Alexander Grimm1, Hubertus Axer2, Bianka Heiling2, Natalie Winter3. 1. Center for Neurology, Tübingen University Hospital, Tübingen, Germany; Hertie Institute for Clinical Brain Research, Eberhard-Karls University Tübingen, Tübingen, Germany. Electronic address: alexander.grimm@med.uni-tuebingen.de. 2. Hans Berger Department of Neurology, Jena University Hospital, Friedrich-Schiller University Jena, Jena, Germany. 3. Center for Neurology, Tübingen University Hospital, Tübingen, Germany; Hertie Institute for Clinical Brain Research, Eberhard-Karls University Tübingen, Tübingen, Germany.
Abstract
OBJECTIVE: Reference values are crucial for nerve ultrasound. Here, we reevaluated normal nerve and fascicle cross-sectional area (CSA) values in humans and compared them to published values. Based on these data, ultrasound pattern sum score (UPSS) boundary values were revisited and readjusted. METHODS: Ultrasound of different peripheral nerves was performed in 100 healthy subjects at anatomically defined landmarks. Correlations with age, gender, height and weight were calculated. RESULTS: Overall, correspondence to other published reference values was high. Gender-dependency was found for the proximal median nerve. Dependency from height occurred in the tibial nerve (TN). Weight-dependency was not found. However, the most obvious differences were found in the TN between men >60 years and women <60 years. Thus, general boundary values were defined using the mean plus the twofold standard deviation for all subjects and nerve segments except for the TN, in which different cut-offs were proposed for elder men. Accordingly, the cut-offs for the UPSS were re-adjusted, none of the individuals revealed more than 2 points at maximum. CONCLUSIONS: The influence of distinct epidemiological factors on nerve size is most prominent in the TN, for which thus several normal values are useful. SIGNIFICANCE: Adjusted reference values improve the accuracy of the UPSS.
OBJECTIVE: Reference values are crucial for nerve ultrasound. Here, we reevaluated normal nerve and fascicle cross-sectional area (CSA) values in humans and compared them to published values. Based on these data, ultrasound pattern sum score (UPSS) boundary values were revisited and readjusted. METHODS: Ultrasound of different peripheral nerves was performed in 100 healthy subjects at anatomically defined landmarks. Correlations with age, gender, height and weight were calculated. RESULTS: Overall, correspondence to other published reference values was high. Gender-dependency was found for the proximal median nerve. Dependency from height occurred in the tibial nerve (TN). Weight-dependency was not found. However, the most obvious differences were found in the TN between men >60 years and women <60 years. Thus, general boundary values were defined using the mean plus the twofold standard deviation for all subjects and nerve segments except for the TN, in which different cut-offs were proposed for elder men. Accordingly, the cut-offs for the UPSS were re-adjusted, none of the individuals revealed more than 2 points at maximum. CONCLUSIONS: The influence of distinct epidemiological factors on nerve size is most prominent in the TN, for which thus several normal values are useful. SIGNIFICANCE: Adjusted reference values improve the accuracy of the UPSS.
Authors: Tim W Rattay; Jennifer Just; Benjamin Röben; Holger Hengel; Rebecca Schüle; Matthis Synofzik; Anne S Söhn; Natalie Winter; Nele Dammeier; Ludger Schöls; Alexander Grimm Journal: Orphanet J Rare Dis Date: 2018-11-03 Impact factor: 4.123
Authors: Marc Dörner; Mihai Ceanga; Frank Schreiber; Jan-Hendrik Stahl; Cornelius Kronlage; Julia Wittlinger; Magdalena Kramer; Sophia Willikens; Stefanie Schreiber; Alexander Grimm; Natalie Winter Journal: Diagnostics (Basel) Date: 2021-02-09
Authors: Glauber Voltan; Fred Bernards Filho; Marcel Nani Leite; Natália Aparecida De Paula; Jaci Maria Santana; Claudia Maria Lincoln Silva; Josafá Gonçalves Barreto; Moises Batista Da Silva; Guilherme Conde; Claudio Guedes Salgado; Marco Andrey Cipriani Frade Journal: Front Med (Lausanne) Date: 2022-09-09