TALLINN UNIVERSITY OF TECHNOLOGY

Department of Health Technologies

IHB0160 – Biomedical Sensors

Nerve conduction velocity

sensors
Report

Sonja Taupadel – 230466IV

Taavi Salum – 221964IVEM

Instructor: Professor Ivo Fridolin

Date of conduct: 16.04.2023

Date of delivery: 18.04.2023

Tallinn 2023
TABLE OF CONTENTS

1. INTRODUCTION .............................................................................................................. 3
2. METHOD AND PRINCIPLE OF NERVE CONDUCTION VELOCITY SENSORS .... 4
2.1. Principle ....................................................................................................................... 5
2.2. Method ......................................................................................................................... 6
2.3. Limitations ................................................................................................................... 7
3. RESULTS AND APPLICABILITY OF NERVE CONDUCTION VELOCITY
SENSORS .................................................................................................................................. 8
4. CONCLUSION .................................................................................................................. 9
5. REFERENCES ................................................................................................................. 10

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1. INTRODUCTION

The nervous system is responsible for the communication between various parts of the body,
making it an essential component of human functioning. Any damage or impairment to the
nerves can cause a wide range of neurological conditions and neuropathy. One of the most
important tools in diagnosing and managing these conditions is nerve conduction velocity
(NCV) testing. NCV measures the speed at which electrical impulses travel through nerves,
providing valuable insights into nerve function and detecting any damage or abnormalities.

To perform NCV testing, nerve conduction velocity sensors are used. These sensors are small
electrodes placed on the skin above the nerve being tested. They send a small electrical impulse
through the nerve and record the time it takes for the impulse to travel from one electrode to
another. The resulting data can be used to calculate nerve conduction velocity and provide
essential information about the health and function of the nervous system.

This report explores the use of nerve conduction velocity sensors in the diagnosis and
management of neurological conditions. It examines the different types of sensors available,
their applications in clinical practice, and the limitations and challenges associated with their
use.

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2. METHOD AND PRINCIPLE OF NERVE CONDUCTION
VELOCITY SENSORS

Nerve conduction velocity testing is a non-invasive diagnostic tool used to evaluate the function
of nerves in the body. The test measures the speed at which electrical impulses travel through
nerves, providing important information about nerve health and detecting any abnormalities or
damage. [1]

NCV testing is commonly employed in the diagnosis and management of a range of

neurological conditions, such as peripheral neuropathy, carpal tunnel syndrome, radiculopathy,
and nerve injuries. It can also help assess the severity of nerve damage and track the progression
of nerve disorders over time. [1]

The test involves placing nerve conduction velocity sensors on the skin above the nerve being
tested. An electrical impulse is then delivered to the nerve using one of the sensors, while the
other sensors record the time it takes for the impulse to travel along the nerve (Figure 1). This
data is analysed to calculate the velocity of the impulse and provide information about the
nerve's function. [1]

Figure 1. Electrode placements for a typical median NCS [2]

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The velocity of the nerve impulse is affected by factors like the size of the nerve, the degree of
myelination, and the temperature of the body. Typically, larger nerves with more myelin have
faster conduction velocities than smaller nerves with less myelin. Lower body temperature can
result in slower conduction velocities, affecting the test results. [3]

NCV testing is a safe and painless procedure, although patients may experience some
discomfort during the test due to the electrical impulses. The test usually lasts between 10 and
60 minutes, depending on the number of nerves being tested. [4]

2.1. Principle

The principle underlying NCV testing is that nerves transmit electrical signals, which are
generated by the movement of charged ions across the nerve cell membrane. The speed of these
signals is determined by the size and myelination of the nerve, which affects the resistance of
the nerve to the flow of ions. [5]

Nerve conduction velocity testing is based on the concept that the velocity of the nerve impulse
is directly proportional to the distance it must travel and inversely proportional to the resistance
of the nerve. Larger and more myelinated nerves have lower resistance and faster conduction
velocities than smaller and less myelinated nerves. The conduction velocity formula can be seen
below. [6]

𝑚 𝑑𝑖𝑠𝑡𝑎𝑛𝑐𝑒(𝑚)
𝐶𝑜𝑛𝑑𝑢𝑐𝑡𝑖𝑜𝑛 𝑣𝑒𝑙𝑜𝑐𝑖𝑡𝑦( )=
𝑠𝑒𝑐 𝑡𝑖𝑚𝑒(𝑠𝑒𝑐)

During NCV testing, nerve conduction velocity sensors are placed on the skin above the nerve
being evaluated. One sensor delivers a brief electrical stimulus to the nerve, while the other
sensors record the time it takes for the impulse to travel along the nerve. The data obtained is
then used to calculate the velocity of the impulse and determine the nerve's function. [5]

The electrical stimulus used during NCV testing is usually of low intensity and produces a
depolarization wave that travels along the nerve fibre. This causes the release of

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neurotransmitters that stimulate downstream nerve cells, and the resulting electrical activity is
detected by the sensors placed on the skin over the nerve. [3]

Here are few common conduction velocity values for different peripheral nerves [3]:
 Median sensory: 45 – 70 m/s
 Median motor: 49 – 64 m/s
 Ulnar sensory: 48 – 74 m/s
 Ulnar motor: 49+ m/s
 Peroneal motor: 44+ m/s
 Tibial motor: 41+ m/s
 Sural sensory: 46 – 64 m/s

It is also important to consider the amplitude of the NCV test signal due to characteristics of
each person and it may give better overview of the problems the patient might have. For
example the sural nerve conduction amplitude is significantly smaller in females, people with
diabetes have lower amplitude. Additionally, for carpal tunnel syndrome the amplitude has a
certain pattern which the doctor can recognize. [3]

2.2. Method

Nerve conduction velocity testing is a specialized procedure typically performed in a clinical

setting by a neurologist or specialist in nerve function testing. The test is designed to evaluate
the health and function of nerves by measuring the speed at which electrical impulses travel
along them. The following steps are typically involved in NCV testing: [5]

1. Preparation: Before the test, the patient is typically asked to remove clothing from the
area and remove watches and accessories. After this nurse cleans the testing area from
oil or cream on the skin. It is advised not to be in contact with any metal objects like
patient table since it can make the test hurt more.
2. Stimulation: During the test, a small electrical impulse is delivered to the nerve using
one of the sensors, and the other sensors record the time it takes for the impulse to travel
along the nerve. The electrical impulse is typically produced by a device which is
connected to wall outlet. The device must have isolated power rails in order to avoid
shocking the patient with high voltage. The intensity of the impulse is carefully
controlled to ensure that it is safe and does not cause discomfort to the patient.

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 3. Recording: The resulting data is recorded and analysed to calculate the velocity of the
nerve impulse and assess nerve function. The sensors used during the test can detect
very small electrical signals, and the data obtained is usually displayed on a computer
monitor or printed out for analysis.
4. Interpretation: Once the test is complete, the results are interpreted by the neurologist
or specialist in nerve function testing. The results are analysed to determine the speed
at which the nerve impulses travelled along the nerve being tested. Any abnormalities
or differences from normal values are noted, and a diagnosis or further testing may be
recommended based on the results.

2.3. Limitations

Nerve conduction velocity testing is a valuable diagnostic tool used to assess the function of
nerves in the body by measuring the speed at which electrical impulses travel through nerves.
Despite its usefulness, NCV testing has limitations that must be considered. Factors such as
body temperature, age, and medical conditions can affect the accuracy of the test [7]. Moreover,
some patients may experience discomfort during the test due to the electrical impulses delivered
to the skin. It is also important to inform the doctor a patient has a pacemaker since the
electrodes used in NCV test may affect the electronic impulses of the medical device [4].

However, despite these limitations, NCV testing remains an essential tool for healthcare
providers in the diagnosis and management of neurological conditions. NCV testing can
provide critical information about nerve health and function, allowing for accurate diagnoses
and the development of effective treatment plans. It is often used to diagnose conditions such
as carpal tunnel syndrome, peripheral neuropathy, and radiculopathy, among others, and to
monitor the progression of neurological conditions and evaluate the effectiveness of treatment.
[7]

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3. RESULTS AND APPLICABILITY OF NERVE
CONDUCTION VELOCITY SENSORS

Nerve conduction velocity testing is a highly applicable and accurate diagnostic tool used to
assess nerve function and diagnose various neurological conditions. The accuracy of NCV
testing depends on several factors, including the type of test, the location of the nerves being
tested, and the experience and skill of the healthcare professional administering the test. In
general, however, NCV testing is considered a highly reliable and accurate tool for assessing
nerve function and diagnosing conditions such as carpal tunnel syndrome, peripheral
neuropathy, and radiculopathy. [4]

One study conducted by Strickland (2010) evaluated the accuracy of NCV testing in the
diagnosis of median neuropathy [8]. The study found that NCV testing had a sensitivity of 88%
and a specificity of 93% in diagnosing median neuropathy, demonstrating its high accuracy and
applicability in this context [8]. Similarly, another study by Alanazy (2017) found that NCV
testing was highly accurate in diagnosing carpal tunnel syndrome, with a sensitivity of larger
than 85% and a specificity of 95% [9].

Overall, these studies demonstrate the applicability and accuracy of NCV testing in diagnosing
various neurological conditions. The results of NCV testing can provide critical information
about nerve function and health, allowing for accurate diagnoses and effective treatment plans.
While NCV testing may have some limitations and discomfort for patients, its reliability and
accuracy make it an essential tool in the field of neurology.

In addition to its diagnostic capabilities, NCV testing can also be used to monitor the
progression of neurological conditions and evaluate the effectiveness of treatment. For
example, a study by Islam et al. (2018) found that NCV testing was effective in monitoring the
progression of diabetic neuropathy and evaluating the effectiveness of treatment in patients with
diabetes. [10]

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4. CONCLUSION

To sum up, nerve conduction velocity testing is a valuable diagnostic tool that helps evaluate
nerve function by measuring the speed at which electrical impulses travel through nerves. This
test is based on the principle that nerves transmit electrical signals generated by charged ions
moving across the nerve cell membrane. The velocity of these signals depends on the nerve's
size and myelination, which affects its resistance to ion flow.

NCV testing is typically conducted by a neurologist or a specialist in nerve function testing in

a clinical setting. The test involves applying electrical impulses to the skin, and the sensors
record the time it takes for the impulse to travel along the nerve. The resulting data is analysed
to determine the nerve's function and detect any abnormalities or damage.

While NCV testing has limitations, its applicability and accuracy have been demonstrated in
various studies. It is a reliable diagnostic tool for detecting nerve disorders such as carpal tunnel
syndrome, peripheral neuropathy, and nerve injuries. Additionally, NCV testing is useful in
monitoring the progression of these conditions and evaluating the effectiveness of treatments.

In conclusion, NCV testing provides essential information about nerve health and function,
making it an important tool for neurologists and other medical professionals. Its ability to
diagnose nerve-related conditions, monitor their progression, and assess treatment efficacy
highlights its critical role in the field of neurology.

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5. REFERENCES

[1] The Johns Hopkins University, “Nerve Conduction Studies,” The Johns Hopkins
University, [Online]. Available: https://www.hopkinsmedicine.org/health/treatment-
tests-and-therapies/nerve-conduction-studies. [Accessed 9 April 2023].
[2] X. Kong, E. Lesser and S. Gozani, “Nerve Conduction Studies: Clinical Challenges and
Engineering Solutions,” 18 March 2010. [Online]. Available:
https://ieeexplore.ieee.org/document/5431932. [Accessed 16 April 2023].
[3] Wikimedia Foundation, Inc., “Nerve conduction velocity,” Wikimedia Foundation, Inc.,
13 February 2023. [Online]. Available:
https://en.wikipedia.org/wiki/Nerve_conduction_velocity. [Accessed 9 April 2023].
[4] A. Balingit, “Nerve Conduction Velocity (NCV) Test: What to Expect,” Healthline
Media LLC, 3 June 2021. [Online]. Available: https://www.healthline.com/health/nerve-
conduction-velocity. [Accessed 9 April 2023].
[5] University of Rochester Medical Center Rochester, “Nerve Conduction Velocity,”
University of Rochester Medical Center Rochester, [Online]. Available:
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&content
id=p07657#:~:text=A%20nerve%20conduction%20velocity%20(NCV,patches%20put
%20on%20your%20skin.. [Accessed 9 April 2023].
[6] OpenWetWare, “Lab 9: Conduction Velocity of Nerves,” OpenWetWare, 1 April 2016.
[Online]. Available:
https://openwetware.org/wiki/Lab_9:_Conduction_Velocity_of_Nerves#:~:text=The%
20conduction%20velocity%20of%20the%20action%20potential%20is%20determined
%20by,m)%2Ftime%20(sec).. [Accessed 9 April 2023].

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[7] National Library of Medicine, “Nerve conduction velocity,” National Library of
Medicine, 4 May 2021. [Online]. Available:
https://medlineplus.gov/ency/article/003927.htm. [Accessed 9 April 2023].
[8] J. W. Strickland and S. N. Gozani, “Accuracy of in-office nerve conduction studies for
median neuropathy: a meta-analysis,” 6 December 2010. [Online]. Available:
https://www.jhandsurg.org/article/S0363-5023(10)01111-1/fulltext#articleInformation.
[Accessed 15 April 2023].
[9] M. H. Alanazy, “Clinical and electrophysiological evaluation of carpal tunnel syndrome:
approach and pitfalls,” July 2017. [Online]. Available:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946360/pdf/Neurosciences-22-
169.pdf. [Accessed 15 April 2023].
[10] R. Islam, T. Rahman, R. Habib, R. Irfan, R. Habib, N. B. Bhowmik and A. Haque,
“Electrophysiological Patterns of Diabetic Polyneuropathy: Experience from a Tertiary
Care Hospital of Bangladesh,” Bangladesh Journals Online, May 2017. [Online].
Available:
https://www.researchgate.net/publication/316735332_Electrophysiological_Patterns_of
_Diabetic_Polyneuropathy_Experience_from_a_Tertiary_Care_Hospital_of_Banglades
h. [Accessed 15 April 2023].

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