Top

Neurological Sciences

Published in:

01-03-2022 | Polyneuropathy | Original Article

Risk factors of asymptomatic reduction of motor conduction velocity of the ulnar nerve across the elbow

Authors: Mauro Mondelli, Palma Ciaramirato, Giuseppe Greco, Ester Pitocchi, Francesco Sicurelli, Claudia Vinciguerra

Published in: Neurological Sciences | Issue 3/2022

Abstract

Introduction

The aim of the study was to check the risk factors for subjects with motor conduction velocity (MCV) reduction of the ulnar nerve across the elbow without symptoms/signs of ulnar neuropathy at the elbow (UNE) using a database of a previous multicenter case–control study on UNE patients.

Methods

From the previous database, we extracted all asymptomatic UNE (A-UNE) and matched for age and sex with a control and UNE groups with a ratio of 1:2. Anthropometric factors were measured and all participants filled in a questionnaire on demographic, lifestyle factors, and medical history. One-sample proportion test and univariate and multivariate logistic regression analyses were performed.

Results

We enrolled 64 A-UNE, 124 UNE, and 124 controls (mean age 53 years). There were more males with A-UNE than females (74.2%). The predominantly or exclusively concerned side of A-UNE was the right. Logistic regression showed that A-UNE was associated with diabetes (OR = 2.99, 95% CI = 1.21–7.39) and width of cubital groove (CGW) (OR = 0.89, 95% CI = 0.81–0.97).

Discussion

Risk factors for A-UNE are different from UNE. The prevalence of right side in A-UNE was not due to particular elbow postures. Diabetes is a risk factor, probably because MCV reduction of the ulnar nerve across the elbow was an early manifestation of asymptomatic polyneuropathy in diabetes. A-UNE is associated with narrow CGW as already demonstrated in UNE, even if the OR was higher in UNE than in A-UNE. Only future longitudinal studies will be able to check whether the A-UNE subjects develop symptoms and signs of true mononeuropathy with time.

Available only for authorised users

Mondelli M, Giannini F, Ballerini M, Ginanneschi F, Martorelli E (2005) Incidence of ulnar neuropathy at the elbow in the province of Siena (Italy). J Neurol Sci 234:5–10. https://doi.org/10.1016/j.jns.2005.02.010CrossRefPubMed

Osei DA, Groves AP, Bommarito K, Ray WZ (2017) Cubital tunnel syndrome: incidence and demographics in a national administrative database. Neurosurgery 80:417–420. https://doi.org/10.1093/neuros/nyw061CrossRefPubMed

Podnar S, Omejec G, Bodor M (2017) Nerve conduction velocity and cross-sectional area in ulnar neuropathy at the elbow. Muscle Nerve 56:E65–E72. https://doi.org/10.1002/mus.25655CrossRefPubMed

Omejec G, Podnar S (2020) Utility of nerve conduction studies and ultrasonography in ulnar neuropathies at the elbow of different severity. Clin Neurophysiol 131:1672–1677. https://doi.org/10.1016/j.clinph.2020.02.019CrossRefPubMed

AAEM, AAN, AAPNR (1999) Practice parameter. Electrodiagnostic studies in ulnar neuropathy at the elbow. Neurology 52:688–690. https://doi.org/10.1212/wnl.52.4.688CrossRef

Pugdahl K, Beniczky S, Wanscher B, Johnsen B, Qerama E, Ballegaard M, Benedek K, Juhl A, Ööpik M, Selmar P, Sønderborg J, Terney D, Fuglsang-Frederiksen A (2017) Neurophysiological localization of ulnar neuropathy at the elbow: validation of diagnostic criteria developed by a taskforce of the Danish Society of clinical neurophysiology. Clin Neurophysiol 28:2205–2210. https://doi.org/10.1016/j.clinph.2017.08.018CrossRef

Mondelli M, Mattioli S, Vinciguerra C, Ciaramitaro P, Aretini A, Greco G, Sicurelli F, Giorgi S, Curti S (2020) Comorbidities, anthropometric, demographic, and lifestyle risk factors for ulnar neuropathy at the elbow: a case control study. J Periph Nervous System 25:401–412. https://doi.org/10.1111/jns.12420CrossRef

Mondelli M, Padua L, Giannini F, Bibbò G, Aprile I, Rossi S (2006) A self-administered questionnaire of ulnar neuropathy at the elbow. Neurol Sci 27:402–411. https://doi.org/10.1007/s10072-006-0719-3CrossRefPubMed

Werner RA, Chiodo T, Spiegelberg T, Franzblau A (2012) Use of hand diagrams in screening for ulnar neuropathy: comparison with elecrodiagnostic studies. Muscle Nerve 46:891–894. https://doi.org/10.1002/mus.23452CrossRefPubMed

10.

Mondelli M, Vinciguerra C, Lazzeretti S, Ciaramitaro P, Sicurelli F, Greco G, Giorgi S, Aretini A (2020) The external elbow measure as surrogate of the anatomical width of cubital groove and possible risk factor of ulnar neuropathy at the elbow. Int J Neurosci 130:884–891. https://doi.org/10.1080/00207454.2019.1709839CrossRefPubMed

11.

Vinciguerra C, Curti S, Aretini A, Sicurelli F, Greco G, Mattioli S, Mondelli M (2020) Clinical findings and electrodiagnostic testing in ulnar neuropathy at the elbow and differences according to site and type of nerve damage. Am J Phys Med Rehabil 99:116–123. https://doi.org/10.1097/PHM.0000000000001286CrossRefPubMed

12.

ISTAT. http://demo.istat.it/bilmens/index.php?anno=2016

13.

Richardson JK, Ho S, Wolf J, Spiegelberg T (2009) The nature of the relationship between smoking and ulnar neuropathy at the elbow. Am J Phys Med Rehabil 88:711–718. https://doi.org/10.1097/PHM.0b013e3181b333e6CrossRefPubMed

14.

Omejec G, Podnar S (2016) What causes ulnar neuropathy at the elbow? Clin Neurophysiol 127:919–924. https://doi.org/10.1016/j.clinph.2015.05.027CrossRefPubMed

15.

Omejec G, Podnar S (2018) Long-term outcomes in patients with ulnar neuropathy at the elbow treated according to the presumed aetiology. Clin Neurophysiol 129:1763–1769. https://doi.org/10.1016/j.clinph.2018.04.753CrossRefPubMed

16.

Ashworth NL, Huang C, Chan MK (2020) Laterality and risk factors for ulnar neuropathy at the elbow. Muscle Nerve 61:101–104. https://doi.org/10.1002/mus.26737CrossRefPubMed

17.

Richardson JK, Green DF, Jamieson SC, Valentin FC (2001) Gender, body mass and age as risk factors for ulnar mononeuropathy at the elbow. Muscle Nerve 24:551–554. https://doi.org/10.1002/mus.1039CrossRefPubMed

18.

Uzunkulaoğlu A, Ikbali Afsar S, Karataş M (2016) Association between gender, body mass index, and ulnar nerve entrapment at the elbow: a retrospective study. J Clin Neurophysiol 33:545–548. https://doi.org/10.1097/WNP.0000000000000288CrossRefPubMed

19.

Richardson JK, Jamieson SC (2004) Cigarette smoking and ulnar mononeuropathy at the elbow. Am J Phys Med Rehabil 83:730–734. https://doi.org/10.1097/01.phm.0000137316.54347.b8CrossRefPubMed

20.

Okamoto M, Abe M, Shirai H, Ueda N (2000) Morphology and dynamics of the ulnar nerve in the cubital tunnel. Observation by ultrasonography. J Hand Surg Br 25:85–89. https://doi.org/10.1054/jhsb.1999.0317CrossRefPubMed

21.

Nakano K, Murata K, Omokawa S, Nakanishi Y, Shimizu T, Kira T, Onishi T, Tanaka Y (2014) Dynamic analysis of the ulnar nerve in the cubital tunnel using ultrasonography. J Shoulder Elbow Surg 23:933–937. https://doi.org/10.1016/j.jse.2014.01.039CrossRefPubMed

22.

Shiri R (2015) A square-shaped wrist as a predictor of carpal tunnel syndrome: a meta-analysis. Muscle Nerve 52:709–713. https://doi.org/10.1002/mus.24761CrossRefPubMed

23.

Mondelli M, Curti S, Farioli A, Aretini A, Ginanneschi F, Greco G, Mattioli S (2015) Anthropometric measurements as a screening test for carpal tunnel syndrome: receiver operating characteristic curves and accuracy. Arthritis Care Res 67:691–700. https://doi.org/10.1002/acr.22465CrossRef

24.

Gazioglu S, Boz C, Cakmak VA (2011) Electrodiagnosis of carpal tunnel syndrome in patients with diabetic polyneuropathy. Clin Neurophysiol 122:1463–1469. https://doi.org/10.1016/j.clinph.2010.11.021CrossRefPubMed

25.

Rota E, Morelli N (2016) Entrapment neuropathies in diabetes mellitus. World J Diabetes 7:342–353. https://doi.org/10.4239/wjd.v7.i17.342CrossRefPubMedPubMedCentral

26.

Gündüz A, Candan F, Asan F, Uslu F, Uzun N, Karaali-Savrun F, Kızıltan ME (2020) Ulnar neuropathy at elbow in patients with type 2 diabetes mellitus. J Clin Neurophysiol 37:220–224. https://doi.org/10.1097/WNP.0000000000000629CrossRefPubMed

27.

Omejec G, Podnar S (2015) Normative values for short-segment nerve conduction studies and ultrasonography of the ulnar nerve at the elbow. Muscle Nerve 51:370–377. https://doi.org/10.1002/mus.24328CrossRefPubMed

Title: Risk factors of asymptomatic reduction of motor conduction velocity of the ulnar nerve across the elbow
Authors: Mauro Mondelli
Palma Ciaramirato
Giuseppe Greco
Ester Pitocchi
Francesco Sicurelli
Claudia Vinciguerra
Publication date: 01-03-2022
Publisher: Springer International Publishing
Keyword: Polyneuropathy
Published in: Neurological Sciences / Issue 3/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-021-05584-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk factors of asymptomatic reduction of motor conduction velocity of the ulnar nerve across the elbow

Abstract

Introduction

Methods

Results

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

Please log in to get access to this content

Other articles of this Issue 3/2022

Neurological manifestation of 22q11.2 deletion syndrome

Development of magnetic resonance imaging of brachial plexus neuralgia

Addiction-induced plasticity in underlying neural circuits

COVID-19 lockdown attack on headache emergency admissions: a multidisciplinary retrospective study

Clinical analysis of 103 cases of tuberculous meningitis complicated with hyponatremia in adults

Early implementation of intended exercise improves quality of life in Parkinson’s disease patients