Comprehensive assessment of the nervous system in patients with vibration disease associated with the combined effects of local and general vibration

Introduction. Under the influence of industrial vibration, disorders form in various body systems, including the central nervous system (CNS). It is advisable to detect changes in the structures of the nervous system by conducting electroneuromyography (ENMG) with testing of sensory and motor axons with F-wave registration, determination of somatosensory evoked potentials, peripheral transcranial magnetic stimulation. The study aims to provide a comprehensive assessment of the structures of the nervous system (peripheral nerves, spinal cord neurons, thalamic region, cortical representation) in patients with vibration disease associated with the combined effects of local and general vibration. Materials and methods. 36 patients with vibration disease were examined, with an average age of 54.8±5.35 years, and an average length of service of 17.9±2.8 years. The results obtained during the study were compared with a control group (CG) of 46 people (48.37±4.18 years) who had no contact with vibration. The researchers conducted an electroneuromyography (ENMG) with testing of the sensory component of peripheral nerves, with the determination of the F-wave and the registration of somatosensory evoked potentials in the upper and lower extremities on the Neuro-EMG-Micro electroneuromyograph (Neurosoft LLC). The specialists have completed peripheral transcranial magnetic stimulation during median nerve testing. Results. In afferent conducting structures, there is a decrease in the speed of conducting an impulse along axons on the arms and legs, and a decrease in the amplitude of the action potential on the legs, the transit time of excitation in the popliteal fossa decreases, the excitability of neurons in the cervical and lumbar spine, subcortical structures (the thalamic nuclei zone) and in the somatosensory cortex decreases. In efferent conducting structures, a decrease in the rate of conduction of an impulse along the nerves of the upper and lower extremities, damage to the motor neurons of the primary motor cortex, neurons of the corticospinal tract and at the level of the lumbar and cervical spine was found. Limitations. A limitation of the study is the fact that transcranial magnetic stimulation was not performed when testing the nerves of the lower extremities. Conclusion. In patients with vibration disease associated with the combined effects of local and general vibration, a decrease in the rate of pulse conduction along afferent axons in the upper extremities was revealed, and a decrease in the action potential of the nerve trunk in the lower extremities. A violation of the pulse conduction time along the afferent pathways of the lumbar and cervical spine has been established. A slowdown in the activation of neurons of afferent conducting structures in the thalamic region, in the area of the somatosensory cortex, as well as a slowdown in the depolarization of efferent neurons of the primary motor cortex and the corticospinal tract was revealed.