Multiple Electrophysiological Evaluation of Carpal Tunnel Syndrome

Abstract

Introduction

To investigate a high-sensitivity electrodiagnostic (EDX) combination for diagnosing mild carpal tunnel syndrome (CTS).

Methods

A total of 68 healthy controls (HCs, 136 hands) and 91 adult patients (CTSs, 162 hands) clinically diagnosed with CTS were enrolled. All patients accepted EDXs, including the sensory ganglia segment method of the median and ulnar nerves, and motor nerve conduction of the median and ulnar nerves. We examined the electrophysiological results and compared the sensitivity and specificity of various sensory nerve detection methods for the median nerve between the two groups.

Results

The electrophysiological results of the CTSs were significantly different from those of HCs. All EDX techniques selected showed high specificity (>96.3%), positive predictive value (>95.2%), and large area under the curve (0.922 as the smallest) for the diagnosis of CTSs. A comparison of the median distal sensory latencies with the ulnar distal sensory latencies in fingers 2 and 4 showed a high sensitivity of 98.1%. Comparison of the nerve conduction study between the median and ulnar nerves in the same hand is the most reliable EDX technique for diagnosing very mild CTS because of its high sensitivity and specificity.

Conclusion

If clinical CTS patients exhibit normal median motor distal latency or sensory nerve conduction velocity across the wrist, a comparison of median and ulnar nerve conduction through the wrist, including M-U and M-U ringdiff, is recommended.

Keywords

carpal tunnel syndrome - electrodiagnostic - nerve conduction studies - median nerve - sensitivity

Statement of Ethics

The study protocol was reviewed and approved by the Ethics Committee of the Affiliated Wuxi People's Hospital of Nanjing Medical University (approval number: KY24088). The requirement for informed consent was waived by our Ethics Committee because of the retrospective nature of the study.

Author Contributions

XY.W and QJ.S designed this study. X.W. drafted this manuscript. P.D., J.J., and JY.Z collected the EDX data. X.W. and J.Z. recruited the participants. X.W. analyzed the data. P.D., J.J., and J.Z. contributed to the discussion. X.W. and Q.S. contributed to the discussion and revised the manuscript accordingly. All authors have contributed to the manuscript and approved the submitted version.

Publikationsverlauf

Eingereicht: 02. April 2025

Angenommen: 27. Juni 2025

Artikel online veröffentlicht:
22. Juli 2025

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