Carotid intima-media thickness in patients with carpal tunnel syndrome.

OBJECTIVES: We measured the carotid intima-media thickness, a surrogate marker of early atherosclerosis, in patients with carpal tunnel syndrome compared to a control group to evaluate the risk of atherosclerotic disease. METHODS: Between January 2011 and December 2011, female patients presenting to the outpatient neurology clinic for pain and paresthesia in the hands were screened for study enrollment. Patients 30 years or older were eligible for the study if they did not have a history of stroke or cardiovascular disease. RESULTS: During the study period, 111 patients (58 in the carpal tunnel syndrome group and 53 in the control group) were enrolled, with a mean age of 56 years (range, 32-79 years). There were no significant differences in baseline characteristics except maximum carotid intima-media thickness and body mass index. The maximum intima-media thickness was greater in the carpal tunnel syndrome group (mean ± SD, 1.05 ± 0.17 mm) than the control group (0.85 ± 0.22 mm; P < .0001). The body mass index was greater among the controls (P = .012). Simple linear regression analysis revealed that age (P < .0001), carpal tunnel syndrome (P < .0001), hypertension (P = .022), and systolic blood pressure (P = .034) were statistically significantly associated with increased intima-media thickness. Multiple linear regression analysis revealed that hypertension (P = .033), systolic blood pressure (P = .022), age (P < .0001), and carpal tunnel syndrome (P < .0001) were significantly associated with increased intima-media thickness, with carpal tunnel syndrome being the most influential factor (ß = 0.489). CONCLUSIONS: The maximum carotid intima-media thickness was significantly increased in patients with carpal tunnel syndrome compared to controls. Chronic inflammation beyond the traditional cardiovascular risk factors might be related to increased carotid intima-media thickness in patients with carpal tunnel syndrome.

Carpal Tunnel Syndrome in Patients with Tremor Dominant Parkinson's Disease.

BACKGROUND: Unilateral hand tremor is one of the cardinal symptoms of Parkinson's disease. Additionally, mechanical traumatic hand movement is one of the risk factors for carpal tunnel syndrome. Our objective in this study was to examine whether repetitive mechanical movement may be related to the development of carpal tunnel syndrome in Parkinson's disease with unilateral hand tremor using neurophysiological methods. METHODS: The study participants included 33 de novo Parkinson's disease patients with unilateral hand tremor, and we compared the tremor hand and non-tremor hand within the same patients. RESULTS: Seven (21.2%) of the 33 patients had carpal tunnel syndrome. All of carpal tunnel syndrome patients showed neurophysiological abnormalities in both the hand without tremor and the hand with tremor. In addition, in patients without carpal tunnel syndrome, the sensory nerve action potential was lower in the hand without tremor than in the hand with tremor, although there were no significant differences. CONCLUSIONS: We concluded that hand tremor in de novo Parkinson's disease patients was not directly related to the development of carpal tunnel syndrome. In contrast, more frequent use of hand without tremor may induce mechanical loading and may be associated with CTS in the hand without tremor. Early diagnosis of Parkinson's disease and proper education in hand use may be essential for preventing carpal tunnel syndrome in Parkinson's disease tremor patients.