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Large electrodes improve nerve conduction repeatability in controls as well as in patients with diabetic neuropathy
Author(s) -
TjonATsien Aimée M.L.,
Lemkes Herman H.P.J.,
van der KampHuyts Antoinette J.C.,
van Dijk J. Gert
Publication year - 1996
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/(sici)1097-4598(199606)19:6<689::aid-mus1>3.0.co;2-6
Subject(s) - repeatability , compound muscle action potential , electrode , nerve conduction , nerve conduction velocity , biomedical engineering , medicine , materials science , electrophysiology , anesthesia , anatomy , mathematics , chemistry , statistics
Recording site is an important cause of variability of compound muscle action potential (CMAP) and conduction parameters, which can be reduced by using large electrodes. Repeatability of CMAP and conduction parameters of conventional and large electrodes was compared in 16 controls and 17 diabetic neuropathic patients, using defined recording sites linked to anatomical landmarks. Right‐sided median, peroneal, and tibial nerves were investigated twice by the same examiner, with a 1–2 week interval. Compared to previous studies, conventional electrodes on strictly defined recording sites resulted in better repeatability: intraindividual coefficients of variation (CV) varied between 4% and 14.4% for all parameters. CV of conduction parameters, not published previously, was smaller than CV of CMAP parameters. The use of large electrodes improved repeatability further: large electrodes resulted in substantially smaller CV for duration, amplitude, area, and changes of amplitude and area over a length of nerve, which were reduced by 10%, 31%, 29%, 27%, and 16%, respectively. Patients had higher CV than controls; large electrodes reduced patient CV more than control CV, resulting in less contrast between groups. Strictly defined recording sites and large electrodes improve repeatability of motor conduction studies to relevant degrees: all CMAP and conduction parameters are suitable for longitudinal studies of neuropathic patients. © 1996 John Wiley & Sons, Inc.