Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study
Abstract Background Although diabetes is considered a major risk factor for carpal tunnel syndrome (CTS), the characteristics of diabetic CTS have not been fully understood. Objective This study is aimed at evaluation of the clinical, electrophysiological, and ultrasonographic findings of non-diabet...
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| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-06881-1 |
| _version_ | 1827635850053156864 |
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| author | Dougho Park Sang-Eok Lee Jae Man Cho Joong Won Yang ManSu Kim Heum Dai Kwon |
| author_facet | Dougho Park Sang-Eok Lee Jae Man Cho Joong Won Yang ManSu Kim Heum Dai Kwon |
| author_sort | Dougho Park |
| collection | DOAJ |
| description | Abstract Background Although diabetes is considered a major risk factor for carpal tunnel syndrome (CTS), the characteristics of diabetic CTS have not been fully understood. Objective This study is aimed at evaluation of the clinical, electrophysiological, and ultrasonographic findings of non-diabetic and diabetic CTS. Methods This retrospective, cross-sectional study included patients diagnosed with CTS. Patient age, sex, involved side, body mass index, clinical and electrophysiological findings, and median nerve cross-sectional area (CSA) were identified. Diabetes was identified through patient or guardian interviews, medical records, and medication history. Linear and binary logistic regression models were established to confirm the associations between the electrophysiological findings, median nerve CSA, and clinical outcomes. Covariates, such as age, sex, body mass index, diabetes, symptom duration, and thenar muscle weakness were adjusted. Results Out of the 920 hands, 126 and 794 belonged to the diabetic and non-diabetic CTS groups, respectively. The patients were significantly older in the diabetic CTS group (P < 0.001). The rate of thenar weakness in the diabetic CTS group was also significantly higher than that in the non-diabetic CTS group (P = 0.009). The diabetic CTS group had a more severe electrodiagnostic grade (P = 0.001). The prolonged onset latency of the compound motor nerve action potential (CMAP) and median nerve CSA were well associated with the degree of clinical symptoms. Increased median nerve CSA was significantly associated with prolonged CMAP onset latency (β = 0.64; P = 0.012), prolonged transcarpal latency (β = 0.95; P = 0.044), and decreased CMAP amplitude (β = -0.17; P = 0.002) in the non-diabetic CTS group. Conclusion Diabetic CTS had more profound electrophysiological abnormalities. Distal motor latency and median nerve CSA were not only associated with each other, but also with clinical symptoms. Further studies are needed to investigate the pathophysiological mechanisms underlying diabetic CTS. |
| first_indexed | 2024-03-09T15:33:11Z |
| format | Article |
| id | doaj.art-718f2d35f091411bb10fdd66e1660186 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-09T15:33:11Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-718f2d35f091411bb10fdd66e16601862023-11-26T12:08:05ZengBMCBMC Musculoskeletal Disorders1471-24742023-09-0124111010.1186/s12891-023-06881-1Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional studyDougho Park0Sang-Eok Lee1Jae Man Cho2Joong Won Yang3ManSu Kim4Heum Dai Kwon5Department of Medical Science and Engineering, School of Convergence Science and Technology, Pohang University of Science and TechnologyDepartment of Rehabilitation Medicine, Pohang Stroke and Spine HospitalDepartment of Neurosurgery, Pohang Stroke and Spine HospitalDepartment of Neurosurgery, Pohang Stroke and Spine HospitalDepartment of Neurosurgery, Pohang Stroke and Spine HospitalDepartment of Neurosurgery, Pohang Stroke and Spine HospitalAbstract Background Although diabetes is considered a major risk factor for carpal tunnel syndrome (CTS), the characteristics of diabetic CTS have not been fully understood. Objective This study is aimed at evaluation of the clinical, electrophysiological, and ultrasonographic findings of non-diabetic and diabetic CTS. Methods This retrospective, cross-sectional study included patients diagnosed with CTS. Patient age, sex, involved side, body mass index, clinical and electrophysiological findings, and median nerve cross-sectional area (CSA) were identified. Diabetes was identified through patient or guardian interviews, medical records, and medication history. Linear and binary logistic regression models were established to confirm the associations between the electrophysiological findings, median nerve CSA, and clinical outcomes. Covariates, such as age, sex, body mass index, diabetes, symptom duration, and thenar muscle weakness were adjusted. Results Out of the 920 hands, 126 and 794 belonged to the diabetic and non-diabetic CTS groups, respectively. The patients were significantly older in the diabetic CTS group (P < 0.001). The rate of thenar weakness in the diabetic CTS group was also significantly higher than that in the non-diabetic CTS group (P = 0.009). The diabetic CTS group had a more severe electrodiagnostic grade (P = 0.001). The prolonged onset latency of the compound motor nerve action potential (CMAP) and median nerve CSA were well associated with the degree of clinical symptoms. Increased median nerve CSA was significantly associated with prolonged CMAP onset latency (β = 0.64; P = 0.012), prolonged transcarpal latency (β = 0.95; P = 0.044), and decreased CMAP amplitude (β = -0.17; P = 0.002) in the non-diabetic CTS group. Conclusion Diabetic CTS had more profound electrophysiological abnormalities. Distal motor latency and median nerve CSA were not only associated with each other, but also with clinical symptoms. Further studies are needed to investigate the pathophysiological mechanisms underlying diabetic CTS.https://doi.org/10.1186/s12891-023-06881-1Carpal tunnel syndromeDiabetic complicationsElectrodiagnosisNeurologic manifestationsUltrasonography |
| spellingShingle | Dougho Park Sang-Eok Lee Jae Man Cho Joong Won Yang ManSu Kim Heum Dai Kwon Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study BMC Musculoskeletal Disorders Carpal tunnel syndrome Diabetic complications Electrodiagnosis Neurologic manifestations Ultrasonography |
| title | Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study |
| title_full | Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study |
| title_fullStr | Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study |
| title_full_unstemmed | Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study |
| title_short | Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study |
| title_sort | characteristics of diabetic and non diabetic carpal tunnel syndrome in terms of clinical electrophysiological and sonographic features a cross sectional study |
| topic | Carpal tunnel syndrome Diabetic complications Electrodiagnosis Neurologic manifestations Ultrasonography |
| url | https://doi.org/10.1186/s12891-023-06881-1 |
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