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.

Ethics. The conclusion of the MEС of East Siberian Institute of Medical and Environmental Research — Protocol No. 5 dated 03/21/2013.

Contributions:
Rusanova D.V. — research concept and design, collection and processing of material, writing and formatting of the article, editing;
Lakhman O.L. — research concept and design, editing;
Slivnitsyna N.V. — collection and processing of material, writing an article, editing.
All co-authors — approving the final version of the article and ensuring the integrity of all parts of the article.

Funding. The study had funding.

Conflict of interest. The authors declare no conflict of interest.

Received: 24.01.2025 / Accepted: 23.02.2025 / Published: 07.04.2025

1. Babanov S.A., Kiryushina T.M. Electroneuromyographic studies in vibration disease. Terapevt. 2023; 8–9. https://elibrary.ru/cvjkxl https://doi.org/10.33920/MED-12-2308-04 (in Russian).

2. Krajnak K.M. Health effects associated with occupational exposure to hand-arm or whole-body vibration. J. Toxicol. Environ. Health. 2018; 21(5): 320–4. https://doi.org/10.1080/10937404.2018.1557576

3. Borzunova Y.M. Evoked potentials of the brain in assessing sensory and cognitive functions in miners of vibro-hazardous professions. Vestnik ural'skoy meditsinskoy akademicheskoy nauki. 2012; (1): 61–62 https://elibrary.ru/pbrfdd (in Russian).

4. Tkachenko P.V. Intersystem rectilinear correlation relationships of characteristics of stimulation electroneuromyography of symmetrical forearm nerves. Regional'nyj vestnik. 2019; 7(32): 2 https://clck.ru/3Hr9UE (in Russian).

5. Tkachenko P.V. Features of the intra-system correlation relationship between the characteristics of the M-response and the F-wave of the muscles and nerves of the forearms involved in the implementation of complexly coordinated bimanual movements. Byulleten' medicinskoj nauki. 2020; 1(17): 24–28 https://elibrary.ru/jgxvkq (in Russian).

6. Katamanova E.V., Kartapol'ceva N.V., Lakhman O.L., Rusanova D.V. Diagnosis of the severity of vibrational disease using evoked brain potentials. Izvestiya Samarskogo nauchnogo centra RAN. 2010; 1(7): 1829–1833 https://elibrary.ru/ndygnf (in Russian).

7. Sauni R., Toivo Р., Paakkonen R. Work disability after diagnosis of hand-arm vibration syndrome. International Archives of Occupational and Environmental Health. 2015; 88: 1061–1068. https://doi.org/10.1007/s00420-015-1034-1

8. Alifirova V.M., Tolmachev I.V., Koroleva E.S., Kucherova K.S. Somatosensory evoked potentials in evaluating the effectiveness of motor rehabilitation in patients with ischemic stroke. Effektivnost' motornoj reabilitacii posle insul'ta. 2020; 14(3): 29–36 https://elibrary.ru/cbmpxc https://doi.org/10.25692/ACEN.2020.3.10 (in Russian).

9. Grigorev F.N., Kuznecov N.A. Detection and estimation of parameters of evoked potentials. Informacionnye processy. 2015; 15 (4): 389–401 https://elibrary.ru/veghxd (in Russian).

10. Makarova I.I., Ignatova Y.P., Markova K.B. Evoked potentials of the brain as a bioelectric phenomenon that reflects the functional state of the nervous system. Verhnevolzhkij nevrologicheskij zhurnal. 2016; 15(3): 29–36. https://elibrary.ru/wiluif (in Russian).

11. Voitenkov V.B., Skripchenko N.V., Matyunina N.V., Klimkin A.V. The nature of impaired conduction along the central motor pathways in patients with serous meningitis. Zhurnal infektologii. 2014; 6(2): 19–23. https://elibrary.ru/ryrkcj (in Russian).

12. Balytskyi O.P. Using transcranial magnetic stimulation for studying functional state of motor centers in patients with ischemic stroke. Likars'kaSprava. 2013; (5): 75–80. https://pubmed.ncbi.nlm.nih.gov/24605637/

13. Le Q., Qu Y., Tao Y., Zhu S. Effects of repetitive transcranial magnetic stimulation on hand function recovery and excitability of the motor cortex after stroke: a meta-analysis. Am. J. Phys. Med. Reha–bil. 2014; 93: 422–30. https://doi.org/10.1097/phm.0000000000000027

14. Kwon H.G., Choi B.Y., Chang C.H., Kim S.H., Jung Y.J., Jang S.H. Recovery of an injured corticospinal tract during a critical period in a patient with intracerebral hemorrhage. NeuroRehabilitation. 2016; 32(1): 27–32. https://doi.org/10.3233/nre-130820

15. Nikolaev S.G. Elektronejromiografiya: klinicheskij praktikum. Ivanovo: PresSto; 2019 (in Russian)

16. Piradov M.A., Bakulin I.S., Zabirova A.H., Lagoda D.Y. Transcranial magnetic stimulation in clinical and research practice. Goryachaya liniya – Telekom; 2024 (in Russian).

17. Afina E.T., Nadezhdina M.V. Somatosensory evoked potentials in differential diagnostics of the level of damage to the brachial plexus. Ural'skij medicinskij zhurnal. 2014; 3: 9–14 https://elibrary.ru/sdejyb (in Russian).

18. Makogon I.S., Borzunova Y.M., Gogoleva O.I., Gusel'nikov S.R. The informational value of neurophysiological methods in the study of pathways and the functional state of the brain in miners. Fundamental'nye issledovaniya. 2012; 10: 60–64 https://clck.ru/3Hr9dS (in Russian).

19. Lakhman O.L., Rusanova D.V. Neurophysiological criteria for the diagnosis of vibrational disease. Medicina truda i promyshlennaya ekologiya. 2017; 9: 108 https://elibrary.ru/zfqkgr (in Russian).

20. Rukavishnikov V.S., Pankov V.A., Lakhman O.L., Bodienkova G.M., Druzhinina P.N., Kolycheva I.V., etc. General patterns of formation of nonspecific pathogenetic mechanisms under the influence of physical factors of the production environment on the body. Byulleten' VSNC SO RAMN. 2001; 2: 79–85 https://elibrary.ru/qcgxyn (in Russian).

21. Handford M., Lepine K., Boccia K., Ruddick F. Hand-arm vibration syndrome: Workers’ experience with functional impairment and disability. J. Hand. Ther. 2017; 30(4): 491–9. https://doi.org/10.1016/j.jht.2016.10.010

22. Rusanova D.V., Lakhman O.L. The state of the central and peripheral conductive structures in patients with vibration disease. Hygiene and Sanitation. 2019; 98(10): 1085–1090 https://doi.org/10.18821/0016-9900-2019-98-10-1085-1090 (in Russian).