Sural sensory nerve action potential: A study in healthy Indian subjects

Background: The sural sensory nerve action potential (SNAP) is an important electrodiagnostic study for suspected peripheral neuropathies. Incorrect technique and unavailability of reference data can lead to erroneous conclusions. Objectives: To establish reference data for sural SNAP in age-stratif...

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Main Authors: Aarthika Sreenivasan, Khushnuma A Mansukhani, Alika Sharma, Lajita Balakrishnan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Annals of Indian Academy of Neurology
Subjects:
Age
Online Access:http://www.annalsofian.org/article.asp?issn=0972-2327;year=2016;volume=19;issue=3;spage=312;epage=317;aulast=Sreenivasan
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spelling doaj-878c32516afb406792e56cbb50b0c8062020-11-25T01:34:33ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492016-01-0119331231710.4103/0972-2327.186786Sural sensory nerve action potential: A study in healthy Indian subjectsAarthika SreenivasanKhushnuma A MansukhaniAlika SharmaLajita BalakrishnanBackground: The sural sensory nerve action potential (SNAP) is an important electrodiagnostic study for suspected peripheral neuropathies. Incorrect technique and unavailability of reference data can lead to erroneous conclusions. Objectives: To establish reference data for sural SNAP in age-stratified healthy subjects at three sites of stimulation. Materials and Methods: A prospective study was conducted in 146 nerves from healthy subjects aged between 18 years and 90 years, stratified into six age groups (a = 18-30 years, b = 31-40 years, c = 41-50 years, d = 51-60 years, e = 61-70 years, and f >71 years). Sural SNAP was recorded antidromically, stimulating at three sites at distances of 14 cm, 12 cm, and 10 cm from the recording electrode. Mean - 2 standard deviation (SD) of the transformed data was used to generate reference values for amplitudes. Analysis of variance (ANOVA) test was used for inter-group and between three sites comparisons of amplitudes. Results: The lower limits of amplitude at 14 cm were 12.4 μV, 10.4 μV, 6.5 μV, 5.3 μV, 2.9 μV, and 1.9 μV; at 12 cm were 13.5 μV, 13.6 μV, 8.5 μV, 7.8 μV, 3.5 μV, and 2.8 μV; and at 10 cm were 16.3 μV, 16.3 μV, 11.1 μV, 10.0 μV, 4.8 μV, and 3.7 μV for groups a, b, c, d, e, and f, respectively. A statistically significant difference in amplitudes was noted from the three different sites of stimulation (P < 0.001). The amplitude differed significantly above the age of 60 years (P < 0.01) but not between groups e and f (P > 0.05). Conclusion: This study provides reference data for sural SNAP in Indian population at three different sites of stimulation along the calf in six age groups. It also shows significant variation in amplitude from the three different sites of stimulation.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2016;volume=19;issue=3;spage=312;epage=317;aulast=SreenivasanAgeamplitudeIndianreference valuesstimulation sitesural
collection DOAJ
language English
format Article
sources DOAJ
author Aarthika Sreenivasan
Khushnuma A Mansukhani
Alika Sharma
Lajita Balakrishnan
spellingShingle Aarthika Sreenivasan
Khushnuma A Mansukhani
Alika Sharma
Lajita Balakrishnan
Sural sensory nerve action potential: A study in healthy Indian subjects
Annals of Indian Academy of Neurology
Age
amplitude
Indian
reference values
stimulation site
sural
author_facet Aarthika Sreenivasan
Khushnuma A Mansukhani
Alika Sharma
Lajita Balakrishnan
author_sort Aarthika Sreenivasan
title Sural sensory nerve action potential: A study in healthy Indian subjects
title_short Sural sensory nerve action potential: A study in healthy Indian subjects
title_full Sural sensory nerve action potential: A study in healthy Indian subjects
title_fullStr Sural sensory nerve action potential: A study in healthy Indian subjects
title_full_unstemmed Sural sensory nerve action potential: A study in healthy Indian subjects
title_sort sural sensory nerve action potential: a study in healthy indian subjects
publisher Wolters Kluwer Medknow Publications
series Annals of Indian Academy of Neurology
issn 0972-2327
1998-3549
publishDate 2016-01-01
description Background: The sural sensory nerve action potential (SNAP) is an important electrodiagnostic study for suspected peripheral neuropathies. Incorrect technique and unavailability of reference data can lead to erroneous conclusions. Objectives: To establish reference data for sural SNAP in age-stratified healthy subjects at three sites of stimulation. Materials and Methods: A prospective study was conducted in 146 nerves from healthy subjects aged between 18 years and 90 years, stratified into six age groups (a = 18-30 years, b = 31-40 years, c = 41-50 years, d = 51-60 years, e = 61-70 years, and f >71 years). Sural SNAP was recorded antidromically, stimulating at three sites at distances of 14 cm, 12 cm, and 10 cm from the recording electrode. Mean - 2 standard deviation (SD) of the transformed data was used to generate reference values for amplitudes. Analysis of variance (ANOVA) test was used for inter-group and between three sites comparisons of amplitudes. Results: The lower limits of amplitude at 14 cm were 12.4 μV, 10.4 μV, 6.5 μV, 5.3 μV, 2.9 μV, and 1.9 μV; at 12 cm were 13.5 μV, 13.6 μV, 8.5 μV, 7.8 μV, 3.5 μV, and 2.8 μV; and at 10 cm were 16.3 μV, 16.3 μV, 11.1 μV, 10.0 μV, 4.8 μV, and 3.7 μV for groups a, b, c, d, e, and f, respectively. A statistically significant difference in amplitudes was noted from the three different sites of stimulation (P < 0.001). The amplitude differed significantly above the age of 60 years (P < 0.01) but not between groups e and f (P > 0.05). Conclusion: This study provides reference data for sural SNAP in Indian population at three different sites of stimulation along the calf in six age groups. It also shows significant variation in amplitude from the three different sites of stimulation.
topic Age
amplitude
Indian
reference values
stimulation site
sural
url http://www.annalsofian.org/article.asp?issn=0972-2327;year=2016;volume=19;issue=3;spage=312;epage=317;aulast=Sreenivasan
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