Abstract Details

Title Laser Doppler Perfusion Imaging in Carpal Tunnel Syndrome: A Study of Neurovascular Dysfunction

Topic Peripheral Nerve

Presentation(s) P02 - (-)

Poster/Presentation
Number 179

Objective

Background BACKGROUND: Maintaining tissue homeostasis is a function of the peripheral nervous system which in part occurs by regulating capillary blood flow. Peripheral nerve denervation may cause neurovascular dysfunction and inflammation leading to microcirculation derangements. We investigate neurovascular function in carpal tunnel syndrome (CTS) patients.

Design/Methods DESIGN/METHODS: Laser perfusion scans using the PeriScan PIM IITM, a non-invasive low-power beam device, were obtained of the palms of -7 control subjects (14 normal hands) and 11 subjects (19 affected hands) of CTS. Scans were performed with the hands at body temperature and after cooling in an ice bath. Scans (arbitrary units) of the 2nd finger (median nerve innervated area) were compared with the scans of 5th finger (ulnar nerve innervated area) and statistically analyzed.

Results RESULTS: CTS patients had lower perfusion in both the median and ulnar innervated areas (2nd finger: 1.39 ± 0.10 (mean±SE) units, 5th finger: 1.52± 0.09 units) compared to controls (2nd finger: 2.29 ± 0.08 units, 5th finger: 2.34 ± 0.06 units) (p<0.0001 t-test) at room temperature (mean: 93oF). After cooling (mean: 69oF), reduction in blood perfusion was greater in normal compared to CTS hands. Median nerve innervated areas had greater reductions in perfusion (control, -0.71± 0.10 units vs. CTS, -0.32 ± 0.10units, p<0.01) than ulnar innervated areas (control, -0.38± 0.10 units vs. CTS -0.21 ± 0.13units, p>0.3).

Conclusions CONCLUSIONS: Neurovascular dysfunction reduced perfusion in both median and ulnar innervated areas in CTS patients, although greater reductions were observed in median nerve innervated areas. These results suggest neuropathy adversely affects innervation in addition to the median nerve in CTS. Study of hand blood perfusion with correlation of disease severity may further validate our findings. This may provide an alternative method for earlier detection and intervention.

Authors/Disclosures
Jennie Valles, MD PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
William J. Groh, MD (Medical University of South Carolina)	No disclosure on file
Jin Li, MD, PhD, FAAN	Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie. Dr. Li has a non-compensated relationship as a member, woman leadership committee with AAN that is relevant to AAN interests or activities.

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