title: Assessment of small sensory fiber function across the spectrum of severity in carpal tunnel syndrome patients.
abstract: BACKGROUND
  In compressive neuropathies, large myelinated nerve fibers are generally thought to be more susceptible. In this study, we investigated small myelinated Aδ and unmyelinated C fiber function in patients with mild, moderate, and severe carpal tunnel syndrome.
  
  
  METHODS
  Forty-four healthy controls and 81 carpal tunnel syndrome patients in the mild, moderate, or severe categories were recruited. Small fiber sensation in the affected hand was determined with quantitative sensory testing.
  
  
  RESULTS
  Cold detection thresholds in the severe carpal tunnel syndrome group (18.9 ± 6.8°C) were significantly impaired compared with controls (27.2 ± 2.1°C) (P < 0.01). Similarly, warm detection thresholds were also impaired in the severe carpal tunnel syndrome group (41.2 ± 3.5°C) compared with control (37.1 ± 2.1°C) (P < 0.01).
  
  
  CONCLUSIONS
  These results support the growing body of evidence that carpal tunnel syndrome can affect small afferent fibers. Muscle Nerve 56: 814-816, 2017.
authors.affiliation: Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta.
authors.forename: Christopher
authors.initials: C
authors.lastname: Clarke
authors.affiliation: Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta.
authors.forename: Christopher
authors.initials: C
authors.lastname: Christensen
authors.affiliation: Division of Plastic Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta.
authors.forename: Matthew W T
authors.initials: MWT
authors.lastname: Curran
authors.affiliation: Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta.
authors.forename: K Ming
authors.initials: KM
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D003080:Cold Temperature / Q000009:adverse effects; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000502:physiology*; D036421:Nerve Fibers, Unmyelinated / Q000502:physiology*; D009431:Neural Conduction / Q000502:physiology; D012684:Sensory Thresholds / Q000502:physiology*; D012720:Severity of Illness Index
keywords: carpal tunnel syndrome; diagnosis; human; quantitative sensory testing; sensory assessment; small sensory fibres