Local Effects of Acupuncture and Nerve Conduction Studies

Inclusion Criteria

• Presence of mild-moderate sensorimotor or sensory median neuropathy, established by pre-existing NCS/EMG study AND
• Baseline NCS study within the past 2 years, consistent with mild-moderate median entrapment neuropathy (CTS) defined as meeting any of the 3 conditions below:
• Prolonged distal Median sensory AND/OR motor latency
• Reduced Median sensory nerve action potentials (SNAP) amplitude by no more than 50%
• Amplitude of the compound muscle action potential (CMAP) recorded from APB > 50% of normal
• Presence of neuropathy symptoms consistent with CTS for at least 3 months

Exclusion Criteria

Conditions in which acupuncture/electroacupuncture may be contraindicated:

• Coagulopathy/ Current anti-coagulation treatment
• Epilepsy
• History of CAD or pacemaker insertion
• Pregnancy
• Presence of any skin condition in the arm, such as dermatitis, bruises, weeping skin, skin lesions, infected skin, or necrotic skin.

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, attention and ability to participate in QST
• 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 EtOH abuse (> 2 drinks/day)
• History of significant neurological disease which may affect sensation, e.g., strokes, Multiple Sclerosis, or spinal cord disorder
• Change in neuropathy medications within the past 2 months
• Change in opioid, benzodiazepines, SSRIs or other sedating medications in the past 2 months

Conditions, which predispose to generalized neuropathy

• Abnormal thyroid function tests (by history)
• 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
• Use of any investigational drugs within the previous six months

Exclusion Criteria based on NCS within the past 2 years:

• Presence of isolated motor Median neuropathy (absence of sensory neuropathy on NCS or absence of sensory symptoms)
• Severe neuropathy symptoms leading to inability to tolerate acupuncture or QST
• Presence of Severe Carpal Tunnel Syndrome, defined as:
• Absent sensory nerve action potential recorded from the second or fifth digit.
• The amplitude of the compound muscle action potential recorded from the APB or ADM is less than 50% of normal (< 2.5 mv)
• Presence of Ulnar neuropathy
• Presence of Martin-Gruber anastomosis

Secondary Exclusion Criteria after WEEK 1 Baseline QST and NCS measurements:

• Failure to comply with QST due to inattentiveness, etc
• Hyperalgesia on QST
• Hypoalgesia on QST
• Inability to confirm diagnosis of mild-moderate CTS (normal NCS)
• Inability to tolerate NCS/QST
• Presence Severe CTS
• Pure Motor Median Neuropathy
• Ulnar Neuropathy