessments of ulnar nerve conduction velocity (NCV), pain assessment using the numerical pain rating scale (NPRS), as well as hand function evaluated using the Quick Disabilities of Arm Shoulder Hand (QuickDASH) questionnaire. After the intervention, the experimental group significantly improved in all outcome measures compared to the control group. Accordingly, ulnar NCV (MD = 2.233 m/sec; CI = 1.63:2.83; p < 0.001; η 2 p = 0.516), NPRS (MD = −1.11; CI = −1.71: −0.50; p < 0.001; η 2 p = 0.208) and QuickDASH (MD = −2.72; CI = −4.54:0.87; p < 0.007; η 2 p = 0.133). The study findings suggest that chitosan phonophoresis may have the potential as a supplementary treatment to hand therapy for individuals with mild to moderate CBTS. This approach demonstrated significant improvements in nerve conduction, pain reduction, and enhancement of hand function. • Chitosan phonophoresis is a novel treatment approach for cubital tunnel syndrome. • Cubital tunnel syndrome impairs hand function, with limited effective conservative options. • Chitosan phonophoresis improved ulnar nerve conduction velocity versus standard care. • Chitosan phonophoresis provided greater pain relief compared to physical therapy alone. • Chitosan's neuroprotective effects make it well-suited for nerve compression disorders. [ABSTRACT FROM AUTHOR]

Aim: Neuromuscular Taping (NMT) is the application of elastic adhesive tape to the skin without any tension in it. NMT creates wrinkles on the surface of the skin to help stretch the skin passively and this elongation force assists in muscle contraction and relaxation. Therefore, this study aimed to assess the effectiveness of NMT in the improvement of sensorimotor complications following diabetic peripheral neuropathy (DPN). Setting and Design: A randomized controlled trial performed at a tertiary health care center. Materials and Methods: A total of 20 participants were recruited and were divided into two groups: The experimental group (EG; N = 10) and the control group (CG; N = 10). Eight weeks of physiotherapy intervention including NMT on bilateral tibialis anterior, tibialis posterior, peroneus longus muscles, transverse arch of the foot, and transcutaneous electrical nerve stimulation (TENS) on the course of bilateral tibial and peroneal nerves for EG. CG received sham taping and TENS as an EG group. The patients were assessed for pre- and post-intervention using the outcomes: Leeds Assessment of Neuropathic Signs and Symptoms and nerve conduction velocity of tibial, peroneal, and sural nerves and H-reflex, Berg Balance Scale, and Pedalo-Sensamove Mini Board. Results: The results revealed that both the groups showed significant improvements in all variables except for the H-reflex of the right and left sides at P > 0.05. EG showed more clinical and symptomatic improvement compared with CG. In EG, most of the variables showed moderate to large effect sizes ranging from 0.66 to 0.97 except for bilateral H-reflex; ranging from 0.15 to 0.33. Conclusion: This study concludes that NMT can be a trustworthy approach to treating DPN. [ABSTRACT FROM AUTHOR]

Background: The visual evoked potential (VEP) is a form of an electrical signal. VEP originates from the visual cortex which is located in Brodman areas 17 and 18 of the occipital lobe. VEP is generated in response to stimulation of the retina by light flashes or pattern stimuli. The advent of VEPs in the 1970s first allowed clinicians to assess neural conduction in the optic nerve. There are many factors that affect VEP such as age and gender; one among them is the hormonal factor. Ovarian and thyroid hormones are vital factors in the generation of olfactory, taste, visual, and auditory neuronal activity. The ovarian hormones progesterone and estrogen play a major role in the conduction of the optic nerve. Aims and Objectives: The aims and objectives of the study are to evaluate the influence of ovarian hormones in the VEPs. Materials and Methods: Among the 1st year medical students, 26 young females (18-20 years of age) were randomly selected. Informed consent was obtained from them and the institutional ethical committee approved the study. Students having regular menstrual periods for the past 6 months with normal visual acuity were included. Those with a history of polycystic ovarian disease, having irregular periods, under hormonal treatment were excluded from the study. Detailed history helps in identifying the proliferative and secretory phases of the menstrual cycle. The P100 wave latency of VEPs was recorded during these two different phases. Results: An unpaired t-test was used for analyzing the data. While comparing the proliferative and secretory phases, P100 wave latency was significantly reduced in the proliferative phase (101±3.6 vs. 97.9 ± 1.43 ms; P < 0.0001). Conclusion: The receptor sensitivity in the visual pathways to dopamine is increased by estrogen which in turn leads to a decrease in the time taken by the visual impulses to reach the visual cortex. Progesterone antagonizes estrogen activity in the central nervous system. Therefore, estrogen is responsible for the reduction in latency during the proliferative phase and progesterone is responsible for the prolonged VEP latency in the secretory phase. Thus, the excitability of the visual system is influenced by the ovarian hormones. [ABSTRACT FROM AUTHOR]

Objective To summarize the electrophysiological and muscle pathological characteristics of Lambert - Eaton myasthenic syndrome (LEMS). Methods and Results Twelve LEMS patients referred to China - Japan Friendship Hospital between January 2010 and December 2021 were included. Clinically, they all showed proximal muscle weakness and reduced or disappeared tendon reflexes. Electrophysiologically, all 12 patients showed decreased compound muscle action potential (CMAP) amplitudes, normal distal motor latency (DML), and normal motor and sensory conduction velocities. Ten patients underwent repetitive nerve stimulation (RNS) test: all had amplitude increments of more than 100% at high - frequency RNS, and 8 had amplitude decrements of more than 15% at low - frequency RNS. Three patients completed the post-exercise facilitation (PEF) test: the ulnar nerve CMAP amplitude reached a peak immediately after maximum voluntary contraction of the abductor digiti minimi for 5-10 s and then gradually decreased to near baseline level after contraction for 60 s; the ulnar nerve CMAP amplitude reached a peak immediately after maximum voluntary contraction for 10 s, and then rapidly decreased to near baseline level after 15 s. On needle EMG, 8 patients showed normal motor unit action potential (MUAP), 3 showed short - duration MUAP mimicking myopathy, and one showed long - duration MUAP mimicking neuropathy. Two patients with normal MUAP underwent biceps biopsy, which showed selective type - fiber atrophy. Conclusions Electrophysiologically, CMAP amplitudes of LEMS patients are usually diffusely low or borderline. LEMS patients have amplitude increments of more than 100% at high-frequency RNS, and some have amplitude decrements of more than 15% at low-frequency RNS. PEF Needle EMG is usually normal, but some show myogenic lesions, and some show neurogenic lesions. Muscle biopsy shows selective type - fiber atrophy. Needle EMG myogenic lesion may not be associated with pathologically selective type - fiber atrophy. [ABSTRACT FROM AUTHOR]

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Introduction: The median and ulnar nerves have been suggested to play a significant role in hand function; however, there are insufficient data to determine the strength of this association. This study aimed to investigate the correlation between hand function as measured with the Grooved pegboard test (GPT) and conduction velocity and latency of the median and ulnar nerves. Methods: We collected convenience samples in the College of Medicine, KSAU-HS. We used GPT to characterize hand function and performed measured nerve conduction velocity (NCV) and latency of the ulnar and median nerves of both hands. We used the Edinburgh handedness inventory (EHI) to determine hand dominance. Results: We recruited 28 healthy medical students aged 20–29 years (mean: 21.46 ± 1.62 years). Most were right-handed (n = 25, 89.3%), with a mean EHI score of 302 ± 210. The mean GPT time was significantly faster in the dominant (65.5 ± 6.4 s) than in the non-dominant (75.0 ± 9.6 s) hand. The NCV for the ulnar nerve of the dominant hand was significantly correlated with GPT (r = -0.52, p = 0.005) while median nerve was not correlated (0.24, p = 0.21). Regression analysis and collinearity test showed that the ulnar NCV explained 20% of the variance in GPT of the dominant hand (R2 = 0.203, p = 0.016). Conclusion: The ulnar nerve conduction velocity, explained 20% of the variance in GPT times of the young men. Performance on this biomarker of neurological health seems to be more influenced by other factors in healthy young individuals. [ABSTRACT FROM AUTHOR]

Guillain-Barré syndrome is the most common acute inflammatory demyelinating peripheral nerve condition. Occasionally, other autoimmune conditions can mimic Guillain-Barré syndrome but may require different diagnostic workup and treatment. We report here two patients with Evans syndrome, a rare hematological autoimmune condition who developed a subacute inflammatory radiculopathy. Similarities and distinguishing clinical and diagnostic features are discussed. [ABSTRACT FROM AUTHOR]

Background: Recurrent ulnar nerve compression after primary anterior subcutaneous transposition is relatively rare, and revision surgery is challenging. This study retrospectively evaluated the clinical outcomes of revision anterior subcutaneous transposition for recurrent ulnar nerve compression. Methods: Eight patients who underwent revision anterior subcutaneous transposition for recurrent ulnar nerve compression were enrolled in this study. The outcomes were based on preoperative and postoperative symptoms, physical examination findings, and electromyographic evaluation. Results: Ulnar nerve enlargement was preoperatively found in all patients with a mean cross sectional area of 0.15 cm2 (range, 0.14–0.18 cm2). Intraoperative findings showed that recurrent compression occurred in three areas, including the medial intermuscular septum (n = 5), the medial epicondyle (n = 6) and nerve entrance to forearm fascia (n = 1). Post-operation, significant improvements were observed in ring/little finger numbness (from severe to mild, p = 0.031), grip strength (from 48.00% to 80.38% of the intact side, p < 0.001) and McGowan grade (from Grade III to Grade I, p = 0.049). Postoperative electromyography test also showed significant improvement in motor nerve conduction at elbow (velocity, 23.30 ± 9.598 vs. 35.30 ± 9.367, p = 0.012; amplitude, 3.40 ± 3.703 vs. 5.65 ± 2.056, p = 0.007) and sensory nerve conduction at wrist (velocity, 27.04 ± 22.450 vs. 36.45 ± 18.099, p = 0.139; amplitude, 1.44 ± 1.600 vs. 4.00 ± 2.642, p = 0.011). Seven of the eight patients reported satisfaction with the postoperative results. Conclusions: Revision anterior subcutaneous transposition was an effective treatment for recurrent ulnar nerve compression from prior failed procedures. [ABSTRACT FROM AUTHOR]

Transient Receptor Potential Vanilloid 1 (TRPV1) is a protein that functions as a non-selective channel receptor that is widely expressed in skin tissue, including keratinocytes, peripheral sensory nerve fibers, and immune cells. Several structural features of TRPV1 are involved in heat-induced activation, where stimulation of TRPV1 elicits a burning sensation, reflecting the receptor's important role in pain. A TRPV1-mediated signalling pathway that functions as an endogenous pain resolution mechanism by inducing nuclear translocation of β-arrestin2 to minimize desensitization of μ-opioid receptors (MOR). TRPV1 agonists can reduce pain primarily by interfering with pain nerve conduction. Several TRPV1 antagonist drug candidates have failed in clinical trials because by interfering with the detection of the above-mentioned stimuli, they triggered serious side effects such as hyperthermia and painful impaired heat detection. In the case of agonists, systemic administration causes more severe side effects such as respiratory damage. Therefore, only topical preparations with limited effectiveness have been developed. The TRPV1 agonist capsaicin is currently the only one approved for the treatment of muscle, bone, neuropathic pain and migraine, and is only available as a low-concentration cream or as a transdermal patch. [ABSTRACT FROM AUTHOR]

Teaching physiology can be challenging as students are initially required to understand basic and abstract concepts. Thus students typically view physiology as a "difficult" subject and place an emphasis on rote learning and memorization. Here, we attempted to address this knowledge gap by introducing a pedagogical intervention into the neurophysiology lesson plan of first-year medical and health physiology students at the University of La Réunion. This intervention aimed to better link abstract concepts (e.g., saltatory conduction) and a pathological disorder (multiple sclerosis), together with a discussion of a specific therapeutic intervention (fampridine). Students were required to complete readings (focused on neurophysiology aspects) and two online quizzes before two scheduled in-person lectures. They could also pose questions on a dedicated online forum. Thereafter, the in-person lectures discussed questions posted on the online forum, provided feedback on poorly answered questions (from the online quizzes), and dealt with questions posed by students attending classes. Student feedback regarding the pedagogic intervention was assessed by an anonymous online survey. This survey revealed that the pedagogical intervention was positively received. For example, 94% of respondents agreed the course was well developed, while 80% indicated that the pedagogical intervention was beneficial in terms of their understanding of basic and abstract neurophysiology concepts. Together, this pedagogical intervention was enthusiastically received by the students who better understood how basic nerve physiology concepts fit into the broader context and that such an understanding can result in the development and the roll-out of unique therapeutic interventions for multiple sclerosis. NEW & NOTEWORTHY: First-year physiology students can find the subject challenging, struggling to understand abstract concepts without any context. To address this, we introduced a pedagogical intervention for first-year medical and health physiology students that aimed to link abstract concepts and a pathological disorder, together with a discussion of a specific therapeutic intervention. This pedagogical intervention was well received by first-year physiology students who better understood how basic nerve physiology concepts can be applied within the clinical setting. Listen to this article's corresponding podcast at https://apspublicationspodcast.podbean.com/e/enhancing-the-understanding-of-abstract-neurophysiology-concepts-by-first-year-students/. [ABSTRACT FROM AUTHOR]

Introduction: One important first-line drug for treating Tuberculosis (TB) is Ethambutol (EMB), which carries a builtin risk of causing optic neuropathy, potentially resulting in permanent visual impairment. The subjective tests currently used in the diagnostic process, such as visual acuity and visual field assessments, may overlook early changes in visual function. The purpose of the present study is to investigate how well Visual Evoked Potentials (VEP) work as an evaluation tool for identifying optic neuropathy. Aim: To assess the utility of VEP in detecting subtle changes in visual function due to EMB-induced optic neuropathy. Materials and Methods: The cross-sectional study conducted at the Department of Physiology, B.J. Medical College, Ahmedabad, Gujarat, India, over approximately five months (August 2023 to December 2023) involved 62 eyes, with 30 eyes from TB patients undergoing EMB treatment and the rest serving as a control group. VEP recordings were made using a Personal Computers (PC)-based, 2-channel Recorders & Medicare Systems Pvt Ltd Nerve Conduction Velocity (NCV) Electromyography (EMG) Mark II machine with standard silversilver chloride disc electrodes. VEP recordings were conducted regardless of the treatment period and the analysis focused on the amplitude and latency of the P100 wave, a critical component of VEP. Statistical analysis was carried out using Student's unpaired t-test to compare the results between both groups, with p-values calculated. Results: The mean age of case was 40±17.4 years and controls was 31.12±12.54 years. The study revealed changes in VEP parameters, specifically showing a progressive reduction in P100 amplitude (p-value=0.0001). Conclusion: The present research highlights the potential of VEP as a sensitive and reliable method for assessing EMBinduced optic neuropathy. Incorporating VEP into routine ophthalmologic assessments for patients receiving EMB could improve TB management while reducing the risk of vision loss. [ABSTRACT FROM AUTHOR]