The threshold tracking nerve conduction study technique: Experience of clinical users unfamiliar with a research-grade neuronal excitability system

• Published in: Clinical neurophysiology practice Vol. 7; pp. 319 - 324
• Main Authors: McIlduff, C.E., Wainger, B.J., Freeman, R.L., Samaan, S., Yator, I., Gutierrez, H., Verga, S., Rutkove, S.B.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-01-2022; Elsevier
• Subjects: Axonal excitability; Biomarker; Clinical electrophysiology; Nerve conduction studies; Neuromuscular disorders; Research Paper; Threshold tracking; Threshold tracking; Biomarker; Neuromuscular disorders; Axonal excitability; Nerve conduction studies; Clinical electrophysiology
• ISSN: 2467-981X; 2467-981X
• DOI: 10.1016/j.cnp.2022.08.003

•Threshold tracking nerve conduction studies (TTNCSs) measure axon excitability.•TTNCSs can objectively characterize neuronal dysfunction and treatment response.•An available research-grade TTNCS system has not been widely implemented .•Clinical electrophysiologists with varying levels of experience can perform TTNCSs.•A user-friendly system and education about TTNCSs could broaden use of the technique.
To 1) explore if clinical electrophysiologists with different degrees of experience performing standard nerve conduction studies could run a threshold tracking nerve conduction study (TTNCS) protocol and 2) learn how clinical users view a research-grade TTNCSs neuronal excitability system.
Five clinical electrophysiologists conducted a TTNCS session using QTracS and then completed a questionnaire describing their impressions.
All of the electrophysiologists completed the QTracS protocol on an initial attempt. Perceived strengths comprised the ease of preparatory steps and quick protocol speed. Identified drawbacks included an unwieldly user-interface. The electrophysiologists indicated that knowledge of TTNCS principles and applications would be critical for incorporation of the method into clinical use.
This pilot study suggests that clinical electrophysiologists can carry out TTNCSs with a research-grade system. The development of a more user-friendly program, along with dedicated education and training, could lead to wider application of the TTNCS technique.
Considered together with clinical presentation and other biomarkers, increased use of TTNCSs could provide improved assessment of neuromuscular disease and treatment response.