Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathy

The objective of this study was to evaluate if the ratio of ulnar sensory nerve action potential (SNAP) over compound muscle action potential (CMAP) amplitudes (USMAR) would help in the distinction between ganglionopathy (GNP) and polyneuropathy (PNP). Methods We reviewed the nerve conductions stud...

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Main Authors: Raphael Ubirajara Garcia, Joao Adilson Gama Ricardo, Cassiana Abreu Horta, Solange Garcia Garibaldi, Anamarli Nucci, Marcondes Cavalcante Franca Junior
Format: Article
Language:English
Published: Thieme Revinter Publicações 2013-07-01
Series:Arquivos de Neuro-Psiquiatria
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2013000700465&lng=en&tlng=en
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author Raphael Ubirajara Garcia
Joao Adilson Gama Ricardo
Cassiana Abreu Horta
Solange Garcia Garibaldi
Anamarli Nucci
Marcondes Cavalcante Franca Junior
author_facet Raphael Ubirajara Garcia
Joao Adilson Gama Ricardo
Cassiana Abreu Horta
Solange Garcia Garibaldi
Anamarli Nucci
Marcondes Cavalcante Franca Junior
author_sort Raphael Ubirajara Garcia
collection DOAJ
description The objective of this study was to evaluate if the ratio of ulnar sensory nerve action potential (SNAP) over compound muscle action potential (CMAP) amplitudes (USMAR) would help in the distinction between ganglionopathy (GNP) and polyneuropathy (PNP). Methods We reviewed the nerve conductions studies and electromyography (EMG) of 18 GNP patients, 33 diabetic PNP patients and 56 controls. GNP was defined by simultaneous nerve conduction studies (NCS) and magnetic resonance imaging (MRI) abnormalities. PNP was defined by usual clinical and NCS criteria. We used ANOVA with post-hoc Tukey test and ROC curve analysis to compare ulnar SNAP and CMAP, as well as USMAR in the groups. Results Ulnar CMAP amplitudes were similar between GNP x PNP x Controls (p=0.253), but ulnar SNAP amplitudes (1.6±3.2 x 11.9±9.1 × 45.7±24.7) and USMAR values (0.3±0.3 × 1.5±0.9 × 4.6±2.2) were significantly different. A USMAR threshold of 0.71 was able to differentiate GNP and PNP (94.4% sensitivity and 90.9% specificity). Conclusions USMAR is a practical and reliable tool for the differentiation between GNP and PNP.
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spelling doaj-art-1664c1997373447b88fcb893b4e9da252025-08-20T03:17:18ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272013-07-0171746546910.1590/0004-282X20130063S0004-282X2013000700465Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathyRaphael Ubirajara GarciaJoao Adilson Gama RicardoCassiana Abreu HortaSolange Garcia GaribaldiAnamarli NucciMarcondes Cavalcante Franca JuniorThe objective of this study was to evaluate if the ratio of ulnar sensory nerve action potential (SNAP) over compound muscle action potential (CMAP) amplitudes (USMAR) would help in the distinction between ganglionopathy (GNP) and polyneuropathy (PNP). Methods We reviewed the nerve conductions studies and electromyography (EMG) of 18 GNP patients, 33 diabetic PNP patients and 56 controls. GNP was defined by simultaneous nerve conduction studies (NCS) and magnetic resonance imaging (MRI) abnormalities. PNP was defined by usual clinical and NCS criteria. We used ANOVA with post-hoc Tukey test and ROC curve analysis to compare ulnar SNAP and CMAP, as well as USMAR in the groups. Results Ulnar CMAP amplitudes were similar between GNP x PNP x Controls (p=0.253), but ulnar SNAP amplitudes (1.6±3.2 x 11.9±9.1 × 45.7±24.7) and USMAR values (0.3±0.3 × 1.5±0.9 × 4.6±2.2) were significantly different. A USMAR threshold of 0.71 was able to differentiate GNP and PNP (94.4% sensitivity and 90.9% specificity). Conclusions USMAR is a practical and reliable tool for the differentiation between GNP and PNP.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2013000700465&lng=en&tlng=enneurofisiologia clinicaganglionopatiapolineuropatianeuronopatia sensitivanervo ulnar
spellingShingle Raphael Ubirajara Garcia
Joao Adilson Gama Ricardo
Cassiana Abreu Horta
Solange Garcia Garibaldi
Anamarli Nucci
Marcondes Cavalcante Franca Junior
Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathy
Arquivos de Neuro-Psiquiatria
neurofisiologia clinica
ganglionopatia
polineuropatia
neuronopatia sensitiva
nervo ulnar
title Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathy
title_full Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathy
title_fullStr Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathy
title_full_unstemmed Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathy
title_short Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathy
title_sort ulnar sensory motor amplitude ratio a new tool to differentiate ganglionopathy from polyneuropathy
topic neurofisiologia clinica
ganglionopatia
polineuropatia
neuronopatia sensitiva
nervo ulnar
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2013000700465&lng=en&tlng=en
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