Abstract Details

Title Utility of Bumps Test in The Diagnosis of Carpal Tunnel Syndrome Compared to Nerve Conduction Study

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-036

Objective To investigate the utility of Bumps test as a rapid, sensitive method to diagnose and characterize the severity of carpal tunnel syndrome (CTS) in comparison with routine nerve conduction study (NCS).

Background The Bumps device has been validated as a rapid, noninvasive, inexpensive method to quantify tactile sensation in patients with generalized neuropathy. It’s potential for the diagnosis of CTS has not been investigated.

Design/Methods Prospective analysis of adult patients (age > 18) without concomitant polyneuropathy referred for electrodiagnostic evaluation of CTS. Historical Objective Distribution (Hi-Ob-Db) scale and the Boston Carpal Tunnel Questionnaire (Boston CTSQ) were assessed and the sensory detection threshold of the second digit was determined by the Bumps device. NCS of the median nerve was used as the gold standard to assess the presence and grade the severity of CTS.

Results The total of 38 patients (28 women and 10 men, with mean age of 51.9 [SD 16.9]) were recruited. Electrodiagnostically 13 (34.2%) had none, 9 (23.7%) mild, 12 (31.6%) moderate and 4 (10.5%) severe median neuropathy at the wrist. Mean BUMPS thresholds were 5.1, 5.6, 9.6 and 9 subsequently (one-way ANOVA p = 0.00628). There was a significant difference between “none/mild” and “moderate/severe” CTS (t-test p = 0.002656), but no reliable threshold could be established. Boston CTS Questionnaire scores were 14.5, 18.1, 24, 15.5 for these groups. There was a relatively strong correlation between BUMPS threshold and median sensory amplitude (rho=-0.6430179, p<0.001). ROC for none/mild versus moderate/severe CTS shows modest sensitivity and poorer specificity.

Conclusions Our data demonstrate that the Bumps test is a useful diagnostic tool to screen for the presence and assess the severity of CTS. It is rapid, inexpensive and easy to administer in a clinic setting. Additional studies including a larger cohort and supplementary diagnostic tools are ongoing.

Authors/Disclosures
Mehdi Ghasemi, MD PRESENTER	Dr. Ghasemi has nothing to disclose.
Christyn M. Edmundson, MD (Swedish Neuroscience Institute)	Dr. Edmundson has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Edmundson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Immunovant. Dr. Edmundson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson and Johnson. Dr. Edmundson has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Edmundson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Argenx. Dr. Edmundson has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Dr. Edmundson has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alnylam. Dr. Edmundson has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB.
Reza Seyedsadjadi, MD	Dr. Seyedsadjadi has received personal compensation for serving as an employee of American Neurological Association. Dr. Seyedsadjadi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SwanBio Therapeutics. Dr. Seyedsadjadi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer. Dr. Seyedsadjadi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. The institution of Dr. Seyedsadjadi has received research support from Cystinosis Research Foundation.
William S. David, MD, PhD, FAAN (EMG /Neuromuscular Unit)	Dr. David has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Dysimmune Disorders foundation. Dr. David has received publishing royalties from a publication relating to health care.

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