, Volume 48, Issue 3, pp 191–196 | Cite as

Sympathetic Skin Response and Boston Questionnaire in Carpal Tunnel Syndrome

  • B. Cevik
  • S. Kurt
  • D. Aksoy
  • V. Solmaz

We aimed to determine relations between the sudomotor efferent nerve fiber function and Boston questionnaire in idiopathic carpal tunnel syndrome (CTS). Median-nerve sympathetic skin responses (SSRs) evoked by wrist stimulation were recorded in 108 CTS patients and compared with those in 88 healthy volunteers. The Boston questionnaire form (BQF) was applied to patients. All patients and healthy individuals were questioned about the autonomic symptoms in the hand (red or purple coloration, excessive sweating, and feeling cold). The average SSR latencies of the patients with CTS were significantly longer than those in the control group (P < 0.001). Positive significant, while weak, correlation was found between the SSR latency, autonomic symptoms, and total sympathetic system scores. No statistically significant relationship was found between the Boston symptom severity, functional capacity scores, and SSR latency. The latter obtained through wrist stimulation was sensitive to support the sudomotor sympathetic dysfunction in patients with CTS. As we found no relationship between the BQF and SSR, these indices may evaluate different aspects of CTS.


carpal tunnel syndrome sympathetic skin response sympathetic activity sudomotor activity Boston questionnaire 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sh. J. Oh, Clinical Electromyography. Nerve Conduction Studies, Lippincott Williams & Wilkins, Philadelphia (2003).Google Scholar
  2. 2.
    Y. Kaplan, S. G. Kurt, and H. Karaer, “Carpal tunnel syndrome in postmenopausal women,” J. Neurol. Sci., 270, Nos. 1-2, 77-81 (2008).Google Scholar
  3. 3.
    C. K. Jablecki, M. T. Andary, Y. T. So, et al., “Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee,” Muscle Nerve, 16, No. 12, 1392–1414 (1993).CrossRefPubMedGoogle Scholar
  4. 4.
    H. O. Sener, N. F. Taşcilar, H. Balaban, and D. Selçuki, “Sympathetic skin response in carpal tunnel syndrome,” Clin. Neurophysiol., 111, No. 8, 1395-1399 (2000).CrossRefPubMedGoogle Scholar
  5. 5.
    A. O. Bayrak, H. E. Tilki, and M. Coşkun, “Sympathetic skin response and axon count in carpal tunnel syndrome,” J. Clin. Neurophysiol., 24, No. 1, 70-75 (2007).CrossRefPubMedGoogle Scholar
  6. 6.
    Z. Ming, J Siivola, S Pietikainen, et al., “Postoperative relief of abnormal vasoregulation in carpal tunnel syndrome,” Clin. Neurol. Neurosurg., 109, No. 5, 413-417 (2007).CrossRefPubMedGoogle Scholar
  7. 7.
    N. Kanzato, Y. Komine, F. Kanaya, and K. Fukiyama, “Preserved sympathetic skin response at the distal phalanx in patients with carpal tunnel syndrome,” Clin. Neurophysiol., 111, No. 11, 2057-2063 (2000).CrossRefPubMedGoogle Scholar
  8. 8.
    N. Kiylioglu, A. Akyol, E. Guney, et al., “Sympathetic skin response in idiopathic and diabetic carpal tunnel syndrome,” Clin. Neurol. Neurosurg., 108, No. 1, 1-7 (2005).CrossRefPubMedGoogle Scholar
  9. 9.
    S. Reddeppa, K. Bulusu, P. R. Chand, et al., “The sympathetic skin response in carpal tunnel syndrome,” Auton. Neurosci., 84, No. 3, 119-121 (2000).CrossRefPubMedGoogle Scholar
  10. 10.
    J. Verghese, A. S. Galanopoulou, and S. Herskovitz, “Autonomic dysfunction in idiopathic carpal tunnel syndrome,” Muscle Nerve, 23, No. 8, 1209-1213 (2000).Google Scholar
  11. 11.
    A. Zyluk and L. Kosovets, “An assessment of the sympathetic function within the hand in patients with carpal tunnel syndrome,” J. Hand. Surg. Eur., 35, No. 5, 402-408 (2010).CrossRefGoogle Scholar
  12. 12.
    S. Kurt, B. Kisacik, Y. Kaplan, et al., “Obesity and carpal tunnel syndrome: is there a causal relationship?,” Eur. Neurol., 59, No. 5, 253-257 (2008).CrossRefPubMedGoogle Scholar
  13. 13.
    L. Padua, P. Pasqualetti, and R. Rosenbaum, “One patient, two carpal tunnels: statistical and clinical analysis – by hand or by patient?,” Clin. Neurophysiol., 116: No. 2, 241–243 (2005).CrossRefPubMedGoogle Scholar
  14. 14.
    American Academy of Neurology, American Association of Electrodiagnostic Medicine, and American Academy of Physical Medicine and Rehabilitation, “Practice parameter for electrodiagnostic studies in carpal tunnel syndrome (summary statement),” Neurology, 43, No. 11, 2404–2405 (1993).Google Scholar
  15. 15.
    B. T. Shahani, J. H. Halperin, P. Boulu, and J. Cohen, “Sympathetic skin response – a method of assessing unmyelinated axon dysfunction in peripheral neuropathies,” J. Neurol. Neurosurg. Psychiatry., 47, No. 5, 536–542 (1984).CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    F. Giannini, R. Cioni, M. Mondelli, et al., “A new clinical scale of carpal tunnel syndrome: validation of the measurement and clinical-neurophysiological assessment,” Clin. Neurophysiol., 113, No. 1, 71–77 (2002).CrossRefPubMedGoogle Scholar
  17. 17.
    M. Mondelli, S. Passero, and F. Giannini, “Provocative tests in different stages of carpal tunnel syndrome,” Clin. Neurol. Neurosurg., 103, No. 3, 178–183 (2001).CrossRefPubMedGoogle Scholar
  18. 18.
    M. Mondelli, F. Reale, F. Sicurelli, and L. Padua, “Relationship between the self-administered Boston questionnaire and electrophysiological findings in follow-up of surgically-treated carpal tunnel syndrome,” J. Hand. Surg. Br., 25, No. 2, 128–134 (2000).CrossRefPubMedGoogle Scholar
  19. 19.
    D. W. Levine, B. P. Simmons, M. J. Koris, et al., “A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome,” J. Bone Joint Surg. Am., 75, No. 11, 1585-1592 (1993).PubMedGoogle Scholar
  20. 20.
    N. Heybeli, R. A. Ozerdemoglu, O. G. Aksoy, and E. F. Mumcu, “Functional and symptomatic scoring used for the assessment of outcome in carpal tunnel release,” Acta Orthop. Traumatol. Turc., 35, No. 2, 147-151 (2001).Google Scholar
  21. 21.
    M. Sezgin, N. A. Incel, S Serhan, et al., “Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and functionality of the Turkish version of the Boston Questionnaire,” Disabil. Rehabil., 28, No. 20, 1281-1285 (2006).CrossRefPubMedGoogle Scholar
  22. 22.
    S. Akman, E. Erturer, M. Celik M, et al., “The results of open surgical release in carpal tunnel syndrome and evaluation of follow-up criteria,” Acta. Orthop. Traumatol. Turc., 36, No. 3, 259-264 (2002).Google Scholar
  23. 23.
    N. Heybeli, S. Kutluhan, S. Demirci, et al., “Assessment of outcome of carpal tunnel syndrome: a comparison of electrophysiological findings and a self-administered Boston questionnaire,” J. Hand. Surg. Br., 27, No. 3, 259-264 (2002).CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Faculty of Medicine, Department of Neurology, Gaziosmanpasa UniversityTokatTurkey
  2. 2.Faculty of Medicine, Department of Neurology, Trakya UniversityEdirneTurkey

Personalised recommendations