1\) INCLUSION CRITERIA:
Participants aged 18-60 years will be categorized into three groups:
1. Healthy Control Group
2. Group Presenting with CTS-like Symptoms
3. Group Diagnosed with CTS Based on Defined Criteria
a) Healthy Control Group: Participants in this group will have no clinical symptoms consistent with CTS based on specified clinical criteria and will be considered normal according to the defined electrophysiological criteria.
b) Group Presenting with CTS-like Symptoms: Participants in this group may exhibit symptoms similar to clinically defined CTS; however, electrophysiological evaluations will show normal findings according to the defined criteria.
b.1) Clinical Findings / Symptoms:
b.1.1) Symptoms:
(A) Sensory symptoms in any of the 1st, 2nd, 3rd, or the radial part of the 4th finger
(B) Symptoms alleviated by shaking, squeezing, or other hand movements
(C) Pain or paresthesia associated with gripping or hand use
(D) Nocturnal paresthesia causing awakening from sleep
b.1.2) Diagnostic Tests / Signs:
1. Tinel Sign
2. Phalen Test
3. Reverse Phalen Test
4. Carpal Tunnel Compression Test
5. Flick Sign
A clinical diagnosis of CTS will require symptoms persisting for at least three months, with at least one of the B, C, or D symptoms in addition to symptom A, plus at least one positive diagnostic test or sign.
b.2) Electrophysiological Evaluation:
b.2.1) Mild CTS:
Median-to-ulnar sensory distal latency difference ≥ 0.4 ms at the 4th finger
Median nerve sensory distal latency ≥ 2.8 ms at the 2nd finger
Median nerve conduction velocity \< 50 m/s
Sensory nerve action potential ≥ 12 µV
b.2.2) Moderate CTS:
Median nerve distal motor latency at Abductor Pollicis Brevis (APB) 4 ms ≤ x \< 6.5 ms
Median nerve conduction velocity \< 50 m/s
Compound Muscle Action Potential (CMAP) ≥ 5 mV
b.2.3) Severe CTS:
Median nerve distal motor latency at APB ≥ 6.5 ms
Median nerve conduction velocity \< 50 m/s and/or CMAP \< 5 mV
c) Group Diagnosed with CTS Based on Defined Criteria: Participants in this group meet the clinical diagnostic criteria for CTS and additionally fulfill electrophysiological evaluation criteria for mild, moderate, or severe CTS.
2\) EXCLUSION CRITERIA:
2.a) Participants Diagnosed with CTS Based on Defined Criteria:
History of cardiac pacemaker
History of lymphedema in the affected extremity
History of cervical radiculopathy
Presence of ipsilateral upper extremity tenosynovitis
Presence of another compressive neuropathy in the ipsilateral upper extremity
History of peripheral polyneuropathy
Presence of metabolic disease
History of fracture in the hand, wrist, or forearm
Current pregnancy
Open wound on the wrist
Uncontrolled medical conditions (including endocrinological, cardiovascular, pulmonary, hematological, hepatic, renal, active systemic inflammatory disease, and/or malignancy)
History of inflammatory rheumatologic or autoimmune disease
Age \<18 years or \>60 years
Trauma to the wrist or median nerve within the last 3 months
Received any injection in the wrist
Undergone any surgical procedure on the wrist
Mental or cognitive incapacity preventing understanding or completion of questionnaires
2.b) Participants Presenting with CTS-like Symptoms:
Mental or cognitive incapacity preventing understanding or completion of questionnaires
Age \<18 years or \>60 years
CTS diagnosis confirmed based on clinical and electrophysiological criteria
2.c) Healthy Control Group Participants:
Mental or cognitive incapacity preventing understanding or completion of questionnaires
Age \<18 years or \>60 years
Presence of any clinical symptoms potentially related to CTS based on defined clinical criteria
Electrophysiological findings consistent with CTS
