Hand Sensorimotor Function and Carpal Tunnel Syndrome

Summary

Principal Investigator: Zong Ming Li
Abstract: DESCRIPTION (provided by applicant): 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 is 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 is 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 is 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.
Funding Period: 2011-04-01 - 2015-03-31
more information: NIH RePORT

Top Publications

  1. pmc Influence of index finger proximal interphalangeal joint arthrodesis on precision pinch kinematics
    Mathieu Domalain
    Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
    J Hand Surg Am 36:1944-9. 2011
  2. pmc Carpal tunnel syndrome impairs thumb opposition and circumduction motion
    Tamara L Marquardt
    Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA
    Clin Orthop Relat Res 472:2526-33. 2014
  3. pmc Effects of carpal tunnel syndrome on reach-to-pinch performance
    Raviraj Nataraj
    Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, United States of America
    PLoS ONE 9:e92063. 2014
  4. pmc Pathokinematics of precision pinch movement associated with carpal tunnel syndrome
    Raviraj Nataraj
    Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, Ohio
    J Orthop Res 32:786-92. 2014
  5. pmc Directional coordination of thumb and finger forces during precision pinch
    Ke Li
    Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, Ohio, United States of America
    PLoS ONE 8:e79400. 2013
  6. ncbi Integration of marker and force data to compute three-dimensional joint moments of the thumb and index finger digits during pinch
    Raviraj Nataraj
    a Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH, USA
    Comput Methods Biomech Biomed Engin 18:592-606. 2015
  7. pmc Robust identification of three-dimensional thumb and index finger kinematics with a minimal set of markers
    Raviraj Nataraj
    Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA
    J Biomech Eng 135:91002. 2013
  8. pmc Removal of visual feedback lowers structural variability of inter-digit force coordination during sustained precision pinch
    Ke Li
    Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland ClinicCleveland, OH 44195, USA
    Neurosci Lett 545:1-5. 2013
  9. pmc Cross recurrence quantification analysis of precision grip following peripheral median nerve block
    Ke Li
    Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
    J Neuroeng Rehabil 10:28. 2013
  10. pmc Influence of nerve supply on hand electromyography coherence during a three-digit task
    Cristian F Pasluosta
    Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA
    J Electromyogr Kinesiol 23:594-9. 2013

Research Grants

  1. Defining and Treating Written Language Disabilities
    VIRGINIA WISE BERNINGER; Fiscal Year: 2013
  2. Effectiveness of Robot-Assisted Hand Movement Training after Stroke
    DAVID JAY REINKENSMEYER; Fiscal Year: 2013
  3. EARLY EVENTS IN ALZHEIMER PATHOGENESIS
    SUE TILTON GRIFFIN; Fiscal Year: 2013
  4. Molecular and Cellular Therapies for Muscular Dystrophy
    Stanley C Froehner; Fiscal Year: 2013
  5. Electrocorticography signals for human hand prosthetics
    Jeffrey G Ojemann; Fiscal Year: 2013

Detail Information

Publications13

  1. pmc Influence of index finger proximal interphalangeal joint arthrodesis on precision pinch kinematics
    Mathieu Domalain
    Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
    J Hand Surg Am 36:1944-9. 2011
    ..To evaluate the impact of proximal interphalangeal (PIP) joint arthrodesis on the kinematics of precision pinch...
  2. pmc Carpal tunnel syndrome impairs thumb opposition and circumduction motion
    Tamara L Marquardt
    Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA
    Clin Orthop Relat Res 472:2526-33. 2014
    ..The thumb is critical to hand function, yet the pathokinematics of the thumb associated with carpal tunnel syndrome are not well understood...
  3. pmc Effects of carpal tunnel syndrome on reach-to-pinch performance
    Raviraj Nataraj
    Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, United States of America
    PLoS ONE 9:e92063. 2014
    ..This study examined the effects of CTS on the kinematic performance of reach-to-pinch maneuver...
  4. pmc Pathokinematics of precision pinch movement associated with carpal tunnel syndrome
    Raviraj Nataraj
    Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, Ohio
    J Orthop Res 32:786-92. 2014
    ..Carpal tunnel syndrome impairs the ability to perform precision pinch across the movement and at digit-contact. The findings may serve to identify deficits in manual dexterity for functional evaluation of CTS...
  5. pmc Directional coordination of thumb and finger forces during precision pinch
    Ke Li
    Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, Ohio, United States of America
    PLoS ONE 8:e79400. 2013
    ....
  6. ncbi Integration of marker and force data to compute three-dimensional joint moments of the thumb and index finger digits during pinch
    Raviraj Nataraj
    a Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH, USA
    Comput Methods Biomech Biomed Engin 18:592-606. 2015
    ..Examining differences in joint moment results when substituting selected steps of this methodological approach suggested greater relative importance for joint centre identification and segment coordinate system alignment. ..
  7. pmc Robust identification of three-dimensional thumb and index finger kinematics with a minimal set of markers
    Raviraj Nataraj
    Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA
    J Biomech Eng 135:91002. 2013
    ....
  8. pmc Removal of visual feedback lowers structural variability of inter-digit force coordination during sustained precision pinch
    Ke Li
    Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland ClinicCleveland, OH 44195, USA
    Neurosci Lett 545:1-5. 2013
    ..This change is reflected in the high-level control strategy, resulting in the two digits being more tightly coupled under somatosensory feedback without visual inputs...
  9. pmc Cross recurrence quantification analysis of precision grip following peripheral median nerve block
    Ke Li
    Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
    J Neuroeng Rehabil 10:28. 2013
    ....
  10. pmc Influence of nerve supply on hand electromyography coherence during a three-digit task
    Cristian F Pasluosta
    Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA
    J Electromyogr Kinesiol 23:594-9. 2013
    ..The results suggest that intermuscular coupling in a voluntary motor task is likely modulated in a functional manner and that different nerves might transport common neural inputs to functionally coupled muscles...
  11. pmc A digit alignment device for kinematic analysis of the thumb and index finger
    Zhilei Liu Shen
    Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, United States
    Gait Posture 36:643-5. 2012
    ..The potential of utilizing this protocol as a standardized tool for digit kinematics was demonstrated using a dynamic task of precision pinching...
  12. ncbi Carpal tunnel syndrome impairs sustained precision pinch performance
    Ke Li
    Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH, USA Electronic address
    Clin Neurophysiol 126:194-201. 2015
    ..The purpose of this study was to investigate effects of carpal tunnel syndrome (CTS) on digit force control during a sustained precision pinch...

Research Grants30

  1. Defining and Treating Written Language Disabilities
    VIRGINIA WISE BERNINGER; Fiscal Year: 2013
    ..The proposed multidisciplinary research has practical significance for improving diagnosis and providing more effective services which may lower such risks. ..
  2. Effectiveness of Robot-Assisted Hand Movement Training after Stroke
    DAVID JAY REINKENSMEYER; Fiscal Year: 2013
    ..It is hypothesized that availability of CST, sensory function, and history of previous exercise will predict the response to different forms of robotic training. ..
  3. EARLY EVENTS IN ALZHEIMER PATHOGENESIS
    SUE TILTON GRIFFIN; Fiscal Year: 2013
    ..The synergy between our aims, approaches, and measures will enable us to meet our goal of defining early cellular interactions toward development of rational interventions in AD. ..
  4. Molecular and Cellular Therapies for Muscular Dystrophy
    Stanley C Froehner; Fiscal Year: 2013
    ..The mechanism of NPC1 phenotype amelioration and its applicability to LGMDs will be studied. Two core facilities will serve the participating laboratories. ..
  5. Electrocorticography signals for human hand prosthetics
    Jeffrey G Ojemann; Fiscal Year: 2013
    ..This project examines whether signals recorded directly from the human brain (during surgery for epilepsy) could be used to control a robotic hand. ..