scholarly journals A double blind study to evaluate the efficacy of Distribution of F-Latency (DFL) in the detection of cervical radiculopathy and myelopathy

2015 ◽  
Vol 7 (1) ◽  
pp. 46-55
Author(s):  
Ehsan Alam Chowdhury ◽  
Md Zakir Hussain ◽  
M Obaidur Rahman ◽  
K Siddique-e Rabbani
Keyword(s):  
Early Stage ◽  
Medical Physics ◽  
Cervical Radiculopathy ◽  
Blind Study ◽  
Invasive Technique ◽  
Correct Prediction ◽  
Double Blind Study ◽  
Mri Findings ◽  
Double Blind ◽  
Subject Selection

Distribution of F-Latency (DFL) is a new parameter in peripheral nerve conduction measurement and an important application of this new technique is the detection of Cervical Radiculopathy and Myelopathy (CRM) at an early stage through an evaluation of its pattern. Typically a single sharp peak corresponds to normalcy while double peak or a broad peak represents pathology. The current study is an exercise in validating DFL as a screening tool for CRM by comparing the data obtained from an extended pool of subjects (56 median nerves of 28 persons) against corresponding MRI findings through a double blind study. Subject selection was done randomly A 1.5 Tesla MRI scanner and a home built Computerised EMG equipment were used for this study. Analysis of data gave a correct prediction or efficacy of 75%, sensitivity of 77% and specificity of 50%. The present study establishes DFL on a stronger footing for assessment of cervical radiculopathy and myelopathy, whether due to spinal cord or nerve root compression. In combination with conventional simple clinical tests, DFL is expected to give better information for diagnosis of CRM. Being a non-invasive technique requiring virtually zero expenditure in consumables, it promises greater access to patients, and could be used for extensive prevalence study, which cannot be performed using MRI. The capability of DFL in detecting subclinical stages of CRM holds a promise as an awareness development tool alongside screening for neuropathy.Bangladesh Journal of Medical Physics Vol.7 No.1 2014 46-55

scholarly journals Improvement in the detection of Cervical Spondylotic Neuropathy through a combination of shifted frequency Distribution of F-Latency (DFL)

2014 ◽  
Vol 6 (1) ◽  
pp. 75-81
Author(s):  
M Obaidur Rahman ◽  
Ehsan Alam Chowdhury ◽  
K Siddique-e Rabbani
Keyword(s):  
Frequency Distribution ◽  
Medical Physics ◽  
Double Blind Study ◽  
Mri Findings ◽  
Double Blind ◽  
Starting Point ◽  
Individual Decisions ◽  
The Individual ◽  
Age Range ◽  
Extended Group

Our extended group in Dhaka University has shown that frequency Distribution of F-Latency (DFL) of peripheral nerve trunks may be used for the detection of Cervical Spondylotic Neuropathy (CSN). A double blind study was performed recently to ascertain the efficacy of DFL in the detection of CSN using MRI findings as the benchmark, which was performed on 62 median nerves of 31 volunteers within an age range of 20 and 80 years. In our laboratory DFL is obtained by grouping F-latency data into 2ms bins and then plotting a frequency polygon. The shapes of the resulting polygons are sorted into two categories: i) single peak and ii) broad peak or multiple peaks. The first category was taken to represent normalcy while the second category was taken to represent CSN. The present work was taken up to study the effect on the polygon patterns due to shifting of the starting point of each bin by 1ms. Two decisions were made for each nerve regarding normalcy or CSN based on both the individual polygon patterns. Two more decisions were made based on the logic AND and logic OR operations of the above two decisions. These four individual decisions from all the nerves were then compared with MRI findings. This shows that such bin shifting and a decision based on OR logic on the two DFLs thus obtained gives the best overall efficacy compared to all the other procedures. DOI: http://dx.doi.org/10.3329/bjmp.v6i1.19762 Bangladesh Journal of Medical Physics Vol.6 No.1 2013 75-81

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