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20180615 Pogul Thesis.pdf (1.48 MB)

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CORTICAL REPRESENTATIONS AND MOTOR PERFORMANCE OF THE DIGITS IN PATIENTS WITH CARPAL TUNNEL SYNDROME

Pogul, Brinda Balchand
http://orcid.org/0000-0003-3377-5630
http://rave.ohiolink.edu/etdc/view?acc_num=csu1529257236449936

Abstract Details

2018, Master of Science in Biomedical Engineering, Cleveland State University, Washkewicz College of Engineering.
Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy and is characterized by compression of the median nerve. Median nerve injury in CTS patients alters the afferent-efferent processing circuit within the central nervous system, affecting digits’ sensory and motor performance. Studies have reported that the disrupted afferent input in CTS reorganizes the digit cortical representation in the primary sensory cortex (S1) of median nerve innervated digits, with the exception of the thumb. However, the extent of altered digit representation in the primary motor cortex (M1) due to CTS remains to be determined. It is important to evaluate S1/M1 reorganization because alterations at the cortical level due to CTS may undermine digit performance, including the interdependency and stability of digit forces during manual tasks. Moreover, by providing augmented tactile information at the digit pad to compensate for patients diminished sensory capacity, it may be possible to reverse or rehabilitate impaired performance. Therefore, the objective of this thesis was to investigate CTS-induced alterations in digit cortical representations of the thumb and forefinger and to examine each individual digits’ motor performance with and without tactile stimulation. Firstly, CTS-induced alterations in the cortical representation of the thumb and forefinger were examined in the S1 and M1 cortices using high resolution functional magnetic resonance imaging (fMRI). Then digit’s interdependency and force stability of the thumb and forefinger were investigated with and without vibrotactile stimulation applied to the digit pad. The results from this study showed that CTS is associated with altered digit cortical representations with decreased activation strength and decreased distinctiveness in both S1 and M1 regions. We also observed that CTS patients demonstrated increased digit interdependency and force variability compared to controls. Forced variability, but not interdependency, improved through tactile stimulation. The results of this thesis helped to identify both alterations at the cortical level as well as digit motor performance of the thumb and forefinger in CTS patients as compared to healthy subjects. It also provided evidence in favor of vibrotactile therapy for motor rehabilitation. This approach may aid in the development of new strategies for diagnosis, rehabilitation, and treatment of this hand disorder.
ZONG-MING LI (Committee Chair)
MOO-YEAL LEE (Committee Member)
ANN REINTHAL (Committee Member)
Biomechanics; Biomedical Engineering; Biomedical Research; Engineering; Neurobiology; Neurology; Neurosciences; Radiology; Rehabilitation; Science Education; Scientific Imaging
Digit Cortical Representations, fMRI, Digit Motor Performance, Carpal Tunnel Syndrome

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Citations

  • Pogul, B. B. (2018). CORTICAL REPRESENTATIONS AND MOTOR PERFORMANCE OF THE DIGITS IN PATIENTS WITH CARPAL TUNNEL SYNDROME [Master's thesis, Cleveland State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=csu1529257236449936

    APA Style (7th edition)

  • Pogul, Brinda. CORTICAL REPRESENTATIONS AND MOTOR PERFORMANCE OF THE DIGITS IN PATIENTS WITH CARPAL TUNNEL SYNDROME. 2018. Cleveland State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=csu1529257236449936.

    MLA Style (8th edition)

  • Pogul, Brinda. "CORTICAL REPRESENTATIONS AND MOTOR PERFORMANCE OF THE DIGITS IN PATIENTS WITH CARPAL TUNNEL SYNDROME." Master's thesis, Cleveland State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=csu1529257236449936

    Chicago Manual of Style (17th edition)

csu1529257236449936
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This open access ETD is published by Cleveland State University and OhioLINK.