• Title/Summary/Keyword: electrophysiological study

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Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy: Pros (당뇨병성 다발신경병증의 조기 진단에서 신경전도검사의 유용성에 관한 논란: 긍정적인 관점에서)

  • Kwon, Ohyun
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.29-32
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    • 2008
  • Although various criteria on the diagnosis of diabetic neuropathy are applied from trial to trial, being tailored in concert with its purpose, the utmost evidences of the diagnosis are subjective symptoms and objective signs of neurologic deficit. The application and interpretation of auxiliary electrophysiological test including nerve conduction study (NCS) should be made on the context of clinical pictures. The evaluation of the functions of small, thinly myelinated or unmyelinated nerve fibers has been increasingly stressed recently with the advent of newer techniques, e.g., measurement of intraepidermal fiber density, quantitative sensory testing, and autonomic function test. And the studies with those techniques have shed light to the nature of the evolution of diabetic neuropathy. The practical application of these techniques to the diagnosis of diabetic neuropathy in the individual patients, however, should be made cautiously due to several shortcomings: limited accessibility, wide overlapping zone between norm and abnormality with resultant unsatisfactory sensitivity and specificity, difficulty in performing subsequent tests, unproven quantitative correlation with clinical deficit, and invasiveness of some technique. NCS, as an extension of clinical examination, is still the most reliable electrophysiological test in evaluating neuropathy and gives the invaluable information about the nature of neuropathy, whereas the newer techniques need more refinement of the procedure and interpretation, and the accumulation of large scaled data of application to be considered as established diagnostic tools of peripheral neuropathy.

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Morphological and morphometric study of pulmonary vein anatomy in relation to cardiac invasive and electrophysiological procedures

  • Harshal Oza;Bhavik Doshi
    • Anatomy and Cell Biology
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    • v.56 no.4
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    • pp.428-434
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    • 2023
  • Pulmonary veins (PVs) and their myocardial sleeves play an important role in the development of atrial fibrillation. Hence, detailed knowledge of PV anatomy is required to improve the procedural success rate and prevent complications during cardiac procedures. The aim of this study was to evaluate the PV anatomy along with anatomical variations in the Indian population. Total 100 formalin fixed cadaveric hearts were examined. The number and pattern of the PVs were observed along with the measurement of their horizontal and vertical diameters. The ovality index for each PV was calculated. Classical PV pattern was observed in 62% cases. Variant pattern like additional right middle PV pattern and left common PV pattern were found in 20% and 10% cases respectively. A separate pattern with presence of both right middle PV and left common PV was observed in 6% cases. In the classical pattern right superior PV was the largest followed by right inferior, left superior and left inferior PV. The additional right middle PV had the smallest diameter whereas the left common PV had the largest diameter. Almost all the veins had greater vertical diameters in comparison to horizontal diameters. The variant PVs were oval and had greater ovality index compared to the normal PVs. In classical pattern 54.8% hearts whereas in variant pattern 79% hearts had one or more oval PV. The given data can help clinicians for planning and execution of various interventional and electrophysiological procedures involving PVs.

Histopathologic Features and CD5+ B-lymphocyte Expression in the Experimental Allergic Neuritis (실험적 자가면역성 말초신경염에서의 조직병리적 병변 및 CD5+ B-림프구의 발현)

  • Cho, Joong-Yang;Choi, Won-Jun;Kim, Sung-Hun;Sung, Jung-Joon;Kim, Ho-Jin;Park, Kyung-Seok;Choi, Ki-Young;Kim, Hyun-Jung;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.1 no.2
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    • pp.91-98
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    • 1999
  • Background : The pathogenesis of acute inflammatory demyelinating polyradiculoneuropathy (AIDP), Guillain Barre syndrome (GBS) is not clear, but it has been known that the immune mechanisms play an important role. Authors performed this study to establish an animal model of experimental allergic neuritis (EAN) by immunizing the myelin components of peripheral nerves and to understand the electrophysiological and histopathological features as well as the ${CD_5}^+$ B-lymphocyte changes in peripheral bloods in the EAN models. Methods : Lewis rats weighing 150-200 gm were injected subcutaneously in soles two times with total myelin, P0, P1, or P2 proteins purified from the bovine cauda eguina. The EAN induction was assessed by evaluating clinical manifestations. The electrophysiological and histopathological features were studied as routine methods. The ${CD_5}^+$ Blymphocytes were double stained using monoclonal FITC conjugated anti-rat CD45RA and R-PE conjugated anti-rat ${CD_5}^+$ antibodies and calculated using a fluorescence activated cell sorter (FACS). Results : The EAN animal models were established. In two out of five, in one out of two, in none out of three, and in none out of one Lewis rats injected with purified total myelin, P0, P1, P2 proteins respectively, They showed slow spontaneous motor activity and weak resistance against pulling back by tails. The typical electrophysiological and histologic findings in total protein and P0 induced EAN animal models were the decreased conduction velocity, the decreased compound muscle action potential (CMAP) amplitude and the dispersion phenomenon. The perivascular infiltrates of lymphocytes with focal demyelinating process were found in light microscopy. The ${CD_5}^+$ B-lymphocyte expression in three EANs were 2.38%, 3.50% 2.50%, which were not significantly increased, compared with those in normal controls. Conclusion : The EAN animal models were successfully established by injecting the total myelin and P0 myelin and they showed electrophysiological and histological features typical of demyelinating process. However they did not show an increased expression of ${CD_5}^+$ B-lymphocyte in peripheral bloods which could be indirect evidence of humoral autoimmunity.

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Seizure and Epilepsy Models on Hippocampal Slices of Rats (흰쥐 해마절편에서의 간질발작 및 간질모델)

  • Kwon, Oh-Young
    • Annals of Clinical Neurophysiology
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    • v.1 no.2
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    • pp.147-153
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    • 1999
  • Hippocampal slice models can be a powerful tool to study the mechanism of partial epilepsy. Despite the loss of connection with the rest of the brain, in vitro hippocampal slice preparations allow detailed physiological and pharmacological studies, which would be impossible, in vivo. There are several methods to induce electrographic seizures on hippocampal slice models. Those are electrical pulse train stimulation, 0 $Mg^{2+}$ artificial cerebrational fluid and high concentration of extracelluar $K^+$ on bath. Among them, the electrically triggered seizure may mimic the physiological communication between neuronal populations without any deterioration of normal physiologic and chemical status of the hippocampal slice models. Presumably, such communication from hyperexcitable areas to other neuronal populations is involved in the development of epilepsy. Electrographic seizures in hippocampal slice models occur in the network of neurons that are involved in epileptic seizures in the hippocampus in vivo. Because these models have many advantages and are very valuable to research of epileptogenesis on partial epilepsy, I would like to introduce the electrophysiological methods to induce electrographic seizure or epilepsy on hippocampal slice models briefly in this paper.

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Quantitative Analysis of Electrophysiological Characteristics of CIDP and CMT Type 1: Sensory Nerve Research (CIDP와 CMT 1형의 전기생리학적 특성에 대한 정량 분석: 감각신경연구)

  • Kang, Ji-Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.151-157
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    • 2021
  • Charcot-Marie-Tooth disease (CMT) is a slowly progressive hereditary degenerative disease and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder characterized by weakness and sensory deficits. The purpose of this study was to analyze and compare the electrophysiological characteristics observed in sensory nerve conduction studies (SNCS) of both diseases. A retrospective study of 65 patients with a diagnosis of CIDP (N=35) and CMT type I (N=30) was performed. This study analyzed No potentials ratio, distal compound nerve action potential (dCNAP) of various nerve types, and a correlation coefficient analysis of the sensory nerve conduction velocity (SNCV). As a result, I found that CMT 1 was more severe systemic demyelinating and axonal polyneuropathy better than CIDP (P<0.05). In a quantitative analysis of dCNAP and SNCV, especially sural nerve was the most severe nerve injury observed in both diseases. In correlation and scatter plot analysis, CMT 1 showed relatively high correlations compared to CIDP based on the correlation coefficient analysis (Fisher's Z test) of SNCV. The results of this study suggested that CMT 1 showed the slowness in SNCV, one of the characteristics of demyelinating polyneuropathy, and this slowing had a uniform pattern. In conclusion, electrophysiological characteristic of SNCS may be useful in the diagnosis and research between patients with CMT 1 and CIDP.

Ultrasound Imaging and Electrophysiological Characteristic According to Activity Levels of Myofascial Trigger Point (근근막 발통점의 활성도에 따른 초음파 영상구조 및 전기생리학적 특성)

  • Kim, Hyun-Jin;Kim, Su-Hyun;Park, Young-Hyun;Oh, Seok;Choi, Ji-Ho;Kim, Tae-Youl
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.8 no.1
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    • pp.23-29
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    • 2010
  • Purpose : This study is to offer clinical primary data that examines the change of imaging structure and the quantitative evaluation of muscle activity on myofascial trigger points. This study examines neuromuscular physiological characteristic by comparing the differences in physical findings, pressure pain threshold, imaging, and electrophysiological characteristics in latent and active myofascial trigger points muscle and normal muscle through the following experimental procedures. Methods : The participants for the study were thirty-three adults in their twenties. We divided three groups into normal, latent and active myofascial trigger points groups by physical findings. We analyzed the results of measured pressure pain, threshold for pain, ultrasound imaging perform for structure characteristic of muscle, surface EMG according to type of muscle contraction for function of muscle contraction. Results : Significant differences were indicated in pressure pain threshold (p<0.05). Significant differences were discovered in the ultrasound imaging analysis. There were increases in muscle Echogenicity white area index (p<0.001). There were significant differences that decrease in %MVIC (p<0.05), increase in MDF (p<0.05). Conclusion : From these results, active rnyotascial trigger points muscle showed quality deterioration on ultrasound imaging and decreased function of muscle contraction, increased motor unit action potential of II type fiber, and electrophysiologically. Imaging structure and neuromuscular physiological characteristic can be diagnostic and quantitative analytical techniques for myofascial pain syndrome and a primary factor that reflected in physical therapy intervention.

Clinical and Electrophysiological Characteristics of Meralgia Paresthetica (대퇴감각이상증의 임상 및 전기생리학적 특징)

  • Choi, Mun Hee;Park, Hanul;Eom, Young In;Joo, In Soo
    • Annals of Clinical Neurophysiology
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    • v.15 no.2
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    • pp.48-52
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    • 2013
  • Background: Meralgia paresthetica (MP) is a mononeuropathy affecting the lateral femoral cutaneous nerve. The disease is often diagnosed clinically, but electrophysiological tests play an important role. The aim of this study is to clarify clinical characteristics of MP as well as the role of sensory nerve conduction study (NCS) in the diagnosis of MP. Methods: Sixty-five consecutive patients with clinical diagnosis of MP between March 2001 and June 2012 were retrospectively reviewed at a single tertiary center. General demographics, clinical characteristics and sensory NCS findings were investigated. Measurements of sensory NCS included the baseline-to-peak amplitude, side-to-side amplitude ratio and the conduction velocity. To compare between the normal and abnormal NCS groups, independent t-tests and chisquare test were performed. Results: Sixty-five patients had male predominance (56.9%) with mean age of $48.4{\pm}13.4$ years (range: 16-75). Seven patients (13.5%) had undergone operation or procedure before the symptom onset. The sensory nerve action potentials were obtainable in 52 (80%) of 65 clinically diagnosed MP patients. Sensory NCS revealed abnormalities in 38 patients (73.1%), and others (n=14, 26.9%) showed normal findings. Between the normal and abnormal NCS groups, there is no statistically significant difference on demographics or clinical features. Conclusions: We clarify the clinical features and sensory NCS findings of MP patients. Due to several limitations of sensory NCS, the diagnosis of MP could be accomplished both clinically and electrophysiologically.

Modulation of Fermented Lotus Root on Pacemaker Potentials in Interstitial Cells of Cajal of Murine Small Intestine (생쥐 소장 카할세포 조절에 발효 연근의 효능 연구)

  • Park, Dong Suk;Kim, Jeong Nam;Kwon, Hyo Eun;Kwon, Min Ji;Park, Eun-Jung;Lee, Hae-Jeung;Kim, Byung Joo
    • Herbal Formula Science
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    • v.29 no.3
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    • pp.119-125
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    • 2021
  • Obejectives : The purpose of this study is to find out the efficacy of pacemaker potentials of interstitial Cells of Cajal (ICC) by Fermented Lotus Root (FLR) in small intestine. Methods : Enzyme digestions were used to separate the ICC. Using electrophysiological methods, pacemaker potentials were measured and intestinal transit rates (ITR) experiments were conducted to identify in vivo gastrointestinal motility. Results : 1. FLR (0.5-10 mg/ml) caused membrane depolarization by electrophysiological methods. 2. In the case of pretreatment with a Ca2+ free solution and thapsigargin, the pacemaker potential disappeared and in this case, FLR did not have a membrane depolarization reaction. 3. Lowering the concentration of extracellular Na+ concentration stoped the pacemaker potentials and inhibited the reaction caused by FLR. Flufenamic acid also inhibited the reaction by FLR. 4. In mice, ITR was increased by FLR. Conclusions : This study shows that FLR can control ICC by an internal/external Ca2+ and Na+. It also shows that FLR can be a good candidate for gastrointestinal motility medication development.

Effect of Cochlear Implant Electrode Array Design on Electrophysiological and Psychophysical Measures: Lateral Wall versus Perimodiolar Types

  • Lee, Ji Young;Hong, Sung Hwa;Moon, Il Joon;Kim, Eun Yeon;Baek, Eunjoo;Seol, Hye Yoon;Kang, Sihyung
    • Journal of Audiology & Otology
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    • v.23 no.3
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    • pp.145-152
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    • 2019
  • Background and Objectives: The present study aims to investigate whether the cochlear implant electrode array design affects the electrophysiological and psychophysical measures. Subjects and Methods: Eighty five ears were used as data in this retrospective study. They were divided into two groups by the electrode array design: lateral wall type (LW) and perimodiolar type (PM). The electrode site was divided into three regions (basal, medial, apical). The evoked compound action potential (ECAP) threshold, T level, C level, dynamic range (DR), and aided air conduction threshold were measured. Results: The ECAP threshold was lower for the PM than for the LW, and decreased as the electrode site was closer to the apical region. The T level was lower for the PM than for the LW, and was lower on the apical region than on the other regions. The C level on the basal region was lower for the PM than for the LW whereas the C level was lower on the apical region than on the other regions. The DRs on the apical region was greater for the PM than for the LW whereas the DR was narrower on the apical region than on the other regions. The aided air conduction threshold was not different for the electrode design and frequency. Conclusions: The current study would support the advantages of the PM over the LW in that the PM had the lower current level and greater DR, which could result in more localized neural stimulation and reduced power consumption.

Effect of Cochlear Implant Electrode Array Design on Electrophysiological and Psychophysical Measures: Lateral Wall versus Perimodiolar Types

  • Lee, Ji Young;Hong, Sung Hwa;Moon, Il Joon;Kim, Eun Yeon;Baek, Eunjoo;Seol, Hye Yoon;Kang, Sihyung
    • Korean Journal of Audiology
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    • v.23 no.3
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    • pp.145-152
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    • 2019
  • Background and Objectives: The present study aims to investigate whether the cochlear implant electrode array design affects the electrophysiological and psychophysical measures. Subjects and Methods: Eighty five ears were used as data in this retrospective study. They were divided into two groups by the electrode array design: lateral wall type (LW) and perimodiolar type (PM). The electrode site was divided into three regions (basal, medial, apical). The evoked compound action potential (ECAP) threshold, T level, C level, dynamic range (DR), and aided air conduction threshold were measured. Results: The ECAP threshold was lower for the PM than for the LW, and decreased as the electrode site was closer to the apical region. The T level was lower for the PM than for the LW, and was lower on the apical region than on the other regions. The C level on the basal region was lower for the PM than for the LW whereas the C level was lower on the apical region than on the other regions. The DRs on the apical region was greater for the PM than for the LW whereas the DR was narrower on the apical region than on the other regions. The aided air conduction threshold was not different for the electrode design and frequency. Conclusions: The current study would support the advantages of the PM over the LW in that the PM had the lower current level and greater DR, which could result in more localized neural stimulation and reduced power consumption.