Clinical trial NCT04967144: Carpal Tunnel Syndrome, Right/Left Judgement
Official title: Right/Left Judgement in Carpal Tunnel Syndrome
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Carpal Tunnel Syndrome
Keywords: Carpal tunnel syndrome, body schema
Lead sponsor: Bozyaka Training and Research Hospital
Sponsor class: OTHER
First posted: 2021-07-19
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Carpal Tunnel Syndrome

Brief summary: The discrimination of the right/left side of the body is related to the integrity of the motor and somatosensory areas at the cortical and subcortical levels. Although some studies have shown that there may be an effect on the right/left representation at the cortical and subcortical levels in cases that cause severe neuropathy and neuropathic pain, this effect has not been proven in milder neuropathies. In this study, the effect on right/left side discrimination will be investigated even in cases with carpal tunnel syndrome. Additionally, the investigators aimed to assess the relationship between right/left discrimination and symptom severity.

Detailed description: The left/right discrimination is a motor imagery task that involves viewing images of a body part and determining whether each image belongs to the left or right side of the body or if it rotates towards it. Some studies have shown that there may be an effect on the right/left representation at the cortical and subcortical levels in cases that cause severe neuropathy and neuropathic pain, this effect has not been proven in milder neuropathies, such as carpal tunnel syndrome. In this study, the relationship between right/left decision accuracy will be compared with control subjects. The investigators will assess the relationship between right/left judgment and symptom severity, two-point discrimination, and handgrip force.

The hypothesis of the study are:

1. The right/left discrimination accuracy is less than the control subjects.
2. Right/left discrimination is in relationship with symptom severity, two-point discrimination, and handgrip force.

Eligibility criteria: Inclusion Criteria:

* Participants with a duration of symptoms associated with unilateral CTS of at least 3 months
* Participants with clinically and nerve conduction study confirmed carpal tunnel syndrome
* All participants will be right-hand dominance and diagnosed with carpal tunnel syndrome on the same side
* Participants with MOCA score minimum 26.

Exclusion Criteria:

* Severe visual impairment that may prevent performing the test
* Polyneuropathy
* Cervical spine surgery history
* Presence of abnormal cervical spine, shoulder, and elbow joint examination findings
* Patients with any history of surgery for the upper extremity
* Congenital/Developmental upper extremity malformations
* Central nervous system disease
* Antihistaminic, gabapentinoids, antiepileptics, methylphenidate, modafinil, neuroleptics use

Primary outcomes:
measure: Left/right judgement Task
timeFrame: 3 months
Secondary outcomes:
measure: Handgrip strength
timeFrame: 3 months
measure: Two-point discrimination test
timeFrame: 3 months
measure: Visual Analogue Scale
timeFrame: 3 months
measure: PainDETECT questionnaire
timeFrame: 3 months
measure: Boston Carpal Tunnel Questionnaire
timeFrame: 3 months
Other outcomes:
Locations:
city: Izmir
country: Turkey
facility: University of Health Sciences Izmir Bozyaka Training and Research Hospital
state: Karabaglar
Study officials:
affiliation: University of Health Sciences Izmir Bozyaka Training and Research Hospital
name: Seniz Akcay, Assoc Prof
role: STUDY_DIRECTOR
affiliation: University of Health Sciences Izmir Bozyaka Training and Research Hospital
name: Altinay Goksel Karatepe, Prof
role: STUDY_CHAIR
affiliation: University of Health Sciences Izmir Bozyaka Training and Research Hospital
name: Fikriye Elif Saka, MD
role: STUDY_CHAIR
affiliation: University of Health Sciences Izmir Bozyaka Training and Research Hospital
name: Asli Koskderelioglu, Assoc Prof
role: STUDY_CHAIR
affiliation: University of Health Sciences Izmir Bozyaka Training and Research Hospital
name: Neslihan Eskut, Specialist
role: STUDY_CHAIR
References:
citation: Breckenridge JD, Ginn KA, Wallwork SB, McAuley JH. Do People With Chronic Musculoskeletal Pain Have Impaired Motor Imagery? A Meta-analytical Systematic Review of the Left/Right Judgment Task. J Pain. 2019 Feb;20(2):119-132. doi: 10.1016/j.jpain.2018.07.004. Epub 2018 Aug 9.
citation: Schmid AB, Coppieters MW. Left/right judgment of body parts is selectively impaired in patients with unilateral carpal tunnel syndrome. Clin J Pain. 2012 Sep;28(7):615-22. doi: 10.1097/AJP.0b013e31823e16b9.
citation: Moseley GL. Why do people with complex regional pain syndrome take longer to recognize their affected hand? Neurology. 2004 Jun 22;62(12):2182-6. doi: 10.1212/01.wnl.0000130156.05828.43.
citation: Williams LJ, Braithwaite FA, Leake HB, McDonnell MN, Peto DK, Lorimer Moseley G, Hillier SL. Reliability and validity of a mobile tablet for assessing left/right judgements. Musculoskelet Sci Pract. 2019 Apr;40:45-52. doi: 10.1016/j.msksp.2019.01.010. Epub 2019 Jan 24.
citation: Akcay S, Koskderelioglu A, Ince B, Elif Saka F, Eskut N, Goksel Karatepe A. Is the left/right judgment task performance altered in unilateral carpal tunnel syndrome: And associated with symptom severity? Musculoskelet Sci Pract. 2022 Dec;62:102641. doi: 10.1016/j.msksp.2022.102641. Epub 2022 Aug 4.