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Median nerve and carpal arch morphology changes in women with type 2 diabetes: a case–control study

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Abstract

Background

The aim of this study is to investigate the changes in median nerve and transverse carpal ligament (TCL)-formed carpal arch morphology as possible risk factors for median nerve entrapment in women with type 2 diabetes.

Methods

The distal carpal tunnel was imaged using ultrasound in 30 female subjects (15 with type 2 diabetes, 15 controls). The morphological parameters of the median nerve and carpal arch were derived from the ultrasound images. One-way analysis of variance (ANOVA) was used for statistical analysis.

Results

Diabetic women had an enlarged median nerve area (p < 0.05), salong with a maller carpal arch size, as indicated by a reduced palmar bowing index of the TCL (p < 0.05), and arch area (p < 0.05) than controls. The distance from the median nerve centroid to the volar boundary of the TCL was reduced in diabetic women (p < 0.05) compared to the controls.

Conclusions

Women with type 2 diabetes have reduced available space for the median nerve within the carpal arch due to the enlarged nerve and reduced arch size, making the median nerve more susceptible to entrapment within the tunnel. The current study shows that presence of diabetes increases the risk of median nerve entrapment in women and requires early detection of symptoms to avoid carpal tunnel syndrome.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

BMI:

Body mass index

CTS:

Carpal tunnel syndrome

CSA:

Cross-sectional area

PBI:

Palmar bowing index

TCL:

Transverse carpal ligament

VPT:

Vibration perception test

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Acknowledgements

The authors thank Dr. Bharani Gopalan at Mother’s Care Diabetes Center for help in recruiting subjects, Karigiri Hospital for providing the hand splint, and Ultraserve Systems for lending the ultrasound machine. Finally, the authors are grateful to all the study participants.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Sensors and Biomedical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India

    Kishor Lakshminarayanan

  2. Department of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, OH, USA

    Rakshit Shah

Authors
  1. Kishor Lakshminarayanan
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  2. Rakshit Shah
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Contributions

K.L. and R.S. designed the study. K.L. recruited the subjects and conducted preliminary tests for eligibility. K.L. collected data from the subjects. K.L. and R.S. analyzed the data. K.L. wrote the manuscript with R.S. contributing to revisions. K.L. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Kishor Lakshminarayanan.

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Ethics approval and consent to participate

The study protocol was approved by the Vellore Institute of Technology Review Board. Subjects read and signed a written informed consent form approved by the Institutional Review Board before participating in the experiment.

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Not applicable.

Conflict of interest

The authors declare that they have no competing interests.

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Lakshminarayanan, K., Shah, R. Median nerve and carpal arch morphology changes in women with type 2 diabetes: a case–control study. J Ultrasound 25, 469–474 (2022). https://doi.org/10.1007/s40477-021-00606-7

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  • DOI: https://doi.org/10.1007/s40477-021-00606-7

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