There is no uniformity in the published literature from different laboratories on the optimal electrode configuration for recording nerve action potentials, and a number of standard texts omit any reference to the effects that interelectrode distance and electrode orientation can have on the shape, amplitude and latency of nerve action potentials. The sensory action potential from the digital nerves of the index finger was recorded at wrist and elbow using bipolar electrodes with the "active" electrode over the median nerve and the "reference" placed 4 cm laterally or proximally along the nerve using interelectrode distances of 4, 3 and 2 cm. These potentials were compared with that recorded using a remote reference on the ipsilateral shoulder, the assumption being that this configuration eliminated the contribution of the reference electrode to the compound nerve action potential. With different electrode configurations, there were significant differences in the shape of the potential, the latencies to onset and peak and the rising- and falling-phase amplitudes. The shorter the distance between the electrodes the greater the distortions. Overall, the distortions were least with the 4 cm interelectrode separation, particularly for short conduction distances.
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