The median nerve is susceptible to compression in the wrist, leading to carpal tunnel syndrome (CTS). CTS is the most common compression neuropathy and have an immense impact on national health care, worker productivity, and quality of life. Despite its high prevalence and public health cost, our understanding of CTS is limited, and the management of CTS awaits improvement. The central notion of this project is that hand sensorimotor function is sensitive to peripheral median neuropathy and that the central nervous system is affected by CTS, causing the associated sensorimotor deficit. We will investigate this notion with quantifiable sensorimotor data from novel biomechanical and neurophysiological studies. This project has three aims consisting of biomechanical, neurophysiological and translational research.
The first aim i s to investigate CTS-induced pathokinematic and pathokinetic performance using dexterous manual tasks of thumb opposition, reach-to-pinch, precision grip, and finger pressing.
The second aim i s to investigate the neurophysiological implications of chronic peripheral neuropathy (i.e., CTS) on the central nervous system by evaluating corticomuscular coupling and stretch reflex.
The third aim i s to identify novel biomechanical and neurophysiological markers for CTS cases using machine learning and classification algorithms. The results of this project will elucidate the pathological mechanisms and behavioral manifestations of CTS and aid in the development of new strategies for diagnosis, evaluation, rehabilitation, and treatment of this disorder. More generally, CTS as a chronic neuropathy serves as an effective model to study sensorimotor mechanisms of the peripheral and central nervous systems. In addition, the methodology developed in this project is applicable to other neuromuscular disorders.

Public Health Relevance

Carpal tunnel syndrome is highly prevalent and costly. One of the distinct consequences of carpal tunnel syndrome is that patients experience inexplicable dropping of objects and clumsiness while performing simple daily tasks. In this project, we propose to study the sensorimotor deficit using novel biomechanical and neurophysiological experiments. The results of this project will elucidate the pathological mechanisms and manifestations of carpal tunnel syndrome. This project is clinically translational to aid in the development of new strategies for diagnosis, evaluation, rehabilitation, and treatment of this disorder.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR056964-04
Application #
8627111
Study Section
Special Emphasis Panel (ZRG1-MOSS-C (03))
Program Officer
Panagis, James S
Project Start
2011-04-01
Project End
2015-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
4
Fiscal Year
2014
Total Cost
$346,185
Indirect Cost
$125,685
Name
Cleveland Clinic Lerner
Department
Other Basic Sciences
Type
Schools of Medicine
DUNS #
135781701
City
Cleveland
State
OH
Country
United States
Zip Code
44195
Li, Ke; Evans, Peter J; Seitz Jr, William H et al. (2015) Carpal tunnel syndrome impairs sustained precision pinch performance. Clin Neurophysiol 126:194-201
Nataraj, Raviraj; Evans, Peter J; Seitz Jr, William H et al. (2014) Pathokinematics of precision pinch movement associated with carpal tunnel syndrome. J Orthop Res 32:786-92
Nataraj, Raviraj; Pasluosta, Cristian; Li, Zong-Ming (2014) Online kinematic regulation by visual feedback for grasp versus transport during reach-to-pinch. Hum Mov Sci 36:134-53
Nataraj, Raviraj; Evans, Peter J; Seitz Jr, William H et al. (2014) Effects of carpal tunnel syndrome on reach-to-pinch performance. PLoS One 9:e92063
Marquardt, Tamara L; Nataraj, Raviraj; Evans, Peter J et al. (2014) Carpal tunnel syndrome impairs thumb opposition and circumduction motion. Clin Orthop Relat Res 472:2526-33
Li, Ke; Nataraj, Raviraj; Marquardt, Tamara L et al. (2013) Directional coordination of thumb and finger forces during precision pinch. PLoS One 8:e79400
Pasluosta, Cristian F; Domalain, Mathieu M; Fang, Yin et al. (2013) Influence of nerve supply on hand electromyography coherence during a three-digit task. J Electromyogr Kinesiol 23:594-9
Li, Ke; Marquardt, Tamara L; Li, Zong-Ming (2013) Removal of visual feedback lowers structural variability of inter-digit force coordination during sustained precision pinch. Neurosci Lett 545:1-5
Li, Ke; Li, Zong-Ming (2013) Cross recurrence quantification analysis of precision grip following peripheral median nerve block. J Neuroeng Rehabil 10:28
Nataraj, Raviraj; Li, Zong-Ming (2013) Robust identification of three-dimensional thumb and index finger kinematics with a minimal set of markers. J Biomech Eng 135:91002

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