Table 1 Inclusion/exclusion criteria
Inclusion criteria | Age: 18–75 |
Sex: M, F | |
CTS diagnosis: EMG at OHSU’s EMG lab within the past 2 years, meeting criteria for mild-to-moderate CTS | |
CTS symptoms: Present for at least 3 months [42] | |
EMG inclusion criteria: mild-moderate median entrapment neuropathy (CTS) defined as meeting any of the following 3 conditions [40, 41]: 1. Prolonged distal median sensory AND/OR motor latency 2. Reduced median sensory nerve action potential (SNAP) amplitude by no more than 50% 3. Amplitude of the compound muscle action potential (CMAP) recorded from abductor pollicis brevis (APB) > 50% of normal | |
Exclusion criteria | Conditions in which acupuncture/electroacupuncture may be contraindicated: - Coagulopathy/current anti-coagulation treatment - Epilepsy - Cardiac pacemaker - Pregnancy - Presence of any skin condition in the arm, such as dermatitis, bruises, other skin lesions |
Conditions in which QST testing may be contraindicated: - Significant cognitive impairment such as diagnosis of Alzheimer’s disease or mental retardation or any other condition interfering with alertness and/or attention - Hospitalization for anxiety or depression in the past 3 months - Current psychiatric diagnoses (other than anxiety or depression) - Illicit drug use in the past month - Current alcohol abuse (>  2 drinks/day) - History of significant neurological disease which may affect sensation: strokes, multiple sclerosis, or spinal cord disorder - Change in neuropathy medications within the past 2 months - Change in opioids, benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), or other sedating medications in the past 2 months | |
Conditions which predispose to generalized neuropathy: - Diabetes mellitus - Uncorrected hypothyroidism - Past chemotherapy treatment | |
Other contraindications: - History of wrist or elbow fracture, past arm trauma, loss of fingers, scarring - History of carpal tunnel release surgery or any other surgery on the arm or shoulder - History of arthritis in the hand and elbow - Use of any investigational drugs within the previous 6 months | |
EMG exclusion criteria; presence of severe CTS, defined as: 1. Absent SNAP recorded from the second digit AND/OR: 2. The amplitude of the CMAP recorded from the ABP muscle is less than 50% of normal (<  2.5 mV) [40, 41] Other EMG exclusion criteria: • Presence of ulnar neuropathy, peripheral neuropathy, or radiculopathy • Presence of Martin-Gruber anastomosis | |
Secondary exclusion criteria | Following Week 1 baseline QST and NCS measurements: - Severe CTS symptoms leading to inability to tolerate acupuncture or QST - Inability to tolerate NCS or QST - Failure to comply with QST due to inattentiveness, etc. - Hyperalgesia or hypoalgesia on QST - Presence of Martin-Gruber anastomosis - Presence of severe CTS - Pure motor median neuropathy - Ulnar neuropathy |