Abstract：
Neurogenic thoracic outlet syndrome (NTOS) is a disabling condition. Its diagnosis remains challenging and is mainly guided by examination. Yet, electrophysiological evaluations are the gold standard for diagnosis of entrapment syndromes. We aimed to assess the interest of electrophysiological evaluation to diagnose NTOS. A systematic literature research was performed using PubMed, ScienceDirect, Embase, Cochrane and Google Scholar databases to collect studies reporting results of electrophysiological assessment of patients with NTOS. Then, a meta-analysis was conducted. Nine studies were eligible and concerned two hundred and thirteen patients. Results were heterogenous among studies and the quality of evidence was very low to moderate. Data could not evaluate sensitivity or specificity of electrophysiological evaluations for NTOS. The meta-analysis found significantly decreased amplitudes of medial antebrachial cutaneous nerve SNAP (sensory nerve action potential), ulnar SNAP, median CMAP (compound motor action potential) and ulnar CMAP. Needle examination found abnormalities for the abductor pollicis brevis, first dorsal interosseous and adductor digiti minimi. Unlike most upper-limb entrapment syndromes, nerve conduction assessment only provided clues in favour of NTOS. Decreased amplitude for ulnar SNAP, medial antebrachial cutaneous SNAP, median CMAP and ulnar CMAP should be assessed, as well as needle examination. Larger studies are needed to evaluate the sensitivity and specificity of electrophysiology in NTOS diagnosis.
摘要：
神经源性胸廓出口综合征（NTOS）是一种致残疾病。它的诊断仍然具有挑战性，主要由检查指导。然而，电生理评估是诊断诱捕综合征的金标准。我们旨在评估电生理评估对诊断NTOS的兴趣。使用PubMed进行了系统的文献研究，ScienceDirect,Embase,Cochrane和GoogleScholar数据库收集报告NTOS患者电生理评估结果的研究。然后，进行了荟萃分析.九项研究符合资格，涉及两百十三例患者。研究结果不一致，证据质量非常低至中等。数据无法评估NTOS电生理评估的敏感性或特异性。荟萃分析发现前臂内侧皮神经SNAP（感觉神经动作电位）的振幅显着降低，尺骨SNAP,中位CMAP(复合运动动作电位)和尺骨CMAP。针头检查发现短腿外展肌异常，第一背侧小骨间和内收肌。与大多数上肢压迫综合征不同，神经传导评估仅提供了有利于NTOS的线索.尺骨SNAP的振幅降低，前臂内侧皮肤SNAP，应评估正中CMAP和尺骨CMAP，以及针头检查。需要更大规模的研究来评估电生理学在NTOS诊断中的敏感性和特异性。
