Potential Use of a New Energy Vision (NEV) Camera for Diagnostic Support of Carpal Tunnel Syndrome: Development of a Decision-Making Algorithm to Differentiate Carpal Tunnel-Affected Hands from Controls

<b>Introduction:</b> Carpal Tunnel Syndrome (CTS) is a prevalent neuropathy requiring accurate, non-invasive diagnostics to minimize patient burden. This study evaluates the New Energy Vision (NEV) camera, an RGB-based multispectral imaging tool, to detect CTS through skin texture and color analysis, developing a machine learning algorithm to distinguish CTS-affected hands from controls. <b>Methods:</b> A two-part observational study included 103 participants (50 controls, 53 CTS patients) in Part 1, using NEV camera images to train a Support Vector Machine (SVM) classifier. Part 2 compared median nerve-damaged (MED) and ulnar nerve-normal (ULN) palm areas in 32 CTS patients. Validations included nerve conduction tests (NCT), Semmes-Weinstein monofilament testing (SWMT), and Boston Carpal Tunnel Questionnaire (BCTQ). <b>Results:</b> The SVM classifier achieved 93.33% accuracy (confusion matrix: [[14, 1], [1, 14]]), with 81.79% cross-validation accuracy. Part 2 identified significant differences (<i>p</i> < 0.05) in color proportions (e.g., red_proportion) and Haralick texture features between MED and ULN areas, corroborated by BCTQ and SWMT. <b>Conclusions:</b> The NEV camera, leveraging multispectral imaging, offers a promising non-invasive CTS diagnostic tool using detection of nerve-related skin changes. Further validation is needed for clinical adoption.