Effects of carpal tunnel syndrome on adaptation of multi-digit forces to object texture

ObjectiveThe ability to adapt digit forces to object properties requires both anticipatory and feedback-driven control mechanisms which can be disrupted in individuals with a compromised sensorimotor system. Carpal tunnel syndrome (CTS) is a median nerve compression neuropathy affecting sensory and motor function in a subset of digits in the hand. Our objective was to examine how CTS patients coordinate anticipatory and feedback-driven control for multi-digit grip force adaptation.MethodsWe asked CTS patients and healthy controls to grasp, lift, and hold an object with different textures.ResultsCTS patients effectively adapted their digit forces to changes in object texture, but produced excessive grip forces. CTS patients also produced larger peak force rate profiles with fewer modulations of normal force prior to lift onset than did controls and continued to increase grip force throughout the lift whereas forces were set at lift onset for the controls.ConclusionsThese findings suggest that CTS patients use less online sensory feedback for fine-tuning their grip forces, relying more on anticipatory control than do healthy controls.SignificanceThese characteristics in force adaptation in CTS patients indicate impaired sensorimotor control which leads to excessive grip forces with the potential to further exacerbate their median nerve compression.

► We examine grip force adaptation in carpal tunnel syndrome (CTS) to understand how the Central Nervous System integrates sensory information from CTS-affected and non-affected digits with motor commands to fine-tune multi-digit forces to changes in object texture.► We found CTS patients were able to adapt their digit forces to texture but did so using excessive force which could lead to an exacerbation of the median nerve compression.► Such digit forces were produced through an imbalance between anticipatory and feedback control mechanisms.