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Research ArticleOriginal Article
Open Access

Electrodiagnostic reference data for motor nerve conduction studies in Saudi Arabia

Mohammed H. Alanazy, Nuha M. Alkhawajah, Moneera O. Aldraihem and Taim Muayqil
Neurosciences Journal January 2020, 25 (1) 25-31; DOI: https://doi.org/10.17712/nsj.2020.1.20190067
Mohammed H. Alanazy
From the Department of Internal Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Nuha M. Alkhawajah
From the Department of Internal Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Moneera O. Aldraihem
From the Department of Internal Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Taim Muayqil
From the Department of Internal Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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    Table 1

    Characteristics of the study participants.

    CharacteristicsUpper limbs study (N=127)Lower limbs study (N=137)
    Mean±SD31.9±10.433.7±11.1
    Age (years)
    Range20 − 6520 − 66
    20 − 296460
    30 − 393136
    40 − 492528
    50 − 59510
    >6023
    Gender n (%)
    Male40 (31.5)46 (33.6)
    Female87 (68.5)91 (66.4)
    Height (cm)
    Mean±SD163.4±9.1163.0±9.4
    Range131 − 189131 − 189
    Weight, (kg)
    Mean±SD72.0±15.874.3±17.9
    Range37 − 13037 − 130
    BMI
    Mean±SD26.9±5.427.9±6.2
    Range15.0 − 50.815.0 − 50.8
    BMI, body mass index
    • View popup
    Table 2

    Summary of the motor NCS values in the upper and lower limbs.

    NervenAmplitude (mV)DML (ms)Conduction velocity (m/s)% Amplitude drop in forearm or leg% Amplitude drop across elbow or FH
    Mean±SD (range)
    Median motor11911.5±2.4 (7.0 – 18.8)3.0±0.36 (2.2 – 3.8)57.8±4.1 (50 – 72)6.1±6.1 (0.0 – 31.4)___
    Ulnar motor11910.0±1.6 (7.0 – 15.9)2.6±0.33 (1.4 – 3.5)60.6±4.6 (49 – 71)*7.0±4.8 (0.0 – 23.8)†3.1±3.5 (0.0 – 16.3)†
    Tibial motor13413.3±3.5 (4.6 – 22.8)3.8±0.7 (2.2 – 5.9)50.1±5.7 (35 – 64)28.7±13.5 (0.0 – 74.8)___
    Fibular motor1345.2±1.9 (1.1 – 12.3)3.9±0.6 (2.0 – 5.5)49.5±4.9 (36 – 69)‡11.1±7.9 (0.0 – 43.9)1.4±5.3 (0.0 – 22.5)
    • ↵* Ulnar motor conduction velocity across the elbow was 69.5±8.0 (52 – 91) m/s, † Two participants with Martin-Gruber anastomosis were excluded, ‡ Fibular motor conduction velocity across fibular head was 58.7±9.1 (38 – 90) m/s, No absent responses. DML - distal motor latency, D2 - index finger, D4 - ring finger, D5 - little finger, FH - fibular head

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    Table 3

    Reference values for motor NCS parameters in the upper and lower limbs.

    NerveAgeAmplitude (mV)DML (ms)Conduction velocity (m/s)Conduction velocity across elbow or FH (m/s)% amplitude drop in the forearm or leg segment% amplitude drop across elbow or FH
    2nd percentile (LLN) †97th percentile (ULN) ‡3rd percentile (LLN) †3rd percentile (LLN) †97th percentile (ULN) ‡97th percentile (ULN) ‡
    Median motor N=119β0* = 2.129 (2.006), β1* = –0.004 (–0.008)
    207.8 (6.3)3.7 (3.8)50 (50)___21.8 (31.4)___
    407.2 (5.4)
    606.6 (4.6)
    Ulnar motor N=119β0* = 2.212 (2.048), β1=–0.004 (–0.008)
    208.4 (6.6) §3.3 (3.5)50 (49)52 (52); slowing compared with the forearm segment = 8 m/s (maximum = 9 m/s)20.4 (23.8)11.3 (16.3)
    407.8 (5.6) §
    607.2 (4.8) §
    Tibial motor N=134
    20 – 667.1 (4.6)5.8 (5.9)40 (35)___58.0 (74.8) ∫___
    Fibular motor N=134β0* = 2.048 (1.841), β1= –0.038 (–0.046)
    203.6 (2.5)5.0 (5.5)40 (36)43 (38); slowing compared with the leg segment = 5 m/s (maximum = 16 m/s)30.0 (44.0)14.5 (22.5)
    401.7 (1.0)
    600.8 (0.4)
    • ↵* Regression coefficients obtained from the quantile regression model: log (predicted value)= β0 + β1 ×(age), † LLN represents the lower limit of the 95% confidence interval at minimum values in the sample, ‡ ULN represents the upper limit of the 95% confidence interval at maximum values in the sample, § Regression model for ulnar CMAP amplitude was estimated at the 5th percentile, as it was not significant at the lower percentiles, ∫ Drop in tibial amplitude with stimulation at popliteal fossa should be interpreted cautiously because supramaximal stimulation may not have been achieved due to pain and technical factors, Data are combined for NCS parameters with no age effect. Age was not significantly associated with tibial CMAP amplitude. Therefore, the reference limit was calculated for the entire group, DML - distal motor latency, FH - fibular head, CMAP - compound muscle action potential, NCS - nerve conduction study

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    Table 4

    Reference data for F-wave minimal latencies determined at the 95th percentile.

    F-waveHeight (cm)Minimal latency (ms), 95th percentileMinimal latency, Mean ± SD (range)
    Mediann=108
    1502424.5±2.1 (20.9 - 30.4)
    16527
    18031
    β0*
    β1*
    -8.374
    0.217
    Ulnarn=95
    1502524.7±2.2 (20.1 - 30.3)
    16528
    18031
    β0*
    β1*
    -5.500
    0.200
    Tibialn=98
    1504645.4±4.0 (35.4 - 56.3)
    16551
    18057
    β0*
    β1*
    -9.930
    0.370
    Fibularn=98
    1504343.9±3.7 (35.7 - 53.6)
    16548
    18054
    β0*
    β1
    -11.650
    0.364
    • ↵* Regression coefficients obtained from the quantile regression model: Predicted F-wave minimal latency = β0 + β1 ×(height in cm)

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Electrodiagnostic reference data for motor nerve conduction studies in Saudi Arabia
Mohammed H. Alanazy, Nuha M. Alkhawajah, Moneera O. Aldraihem, Taim Muayqil
Neurosciences Journal Jan 2020, 25 (1) 25-31; DOI: 10.17712/nsj.2020.1.20190067

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Electrodiagnostic reference data for motor nerve conduction studies in Saudi Arabia
Mohammed H. Alanazy, Nuha M. Alkhawajah, Moneera O. Aldraihem, Taim Muayqil
Neurosciences Journal Jan 2020, 25 (1) 25-31; DOI: 10.17712/nsj.2020.1.20190067
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  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Appendix 1 Correlations of age, sex, height, weight, and BMI with motor nerve action potential amplitude, distal latency, and conduction velocity.
    • Appendix 2 Quantile regression analysis output.
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