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Sural radial amplitude ratio: A study in healthy Indian subjects

1 Clinical Neurophysiology, Bombay Hospital, Mumbai, Maharashtra, India
2 Neuro-Electrophysiologist, Dhonde Hospital, Nanded, Maharashtra, India
3 Neurophysiologist CNS Clinic, Navi Mumbai, Maharashtra, India
4 Associate Consultant, Bombay Hospital, Mumbai, Maharashtra, India
5 Neurophysiologist, Apollo Hospital, Navi Mumbai, Maharashtra, India
6 Junior Consultant, Bombay Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Khushnuma Mansukhani,
Bombay Hospital, EMG Department, 2nd Floor, MRC Building, 12, Marine Lines, Mumbai - 0400020, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.AIAN_321_20

Context: The amplitude ratio of sural radial sensory nerve action potential is used as a sensitive measure for the diagnosis of an early distal axonal peripheral neuropathy. There is no age-stratified reference data available. Aim: To establish age-stratified sural radial amplitude ratio (SRAR) reference data in healthy Indian subjects. Study Setting and Design: The study was conducted in the electrodiagnostic laboratory of a tertiary city hospital and is an analytical, prospective, and field trial study.Materials and Methods: A prospective study was conducted on 146 healthy volunteers between 18 and 86 years, stratified into 6 groups, a = 18–30 years, b = 31–40 years, c = 41–50 years, d = 51–60 years, e = 61–70 years, and f = >70 years. Sural: Radial amplitude ratio was calculated. Statistical Methods: Stata 12.1 statistical program was used. Lower limit of SRAR was obtained (mean-2SD of transformed data). ANOVA defined the intergroup variability, and linear regression and Pearson's correlation assessed the statistical significance. Results: The lower limit of normal SRAR, for each age group is as follows: a: 0.30, b: 0.23, c: 0.20, d: 0.17, e: 0.17, and f: 0.08. SRAR of groups a, b, c was significantly different from groups e and f. Similarly, SRAR was significantly different between groups d and f but not between groups d and e or a, b, c, d. Conclusion: This study provides age-stratified reference data for SRAR. There is evidence to suggest that SRAR varies with age; hence, a single value of SRAR should not be used when diagnosing a peripheral neuropathy based on this criterion.

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    -  Mansukhani K
    -  Dhonde M
    -  Sreenivasan A
    -  Sharma A
    -  Balakrishnan L
    -  Chavan P
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