Noninvasive Invastigation of Excitability Parameters of the Finger Branches of Median Nerve by Threshold Tracking Method

N. Dalkilic, S. Tuncer, Ilksen Burat
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Abstract

To provide a basis for basic and clinical studies, we aimed to establish the excitability properties of thumb, index and medius fingers innervated by median nerve by using threshold tracking methods from both right and left hands of right-handed volunteers. In addition to that, possible differences were investigated between the fingers of left and right hands. Experiments were performed on 21 right-handed healthy volunteers. The protocols of threshold tracking method were applied to all subjects. To conduct excitability measurements, median nerve was stimulated at elbow, then non-invasive muscle compound action potential recordings were performed from medius, index and thumb fingers of left and right hand with ring-shaped electrodes. During an experiment, threshold electrotonus, recovery cycle, threshold current stimulus-response relationship and the amount of threshold charge-stimulus duration relationship curves were plotted. Some of the excitability parameters such as refractoriness (%) at 2 ms, strength duration time constant (ms), resting current-voltage (I-V) slope, rheobase and 50% stimulus intensity required to have the maximal response (mA) did not differ significantly (p <0.05) for three fingers of left and right hand. The stimulus-response, strength-duration relationship, 40% threshold electrotonus, current-threshold relationship and recovery cycle curves were obtained. For all of these curves, there were no significant difference (p < 0.05), either. The results showed that there was no statistical significance between the observed fingers. Detailed analysis of these curves also indicated that the activities of all fast, slow and rectifier K+ channels in the membrane of median nerve that innervate finger muscles were similar. Similarly, no significant differences were seen for activity of Na+ channels
阈值追踪法无创性研究正中神经指支兴奋性参数
为了为基础研究和临床研究提供依据,我们利用右撇子志愿者左右双手的阈值追踪方法,建立受正中神经支配的拇指、食指和中指的兴奋性特性。除此之外,研究人员还调查了左手和右手手指之间可能存在的差异。实验在21名健康的右撇子志愿者身上进行。所有受试者均采用阈值跟踪方法。刺激肘部正中神经进行兴奋性测量,然后用环形电极对左、右手中、食指、拇指进行无创肌肉复合动作电位记录。实验中绘制了阈值电张力、恢复周期、阈值电流刺激-反应关系曲线和阈值电荷量刺激持续时间关系曲线。2 ms时的耐火度(%)、强度持续时间常数(ms)、静息电流-电压(I-V)斜率、流变基、达到最大反应所需的50%刺激强度(mA)等兴奋性参数在左手和右手三个手指间无显著差异(p <0.05)。得到刺激-反应关系、强度-持续时间关系、40%阈值电张力关系、电流-阈值关系和恢复周期曲线。所有曲线均无显著性差异(p < 0.05)。结果显示,观察手指间差异无统计学意义。对这些曲线的详细分析还表明,支配手指肌肉的正中神经膜上所有快、慢、整流K+通道的活动都是相似的。同样,Na+通道的活性也没有显著差异
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