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\cols2\colno1\colw7653\colsr-0\colno2\colw3440\pard\li720\ri0\sl-133\slmult0 \fs
14\cf0\f0\charscalex100 {European Journal of Neurology}{ }\fs14\cf0\f0\charscale
x100 {2011,}{ }\fs14\cf0\f0\charscalex100 {18:}{ }\fs14\cf0\f0\charscalex100 {72
6\uc1\u8211X730}\par\column\pard\li0\ri0\sl-133\slmult0 \fs12\cf0\f0\charscalex1
00 {doi:10.1111/j.1468-1331.2010.03261.x}\par\pard\sect\sectd\sbknone\pard\li720
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li720\ri0\sl-493\slmult0 \fs32\cf0\f0\charscalex100 {Gabapentin for the treat
ment of carpal tunnel syndrome: a}\par\pard\li720\ri0\sl-386\slmult0 \fs32\cf0\f
0\charscalex100 {randomized controlled trial}\par\pard\li720\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li720\ri0\sl-240\slmult0 \fs22\cf0\f0\charscalex100 {A. C. F.
Hui, S. M. Wong, H. W. Leung, B. L. Man, E. Yu and L. K. S. Wong}\par\pard\li72
0\ri0\sl-226\slmult0 \fs16\cf0\f0\charscalex100 {Department of Medicine, Electro

diagnostic Unit, Prince of Wales Hospital, Chinese University of Hong Kong, Shat
in, Hong Kong}\par\pard\sect\sectd\sbknone\cols2\colno1\colw3106\colsr-0\colno2\
colw7986\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex10
0 {Keywords:}\par\pard\li720\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {carp
al tunnel syndrome,}\par\pard\li720\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex10
0 {clinical and diagnos-}\par\pard\li720\ri0\sl-240\slmult0 \fs18\cf0\f0\charsca
lex100 {tic, clinical neurophysi-}\par\pard\li720\ri0\sl-240\slmult0 \fs18\cf0\f
0\charscalex100 {ology, investigations,}\par\pard\li720\ri0\sl-240\slmult0 \fs18
\cf0\f0\charscalex100 {neurological disorders,}\par\pard\li720\ri0\sl-240\slmult
0 \fs18\cf0\f0\charscalex100 {neuromuscular diseases,}\par\pard\li720\ri0\sl-226
\slmult0 \fs18\cf0\f0\charscalex100 {neuropathic pain, pain,}\par\pard\li720\ri0
\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {peripheral neuropathies,}\par\pard\l
i720\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {randomized clinical trial}\p
ar\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-240\slmult0 \fs
16\cf0\f0\charscalex100 {Received 5 July 2010}\par\pard\li720\ri0\sl-200\slmult0
\fs16\cf0\f0\charscalex100 {Accepted 11 October 2010}\par\pard\li720\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li72
0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-373\slmult0 \fs20\cf0\f0\ch
arscalex100 {Introduction}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-226\slmult0 \*\tx9
60\fs18\cf0\f0\charscalex100 {Objective:}\tab \fs18\cf0\f0\charscalex100 {Based
on its e\uc1\u64259Xcacy in treating neuropathic pain, gabapentin may be}\par\pa
rd\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {e\uc1\u64256Xective for th
e treatment of carpal tunnel syndrome (CTS). The purpose of this study}\par\pard
\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {was to evaluate the e\uc1\u6
4259Xcacy of gabapentin for symptom relief in CTS.}\par\pard\li0\ri0\sl-240\slmu
lt0 \*\tx906\fs18\cf0\f0\charscalex100 {Methods:}\tab \fs18\cf0\f0\charscalex100
{We conducted a randomized, double-blinded, placebo-controlled trial}\par\pard\
li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {recruiting patients with newl
y diagnosed idiopathic CTS of more than a period of}\par\pard\li0\ri0\sl-240\slm
ult0 \fs18\cf0\f0\charscalex100 {three months. Diagnosis was based on characteri
stic symptoms with electrophysio-}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\
charscalex100 {logical con\uc1\u64257Xrmation. Patients were randomly assigned t
o an active group receiving}\par\pard\li0\ri0\sl-226\slmult0 \fs18\cf0\f0\charsc
alex100 {gabapentin (starting dose 300 mg once daily to a target of 900 mg daily
) or a placebo}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {grou
p. Primary end-point was the global symptom score (GSS), which was measured}\par
\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {at baseline, two, and e
ight weeks.}\par\pard\li0\ri0\sl-253\slmult0 \*\tx786\fs18\cf0\f0\charscalex100
{Results:}\tab \fs18\cf0\f0\charscalex100 {There was no signi\uc1\u64257Xcant di
\uc1\u64256Xerence in baseline variables between the two}\par\pard\li0\ri0\sl-22
6\slmult0 \fs18\cf0\f0\charscalex100 {treatment groups. Hundred and forty patien
ts were enrolled in the study, of whom 71}\par\pard\li0\ri0\sl-240\slmult0 \fs18
\cf0\f0\charscalex100 {were randomly assigned to gabapentin group and 69 assigne
d to placebo group. Both}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscale
x100 {gabapentin and placebo produced signi\uc1\u64257Xcant improvement in sympt
oms at two and}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {eigh
t weeks. The GSS at 2 and 8 weeks was 16.4 (SD 9.4) and 13.4 (SD 9.7),}\par\pard
\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {respectively, in the active
group versus 14.9 (SD 9.0) and 12.5 (SD 8.9) in the control}\par\pard\li0\ri0\sl
-240\slmult0 \fs18\cf0\f0\charscalex100 {group (}\fs18\cf0\f0\charscalex100 {P}{

}\fs18\cf0\f0\charscalex100 {< 0.01). But by eight weeks, the mean reduction in

symptom severity of}\par\pard\li0\ri0\sl-266\slmult0 \fs18\cf0\f0\charscalex100
{patients on gabapentin [}\fs18\cf0\f0\charscalex100 {)}\fs18\cf0\f0\charscalex
100 {10.4 (SD 10.8)] was not signi\uc1\u64257Xcant when compared with}\par\pard\
li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {placebo [}\fs18\cf0\f0\charsc
alex100 {)}\fs18\cf0\f0\charscalex100 {8.7 (SD 8.1),}{ }\fs18\cf0\f0\charscalex1
00 {P}{ }\fs18\cf0\f0\charscalex100 {< 0.39]. Adverse events were not severe and
included diz-}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {zine
ss, somnolence, and headache.}\par\pard\li0\ri0\sl-240\slmult0 \*\tx1146\fs18\cf
0\f0\charscalex100 {Conclusions:}\tab \fs18\cf0\f0\charscalex100 {Gabapentin did
not produce a signi\uc1\u64257Xcant reduction in symptom severity}\par\pard\li0
\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {compared with placebo over an ei
ght-week period.}\par\pard\li2453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2453\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li2453\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li2453\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2453\ri0\sl-280\slmult0 \fs20\c
f0\f0\charscalex100 {Methods}\par\pard\sect\sectd\sbknone\cols2\colno1\colw5560\
colsr-0\colno2\colw5533\pard\li720\ri0\sl-360\slmult0 \fs18\cf0\f0\charscalex100
{The treatment of carpal tunnel syndrome (CTS)}\par\pard\li720\ri0\sl-240\slmul
t0 \fs16\cf0\f0\charscalex100 {includes splinting, oral drugs, steroid injection
s, and}\par\pard\li720\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {decompress
ive surgery, but there is no agreement as to}\par\pard\li720\ri0\sl-240\slmult0
\fs16\cf0\f0\charscalex100 {\uc1\u64257Xrst-line therapy of choice [1\uc1\u8211X
4]. Previous studies have}\par\pard\li720\ri0\sl-240\slmult0 \fs16\cf0\f0\charsc
alex100 {con\uc1\u64257Xrmed the e\uc1\u64256Xect of gabapentin (1-[aminomethyl]
-}\par\pard\li720\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {cyclohexaneacet
ic acid; Neurontin, P\uc1\u64257Xzer) in relieving}\par\pard\li720\ri0\sl-240\sl
mult0 \fs16\cf0\f0\charscalex100 {neuropathic pain syndromes such as trigeminal
neu-}\par\pard\li720\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {ralgia, diab
etic neuropathy, re\uc1\u64258Xex sympathetic dystro-}\par\pard\li720\ri0\sl-240
\slmult0 \fs16\cf0\f0\charscalex100 {phy, multiple sclerosis, and post-herpetic
neuralgia}\par\pard\li720\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {[5\uc1\
u8211X8]. The objective of this study was to evaluate the}\par\pard\li720\ri0\sl
-226\slmult0 \fs16\cf0\f0\charscalex100 {safety and e\uc1\u64259Xcacy of gabapen
tin in the treatment of}\par\pard\li720\ri0\sl-240\slmult0 \fs18\cf0\f0\charscal
ex100 {idiopathic CTS.}\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li7
20\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li720\ri0\sl-186\slmult0 \fs14\cf0\f0\charscalex100 {Correspondence: A. C.
F. Hui, Department of Medicine, Electrodi-}\par\pard\li720\ri0\sl-200\slmult0 \f
s12\cf0\f0\charscalex100 {agnostic Unit, Prince of Wales Hospital, Chinese Unive
rsity of Hong}\par\pard\li720\ri0\sl-200\slmult0 \fs12\cf0\f0\charscalex100 {Kon
g, Shatin, Hong Kong (tel.: (852) 23661888; fax: (852) 23664555;}\par\pard\li720
\ri0\sl-200\slmult0 \fs14\cf0\f0\charscalex100 {e-mail: neurologycare@yahoo.com)
.}\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li720\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {726}\pa
r\column\pard\li0\ri0\sl-360\slmult0 \fs18\cf0\f0\charscalex100 {This randomized
, double-blinded, controlled trial was}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf
0\f0\charscalex100 {performed to determine the e\uc1\u64256Xectiveness of gabape
ntin}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {compared with
placebo for CTS. The study enrolled}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f
0\charscalex100 {consecutive patients with newly diagnosed idiopathic}\par\pard\
li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {CTS for more than three month
s and was conducted at}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex1
00 {a single center, The Prince of Wales Hospital, Hong}\par\pard\li0\ri0\sl-240
\slmult0 \fs18\cf0\f0\charscalex100 {Kong, China. Diagnosis was based on charact
eristic}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {symptoms an
d electrophysiological study (EPS) con-}\par\pard\li0\ri0\sl-240\slmult0 \fs18\c
f0\f0\charscalex100 {\uc1\u64257Xrmation in keeping with standard guidelines [9]
.}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {Motor and sensory
nerve conduction studies were per-}\par\pard\li0\ri0\sl-226\slmult0 \fs18\cf0\f
0\charscalex100 {formed in median and ulnar nerves using standard}\par\pard\li0\

ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {techniques of supramaximal stimul

ation and surface}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {e
lectrodes. Compound muscle action potentials, distal}\par\pard\li0\ri0\sl-240\sl
mult0 \fs18\cf0\f0\charscalex100 {motor latencies (DML), nerve conduction veloci
ties,}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {and sensory n
erve action potentials were measured. All}\par\pard\li0\ri0\sl-240\slmult0 \fs18
\cf0\f0\charscalex100 {participants provided written informed consent before}\pa
r\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {entry, and the trial h
ad been approved by the university}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0
\charscalex100 {and hospital ethics committees. The study conformed to}\par\pard
\li3120\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3120\ri0\sl-213\slmult0 \fs18\cf
0\par\pard\li3120\ri0\sl-186\slmult0 \fs12\cf0\f0\charscalex100 {}{ }\fs12\cf0\f0
\charscalex100 {2010 The Author(s)}\par\pard\li1613\ri0\sl-133\slmult0 \fs12\cf0
\f0\charscalex100 {European Journal of Neurology}{ }\fs12\cf0\f0\charscalex100 {}
{ }\fs12\cf0\f0\charscalex100 {2010 EFNS}\par\pard\sect\sectd\sbknone\pard\sect\
sectd\sbkpage\pgwsxn11893\pghsxn15640\marglsxn666\margrsxn133\margtsxn666\margbs
xn146\cols2\colno1\colw5373\colsr-0\colno2\colw5720\pard\li533\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li533\ri0\sl-21
3\slmult0 \fs18\cf0\par\pard\li533\ri0\sl-280\slmult0 \fs18\cf0\f0\charscalex100
{the Declaration of Helsinki and Good Clinical Practice}\par\pard\li533\ri0\sl240\slmult0 \fs16\cf0\f0\charscalex100 {guidelines. The trial was registered at
ClinicalTrial.gov}\par\pard\li533\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100
{with the identi\uc1\u64257Xcation number NCT 00137735.}\par\pard\li720\ri0\sl-2
40\slmult0 \fs16\cf0\f0\charscalex100 {The following inclusion and exclusion cri
teria applied:}\par\pard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li533\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li533\ri0\sl-173\slmult0 \fs16\cf0\f0\charscale
x100 {Inclusion criteria}\par\pard\li533\ri0\sl-360\slmult0 \fs16\cf0\f0\charsca
lex100 {Sensory symptoms over median nerve distribution for}\par\pard\li533\ri0\
sl-240\slmult0 \fs18\cf0\f0\charscalex100 {more than three months.}\par\pard\li7
20\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {Con\uc1\u64257Xrmatory electro
physiological results de\uc1\u64257Xned as}\par\pard\li533\ri0\sl-240\slmult0 \f
s16\cf0\f0\charscalex100 {prolonged median nerve DML >4 ms or median-ulnar}\par\
pard\li533\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {palmer sensory latency
di\uc1\u64256Xerence >0.5 ms.}\par\pard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li533\ri0\sl-173\slmult0 \fs16\
cf0\f0\charscalex100 {Exclusion criteria}\par\pard\li533\ri0\sl-360\slmult0 \fs1
6\cf0\f0\charscalex100 {Patients with severe CTS: clinical examination showing}\
par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {wastage of the the
nar muscles or EPS evidence of very}\par\pard\li533\ri0\sl-226\slmult0 \fs16\cf0
\f0\charscalex100 {severe disease. (These patients were referred for surgical}\p
ar\pard\li533\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {decompression on pr
esentation.)}\par\pard\li720\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {Clin
ical or electrophysiological evidence of accom-}\par\pard\li533\ri0\sl-240\slmul
t0 \fs16\cf0\f0\charscalex100 {panying conditions that could mimic CTS or interf
ere}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {with its eval
uation, such as proximal median neuropa-}\par\pard\li533\ri0\sl-240\slmult0 \fs1
8\cf0\f0\charscalex100 {thy, cervical radiculopathy, or polyneuropathy.}\par\par
d\li720\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {Patients who require anti
convulsants for other con-}\par\pard\li533\ri0\sl-240\slmult0 \fs18\cf0\f0\chars
calex100 {ditions, e.g., epilepsy, trigeminal neuralgia.}\par\pard\li720\ri0\sl240\slmult0 \fs16\cf0\f0\charscalex100 {Patients who have received previous ster
oid injection}\par\pard\li533\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {or
oral steroid therapy for CTS.}\par\pard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li533\ri0\sl-173\slmult0 \fs16\c
f0\f0\charscalex100 {Pregnant individuals}\par\pard\li533\ri0\sl-360\slmult0 \fs
16\cf0\f0\charscalex100 {Patients were randomly assigned to one of two groups:}\
par\pard\li533\ri0\sl-226\slmult0 \fs16\cf0\f0\charscalex100 {the active group r
eceived oral gabapentin (titration}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\
f0\charscalex100 {schedule: 300 mg once daily for 1 week, 300 mg twice}\par\pard
\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {daily for 1 week, and from

then on three times daily),}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\cha

rscalex100 {and the control group received oral placebo. The pla-}\par\pard\li53
3\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {cebo tablets were identical in
appearance to the gaba-}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscal
ex100 {pentin ones and distributed according to a preset}\par\pard\li533\ri0\sl240\slmult0 \fs16\cf0\f0\charscalex100 {randomization protocol. Randomization wa
s per-}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {formed by
a computer-generated list of numbers. The}\par\pard\li533\ri0\sl-240\slmult0 \fs
16\cf0\f0\charscalex100 {following were recorded at baseline: demographic}\par\p
ard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {characteristics, nerve
conduction parameters, and}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\chars
calex100 {functional assessment, in the form of grip strength}\par\pard\li533\ri
0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {measurements performed by a trained
occupational}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {the
rapist, using a JAMAR hydraulic hand dynamom-}\par\pard\li533\ri0\sl-240\slmult0
\fs18\cf0\f0\charscalex100 {eter (Sammons Preston Inc, Illinois).}\par\pard\li5
33\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li533\ri0\sl-173\slmult0 \fs16\cf0\f0\charscalex100 {Outcome measure}\par\p
ard\li533\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100 {A research assistant (E
Y) who was masked as to the}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\char
scalex100 {allocation of treatment assessed the global symptom}\par\pard\li533\r
i0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {score (GSS) of all patients at bas
eline, 2, and 8 weeks to}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charsca
lex100 {assess the response to treatment [10\uc1\u8211X12]. This is a scor-}\par
\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {ing system \uc1\u6425
7Xrst devised by Herskovitz [10], which rates}\par\pard\li533\ri0\sl-240\slmult0
\fs16\cf0\f0\charscalex100 {symptoms on a scale of 0 (no symptoms) to 10 (sever
e) in}\par\pard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li533\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li533\ri0\sl-173\slmult0 \fs14\cf0\f0\charscalex100 {}{ }
\fs14\cf0\f0\charscalex100 {2010 The Author(s)}\par\column\pard\li13\ri0\sl-186\
slmult0 \*\tx4213\fs16\cf0\f0\charscalex100 {Gabapentin for the treatment of car
pal tunnel syndrome}\tab \fs18\cf0\f0\charscalex100 {727}\par\pard\li0\ri0\sl-21
3\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\s
l-306\slmult0 \fs16\cf0\f0\charscalex100 {\uc1\u64257Xve categories: pain, numbn
ess, paraesthesia, weakness/}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\chars
calex100 {clumsiness, and nocturnal awakening. The patient was}\par\pard\li0\ri0
\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {asked to give a score corresponding
to his or her sub-}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {
jective assessment in each of these categories, and the}\par\pard\li0\ri0\sl-240
\slmult0 \fs18\cf0\f0\charscalex100 {sum of the scores in each category was the
global}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {symptom scor
e, so that the highest possible score is 50.}\par\pard\li0\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-173\slmult
0 \fs16\cf0\f0\charscalex100 {Statistical analyses}\par\pard\li0\ri0\sl-360\slmu
lt0 \fs18\cf0\f0\charscalex100 {The sample size was calculated based on results
from}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {previous trial
s in CTS. Considering 25% as a conser-}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf
0\f0\charscalex100 {vative estimate of placebo response, a gabapentin}\par\pard\
li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {response of 50% on the clinic
al severity score would be}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charsca
lex100 {considered a clinically important \uc1\u64257Xnding. A sample size}\par\
pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {of 65 patients per group
would provide 80% power to}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charsc
alex100 {detect a di\uc1\u64256Xerence of 30%, assuming}{ }\fs18\cf0\f0\charscal
ex100 {a}{ }\fs18\cf0\f0\charscalex100 {= 0.05. After}\par\pard\li0\ri0\sl-240\s
lmult0 \fs18\cf0\f0\charscalex100 {the performance of normality test to justify
their use,}\par\pard\li0\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {di\uc1\u
64256Xerences from baseline values were compared by}\par\pard\li0\ri0\sl-240\slm
ult0 \fs18\cf0\f0\charscalex100 {paired Students}{ }\fs18\cf0\f0\charscalex100 {
t}\fs18\cf0\f0\charscalex100 {-test, and comparisons of change were}\par\pard\li

0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {made by analysis of variance (o

ne-way}{ }\fs12\cf0\f0\charscalex100 {ANOVA}\fs18\cf0\f0\charscalex100 {). The n
ull}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {hypothesis was
that we expected no di\uc1\u64256Xerence in mean}\par\pard\li0\ri0\sl-240\slmult
0 \fs18\cf0\f0\charscalex100 {GSS between the two.}{ }\fs18\cf0\f0\charscalex100
{P}\fs18\cf0\f0\charscalex100 {-values <0.05 were regarded as}\par\pard\li0\ri0
\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {signi\uc1\u64257Xcant. The intent-to
-treat population was de\uc1\u64257Xned}\par\pard\li0\ri0\sl-240\slmult0 \fs18\c
f0\f0\charscalex100 {as the population of all patients who were randomized}\par\
pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {and treated with at leas
t one dose of study medication.}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li0\ri0\sl-386\slmult0 \fs20\cf0\f0\charscalex100 {Results}\par\pard\li0\ri0
\sl-360\slmult0 \fs18\cf0\f0\charscalex100 {Patient recruitment began in January
2004 and was}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {compl
eted December 2007. Of the 169 patients}\par\pard\li0\ri0\sl-240\slmult0 \fs18\c
f0\f0\charscalex100 {screened, nine had diabetes mellitus, eight had other}\par\
pard\li0\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {co-existing peripheral n
europathy/radiculopathy, and}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\chars
calex100 {12 decided not to participate. Therefore, they were not}\par\pard\li0\
ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {included in the analysis. A total
of 140 patients were}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex10
0 {eligible and agreed to participate, of which 71 were}\par\pard\li0\ri0\sl-240
\slmult0 \fs18\cf0\f0\charscalex100 {randomly assigned to gabapentin group and 6
9 to}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {control group.
The \uc1\u64258Xow of patient participation is}\par\pard\li0\ri0\sl-240\slmult0
\fs18\cf0\f0\charscalex100 {depicted in Fig. 1, and the baseline characteristic
s are}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {illustrated i
n Table 1. There was no signi\uc1\u64257Xcant di\uc1\u64256Xer-}\par\pard\li0\ri
0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {ence in variables such as age and f
unctional status and}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100
{in the severity of electrophysiological parameters distal}\par\pard\li0\ri0\sl
-240\slmult0 \fs18\cf0\f0\charscalex100 {motor latency and sensory nerve conduct
ion velocity}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {betwee
n the two treatment groups. No patients were}\par\pard\li0\ri0\sl-240\slmult0 \f
s18\cf0\f0\charscalex100 {lost to follow up, as this was a short trial, but nine
}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {withdraw from the
gabapentin and eight from the pla-}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0
\charscalex100 {cebo groups by completion. Both gabapentin and pla-}\par\pard\li
0\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {cebo produced signi\uc1\u64257X
cant reduction in symptoms at two}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\
charscalex100 {and 8 weeks; the GSS at 2 and 8 weeks was 16.4 (SD}\par\pard\li0\
ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {9.4) and 13.4 (SD 9.7) respective
ly in the active group}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex1
00 {versus 14.9 (SD 9.0) and 12.5 (SD 8.9) in the control}\par\pard\li0\ri0\sl-2
40\slmult0 \fs18\cf0\f0\charscalex100 {(}\fs18\cf0\f0\charscalex100 {P}{ }\fs18\
cf0\f0\charscalex100 {< 0.01), Table 2 and Fig. 2. However, the mean}\par\pard\l
i0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {reduction in symptom severity
in the gabapentin was}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex10
0 {not signi\uc1\u64257Xcant when compared with placebo at both}\par\pard\li0\ri
0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {time points, Table 3.}\par\pard\sec
t\sectd\sbknone\pgwsxn11893\pghsxn15640\marglsxn666\margrsxn133\pard\li533\ri0\s
l-146\slmult0 \fs14\cf0\f0\charscalex100 {European Journal of Neurology}{ }\fs14
\cf0\f0\charscalex100 {}{ }\fs14\cf0\f0\charscalex100 {2010 EFNS}{ }\fs14\cf0\f0\
charscalex100 {European Journal of Neurology}{ }\fs14\cf0\f0\charscalex100 {18}\
fs14\cf0\f0\charscalex100 {, 726\uc1\u8211X730}\par\pard\sect\sectd\sbknone\pgws
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{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4453\shptop4480\shpright6093\shpbottom5093\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2041\shpz8\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 613}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,613);(1640,613);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 5410}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}

{\sp{\sn lineType}{\sv 0}}

{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4453\shptop5600\shpright6093\shpbottom6413\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2042\shpz9\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 813}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,813);(1640,813);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4453\shptop5600\shpright6093\shpbottom6413\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2043\shpz10\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 813}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,813);(1640,813);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 5410}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4560\shptop6933\shpright6200\shpbottom7640\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2044\shpz11\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 707}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,720);(1640,720);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}

{\sp{\sn fillColor}{\sv 16777215}}

{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4560\shptop6933\shpright6200\shpbottom7640\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2045\shpz12\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 707}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,720);(1640,720);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 5410}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2413\shptop4480\shpright4053\shpbottom5093\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2046\shpz13\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 613}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,613);(1640,613);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2413\shptop4480\shpright4053\shpbottom5093\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2047\shpz14\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 613}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,613);(1640,613);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}

{\sp{\sn fFillOK}{\sv 1}}

{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 5410}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2413\shptop5600\shpright4053\shpbottom6413\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2048\shpz15\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 813}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,813);(1640,813);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2413\shptop5600\shpright4053\shpbottom6413\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2049\shpz16\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 813}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,813);(1640,813);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 5410}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2413\shptop6933\shpright4053\shpbottom7640\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2050\shpz17\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 707}}

{\sp{\sn shapePath}{\sv 4}}

{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,720);(1640,720);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2413\shptop6933\shpright4053\shpbottom7640\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2051\shpz18\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1640}}
{\sp{\sn geoBottom}{\sv 707}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,720);(1640,720);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}
{\sp{\sn lineWidth}{\sv 5410}}
{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3240\shptop2946\shpright4253\shpbottom3453\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2052\shpz19\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1013}}
{\sp{\sn geoBottom}{\sv 507}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(1026,13);(53,493);(53,493);(53,493);(40,493);(53,
480);(1013,0);(1026,0);(1026,0);(1026,0);(1026,13);(80,520);(0,520);(40,453);(10
26,13);(1026,13);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4253\shptop2946\shpright5280\shpbottom3453\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2053\shpz20\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}

{\sp{\sn fFlipH}{\sv 0}}

{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1027}}
{\sp{\sn geoBottom}{\sv 507}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(0,0);(973,480);(973,480);(973,493);(973,493);(973
,493);(0,13);(0,0);(0,0);(0,0);(0,0);(986,453);(1026,506);(946,506);(0,0);(0,0);
}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3200\shptop4066\shpright3266\shpbottom4480\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2054\shpz21\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 66}}
{\sp{\sn geoBottom}{\sv 414}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(40,0);(40,360);(40,360);(40,360);(26,360);(26,360
);(26,0);(26,0);(40,0);(40,0);(40,0);(66,346);(40,413);(0,346);(40,0);(40,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft5240\shptop4066\shpright5306\shpbottom4480\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2055\shpz22\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 66}}
{\sp{\sn geoBottom}{\sv 414}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(40,0);(40,360);(40,360);(40,360);(26,360);(26,360
);(26,0);(26,0);(40,0);(40,0);(40,0);(66,346);(40,413);(0,346);(40,0);(40,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}

{\sp{\sn lineType}{\sv 0}}

{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft5240\shptop5080\shpright5306\shpbottom5600\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2056\shpz23\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 66}}
{\sp{\sn geoBottom}{\sv 520}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(40,0);(40,453);(40,466);(40,466);(26,466);(26,453
);(26,0);(26,0);(40,0);(40,0);(40,0);(66,453);(40,520);(0,453);(40,0);(40,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3440\shptop2333\shpright5066\shpbottom2840\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2057\shpz24\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1626}}
{\sp{\sn geoBottom}{\sv 507}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,506);(1640,506);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 16777215}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3440\shptop2333\shpright5066\shpbottom2840\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2058\shpz25\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1626}}
{\sp{\sn geoBottom}{\sv 507}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,506);(1640,506);(1640,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 0}}

{\sp{\sn lineWidth}{\sv 5410}}

{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineDashing}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4226\shptop1920\shpright4293\shpbottom2333\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2059\shpz26\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 67}}
{\sp{\sn geoBottom}{\sv 413}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(40,0);(40,360);(40,360);(40,360);(26,360);(26,360
);(26,0);(26,0);(40,0);(40,0);(40,0);(66,346);(40,413);(0,346);(40,0);(40,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4253\shptop2093\shpright5680\shpbottom2160\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2060\shpz27\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 1427}}
{\sp{\sn geoBottom}{\sv 67}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(0,26);(1373,26);(1386,26);(1386,40);(1386,40);(13
73,40);(0,40);(0,40);(0,40);(0,26);(0,26);(1373,0);(1440,40);(1373,66);(0,26);(0
,26);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3200\shptop5080\shpright3266\shpbottom5600\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2061\shpz28\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 66}}

{\sp{\sn geoBottom}{\sv 520}}

{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(40,0);(40,453);(40,466);(40,466);(26,466);(26,453
);(26,0);(26,0);(40,0);(40,0);(40,0);(66,453);(40,520);(0,453);(40,0);(40,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3200\shptop6413\shpright3266\shpbottom6933\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2062\shpz29\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 66}}
{\sp{\sn geoBottom}{\sv 520}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(40,0);(40,453);(40,466);(40,466);(26,466);(26,453
);(26,0);(26,0);(40,0);(40,0);(40,0);(66,453);(40,520);(0,453);(40,0);(40,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft5240\shptop6413\shpright5306\shpbottom6933\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2063\shpz30\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 66}}
{\sp{\sn geoBottom}{\sv 520}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;16;(40,0);(40,453);(40,466);(40,466);(26,466);(26,453
);(26,0);(26,0);(40,0);(40,0);(40,0);(66,453);(40,520);(0,453);(40,0);(40,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;34;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1386\shptop8493\shpright5866\shpbottom8506\shpfhdr0\shpw

r3\shpwrk0\shpfblwtxt1\shplid2064\shpz31\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 4480}}
{\sp{\sn geoBottom}{\sv 13}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,13);(4480,13);(4480,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1386\shptop11533\shpright5866\shpbottom11546\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2065\shpz32\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 4480}}
{\sp{\sn geoBottom}{\sv 13}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,13);(4480,13);(4480,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1386\shptop9186\shpright3826\shpbottom9186\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2066\shpz33\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 2440}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,0);(2440,0);(2440,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3826\shptop8853\shpright4733\shpbottom8853\shpfhdr0\shpw

r3\shpwrk0\shpfblwtxt1\shplid2067\shpz34\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 907}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,0);(906,0);(906,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft4960\shptop8853\shpright5866\shpbottom8853\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2068\shpz35\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 906}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,0);(906,0);(906,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3600\shptop9186\shpright5866\shpbottom9186\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2069\shpz36\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 2266}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,0);(2280,0);(2280,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1386\shptop12533\shpright5866\shpbottom12546\shpfhdr0\sh

pwr3\shpwrk0\shpfblwtxt1\shplid2070\shpz37\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 4480}}
{\sp{\sn geoBottom}{\sv 13}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,13);(4480,13);(4480,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1386\shptop13973\shpright5866\shpbottom13986\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2071\shpz38\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 4480}}
{\sp{\sn geoBottom}{\sv 13}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,13);(4480,13);(4480,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft1386\shptop13226\shpright3506\shpbottom13226\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2072\shpz39\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 2120}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,0);(2120,0);(2120,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft3506\shptop12880\shpright4266\shpbottom12880\shpfhdr0\sh

pwr3\shpwrk0\shpfblwtxt1\shplid2073\shpz40\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 760}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,0);(760,0);(760,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft5146\shptop12880\shpright5866\shpbottom12880\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2074\shpz41\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 720}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,0);(720,0);(720,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft2640\shptop13226\shpright5866\shpbottom13226\shpfhdr0\sh
pwr3\shpwrk0\shpfblwtxt1\shplid2075\shpz42\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 3226}}
{\sp{\sn geoBottom}{\sv 0}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,0);(3226,0);(3226,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft7213\shptop8866\shpright10373\shpbottom11760\shpfhdr0\sh

pwr3\shpwrk0\shpfblwtxt1\shplid2076\shpz43\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 3160}}
{\sp{\sn geoBottom}{\sv 2894}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;19;(0,0);(400,0);(400,2893);(0,2893);(0,0);(1386,866)
;(1773,866);(1773,2893);(1386,2893);(1386,866);(0,0);(0,0);(2773,1186);(3160,118
6);(3160,2893);(2773,2893);(2773,1186);(0,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;40;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 0}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6813\shptop8520\shpright9986\shpbottom11760\shpfhdr0\shp
wr3\shpwrk0\shpfblwtxt1\shplid2077\shpz44\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 3173}}
{\sp{\sn geoBottom}{\sv 3240}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;19;(0,0);(400,0);(400,3253);(0,3253);(0,0);(1386,1013
);(1773,1013);(1773,3253);(1386,3253);(1386,1013);(0,0);(0,0);(2773,1413);(3160,
1413);(3160,3253);(2773,3253);(2773,1413);(0,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;40;16384;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45824;1;45
824;1;45824;1;45824;1;45824;24577;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 12566463}}
{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}
{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft9600\shptop8613\shpright9693\shpbottom8693\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2078\shpz45\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 93}}
{\sp{\sn geoBottom}{\sv 80}}
{\sp{\sn shapePath}{\sv 4}}
{\sp{\sn pVerticies}{\sv 8;5;(0,0);(0,80);(80,80);(80,0);(0,0);}}
{\sp{\sn pSegmentInfo}{\sv 2;12;16384;45824;1;45824;1;45824;1;45824;1;45824;2457
7;32768}}
{\sp{\sn fFillOK}{\sv 1}}
{\sp{\sn fFilled}{\sv 1}}
{\sp{\sn fillColor}{\sv 12566463}}

{\sp{\sn fLine}{\sv 0}}{\sp{\sn lineColor}{\sv 0}}

{\sp{\sn lineType}{\sv 0}}
{\sp{\sn fArrowheadsOK}{\sv 0}}
{\sp{\sn fBehindDocument}{\sv 1}}
{\sp{\sn fLayoutInCell}{\sv 1}}}}
{\shp{\*\shpinst\shpleft6520\shptop8346\shpright6520\shpbottom11760\shpfhdr0\shp
wr3\shpwrk0\shpfblwtxt1\shplid2079\shpz46\shpbxpage\shpbypage
{\sp{\sn shapeType}{\sv 0}}
{\sp{\sn fFlipH}{\sv 0}}
{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn rotation}{\sv 0}}
{\sp{\sn geoRight}{\sv 0}}
{\sp{\sn geoBottom}{\sv 3414}}
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3\margtsxn666\margbsxn146\cols3\colno1\colw2880\colsr-0\colno2\colw2226\colsr-0\
colno3\colw5986\pard\li720\ri0\sl-186\slmult0 \*\tx1280\fs18\cf0\f0\charscalex10
0 {728}\tab \fs16\cf0\f0\charscalex100 {A. C. F. Hui}{ }\fs16\cf0\f0\charscalex1

00 {et al.}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl

-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-226\slmult0 \fs16\cf0\f0\charscal
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pard\li0\ri0\sl-280\slmult0 \fs16\cf0\f0\charscalex100 {140 patients eligible}\p
ar\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100\b {
29 excluded:}\b0 \par\pard\li0\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100\b {
12 refused to participate}\b0 \par\pard\li0\ri0\sl-200\slmult0 \fs16\cf0\f0\char
scalex100\b {17 did not meet criteria}\b0 \par\pard\sect\sectd\sbknone\pgwsxn118
93\pghsxn15640\marglsxn666\margrsxn133\cols4\colno1\colw1840\colsr-0\colno2\colw
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t0 \fs18\cf0\par\pard\li866\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li866\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li866\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li866\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li866\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li866\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li866\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li866\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li866\ri0\sl-240\slmult0 \
fs16\cf0\f0\charscalex100\b {Baseline}\b0 \par\pard\li720\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl
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0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li720\ri0\sl-280\slmult0 \fs14\cf0\f0\charscalex100\b {Assessment}\b0 \par\p
ard\li746\ri0\sl-200\slmult0 \fs16\cf0\f0\charscalex100\b {at 2 weeks}\b0 \par\c
olumn\pard\li280\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li280\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li280\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li280\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li280\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {
Gabapentin}\par\pard\li506\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li506\ri0\sl-21
3\slmult0 \fs18\cf0\par\pard\li506\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li506\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li506\ri0\sl-200\slmult0 \fs16\cf0\f0\chars
calex100\i {n}\i0 \fs16\cf0\f0\charscalex100 { = 71}\par\pard\li480\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li480\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li480\ri0\sl-320\slmult0 \fs16\cf0\f0\charscal
ex100\i {n}\i0 \fs16\cf0\f0\charscalex100 { = 67}\par\pard\li40\ri0\sl-213\slmul
t0 \fs16\cf0\f0\charscalex100\i {n}\i0 \fs16\cf0\f0\charscalex100 { = 3 adverse
event}\par\pard\li0\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100\i {n}\i0 \fs16
\cf0\f0\charscalex100 { = 1 lack of efficacy}\par\pard\li506\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li506\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li506\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li506\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100\i
{n}\i0 \fs16\cf0\f0\charscalex100 { = 62}\par\pard\li93\ri0\sl-186\slmult0 \fs1
6\cf0\f0\charscalex100\i {n}\i0 { }\fs16\cf0\f0\charscalex100 {= 2 adverse event
}\par\pard\li26\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100\i {n}\i0 { }\fs16\
cf0\f0\charscalex100 {= 3 lack of efficacy}\par\column\pard\li386\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li386\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li386\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li386\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li38
6\ri0\sl-346\slmult0 \fs18\cf0\f0\charscalex100 {Placebo}\par\pard\li480\ri0\sl213\slmult0 \fs18\cf0\par\pard\li480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li480
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li480\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li480\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100\i {n}\i0 \fs16\cf0\f0\cha
rscalex100 { = 69}\par\pard\li480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li480\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li480\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li480\ri0\sl-360\slmult0 \fs16\cf0\f0\charscalex100\i {n}\i0 \fs16\cf0\f0\charsc
alex100 { = 67}\par\pard\li66\ri0\sl-200\slmult0 \fs16\cf0\f0\charscalex100\i {n
}\i0 { }\fs16\cf0\f0\charscalex100 {= 1 adverse event}\par\pard\li0\ri0\sl-213\s
lmult0 \fs16\cf0\f0\charscalex100\i {n}\i0 { }\fs16\cf0\f0\charscalex100 {= 1 la

ck of efficacy}\par\pard\li586\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li586\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li586\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li5
86\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100\i {n}\i0 \fs16\cf0\f0\charscale
x100 { = 61}\par\pard\li173\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100\i {n}\
i0 { }\fs16\cf0\f0\charscalex100 {= 1 adverse event}\par\pard\li106\ri0\sl-186\s
lmult0 \fs16\cf0\f0\charscalex100\i {n}\i0 { }\fs16\cf0\f0\charscalex100 {= 5 la
ck of efficacy}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\
ri0\sl-333\slmult0 \*\tx640\fs16\cf0\f0\charscalex100 {Figure 1}\tab \fs16\cf0\f
0\charscalex100 {Patient \uc1\u64258Xow chart.}\par\pard\sect\sectd\sbknone\pgws
xn11893\pghsxn15640\marglsxn666\margrsxn133\cols3\colno1\colw5586\colsr-0\colno2
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rd\li720\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li720\ri0\sl-293\slmult0 \*\tx126
6\fs14\cf0\f0\charscalex100 {Table 1}\tab \fs14\cf0\f0\charscalex100 {Baseline c
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93\fs14\cf0\f0\charscalex100 {Gabapentin}\tab \fs14\cf0\f0\charscalex100 {Placeb
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par\pard\li93\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li93\ri0\sl-253\slmult0 \fs1
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harscalex100 {Placebo}\par\pard\sect\sectd\sbknone\pgwsxn11893\pghsxn15640\margl
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14.9 (0.0)}\par\pard\li0\ri0\sl-200\slmult0 \fs14\cf0\f0\charscalex100 {12.5 (8.
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he}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {maximal dose was
achieved. Therefore, we think that}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f
0\charscalex100 {higher doses would not produce better results, but}\par\pard\li

0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {would cause more adverse reacti

ons. Another question}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex10
0 {is whether the active group would fare better if the}\par\pard\li0\ri0\sl-240
\slmult0 \fs18\cf0\f0\charscalex100 {trial was longer. From the experience of st
udies on}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {CTS and ne
uropathic pain using gabapentin, an e\uc1\u64256Xect}\par\pard\sect\sectd\sbknon
e\pgwsxn11893\pghsxn15640\marglsxn666\margrsxn133\cols2\colno1\colw5373\colsr-0\
colno2\colw5720\pard\li720\ri0\sl-173\slmult0 \fs18\cf0\f0\charscalex100 {A simi
lar proportion of patients in both groups}\par\pard\li533\ri0\sl-240\slmult0 \fs
16\cf0\f0\charscalex100 {experienced side e\uc1\u64256Xects such as dizziness an
d somno-}\par\pard\li533\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {lence wh
ich are listed in Table 4.}\par\pard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li533\ri0\sl-386\slmult0 \fs20\cf0\f0\charscalex100 {Discussion}\par\pard\li533
\ri0\sl-360\slmult0 \fs16\cf0\f0\charscalex100 {The only oral drug that has been
convincingly shown}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex10
0 {to be e\uc1\u64256Xective for CTS is oral steroid, but its e\uc1\u64259Xcacy}
\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {is short term [10
\uc1\u8211X13]. Steroids relieve local ischaemia}\par\pard\li533\ri0\sl-240\slmu
lt0 \fs16\cf0\f0\charscalex100 {and reduce synovial swelling in the carpal tunne
l. In}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {view of the
mostly chronic nature of this disorder,}\par\pard\li533\ri0\sl-240\slmult0 \fs1
6\cf0\f0\charscalex100 {there is a need for a safer alternative. The anti-epi-}\
par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {leptic drug gabape
ntin is a promising choice as there}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0
\f0\charscalex100 {are similarities in the pathophysiologic and biochem-}\par\pa
rd\li533\ri0\sl-226\slmult0 \fs16\cf0\f0\charscalex100 {ical mechanisms underlyi
ng epilepsy and neuropathic}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\char
scalex100 {pain. Based on its e\uc1\u64259Xcacy in other neuropathies,}\par\pard
\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {gabapentin is widely used
for pain relief, but its}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charsca
lex100 {e\uc1\u64256Xectiveness in CTS is uncertain. In this trial,}\par\pard\li
533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {although both gabapentin and
placebo produced sig-}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex
100 {ni\uc1\u64257Xcant reduction in symptom relief, no di\uc1\u64256Xerence was
}\par\pard\li533\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {detected between
groups.}\par\pard\li720\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {Previous
evaluations of this drug in CTS have shown}\par\pard\li533\ri0\sl-240\slmult0 \
fs16\cf0\f0\charscalex100 {bene\uc1\u64257Xcial e\uc1\u64256Xects, but none had
used RCT methodology,}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex
100 {and compared with these other studies, the current trial}\par\pard\li533\ri
0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {used a larger sample size [14\uc1\u
8211X17]. In the \uc1\u64257Xrst study}\par\pard\li533\ri0\sl-240\slmult0 \fs16\
cf0\f0\charscalex100 {published in abstract form that had addressed this issue,}
\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {\uc1\u64257Xve pa
tients were treated with gabapentin (mean dose}\par\pard\li533\ri0\sl-240\slmult
0 \fs16\cf0\f0\charscalex100 {of 1150 mg/day) and another \uc1\u64257Xve with ca
rbamazepine;}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {both
groups reported moderate symptomatic improve-}\par\pard\li533\ri0\sl-226\slmult
0 \fs16\cf0\f0\charscalex100 {ment [14]. Duman reported reduced symptoms in an}\
par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {observational tria
l of 21 patients using the drug at an}\par\pard\li533\ri0\sl-240\slmult0 \fs16\c
f0\f0\charscalex100 {average dose of 648 mg/day, and in another open label}\par\
pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {trial, Erdemoglu repor
ted that symptoms and func-}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\char
scalex100 {tional status improved with gabapentin at a higher}\par\pard\li533\ri
0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {median dosage of 1800 mg/day [16,17
]. But as we saw in}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex10
0 {this study, placebo alone produces a substantial}\par\pard\li533\ri0\sl-240\s
lmult0 \fs18\cf0\f0\charscalex100 {reduction in symptoms.}\par\pard\li720\ri0\sl
-240\slmult0 \fs16\cf0\f0\charscalex100 {Would we have obtained a positive resul

t if a higher}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100 {dos

e had been used? Given the percentage of patients}\par\pard\li533\ri0\sl-240\slm
ult0 \fs16\cf0\f0\charscalex100 {with side e\uc1\u64256Xects from anti-epileptic
drugs and as this}\par\pard\li533\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100
{was the \uc1\u64257Xrst large trial to evaluate gabapentin e\uc1\u64259Xcacy}\
par\pard\li533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li533\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li533\ri0\sl-226\slmult0 \fs14\cf0\f0\charscalex100 {}{ }\fs14\c
f0\f0\charscalex100 {2010 The Author(s)}\par\column\pard\li0\ri0\sl-240\slmult0
\fs18\cf0\f0\charscalex100 {is commonly evident by 2\uc1\u8211X4 weeks. The resu
lts of}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {trials in th
e management CTS commonly show a rapid}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf
0\f0\charscalex100 {onset of action; the main concern is whether the}\par\pard\l
i0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {bene\uc1\u64257Xcial e\uc1\u64
256Xect is sustained long term.}\par\pard\li186\ri0\sl-226\slmult0 \fs16\cf0\f0\
charscalex100 {Carpal tunnel syndrome is caused by compression of}\par\pard\li0\
ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {the median nerve within the carpa
l tunnel, and to date}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex10
0 {the most e\uc1\u64256Xective therapy is targeted at reducing the}\par\pard\li
0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {swelling through the injection
of steroid or division of}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscal
ex100 {the \uc1\u64258Xexor retinaculum [18\uc1\u8211X22]. As gabapentin appears
}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {to have limited e\
uc1\u64259Xcacy and would be required to be}\par\pard\li0\ri0\sl-240\slmult0 \fs
18\cf0\f0\charscalex100 {taken for a long time (because the majority of patients
}\fs12\cf0\f0\charscalex100 {}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\chars
calex100 {symptoms persist if left untreated [23,24]), current evi-}\par\pard\li
0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {dence does not support its rout
ine use for CTS.}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl386\slmult0 \fs20\cf0\f0\charscalex100 {Acknowledgements}\par\pard\li0\ri0\sl-36
0\slmult0 \fs18\cf0\f0\charscalex100 {This study was funded in part by an invest
igator-initi-}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {ated
grant from P\uc1\u64257Xzer, Inc. The study was designed and}\par\pard\li0\ri0\s
l-226\slmult0 \fs18\cf0\f0\charscalex100 {conducted independently by the authors
. Collection of}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {dat
a, analyses, and interpretation of the data were}\par\pard\li0\ri0\sl-240\slmult
0 \fs18\cf0\f0\charscalex100 {performed by the authors, and the manuscript was}\
par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {prepared without rev
iew by P\uc1\u64257Xzer.}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-186\slmult0 \fs20\cf0\f0\chars
calex100 {Disclosure of con\uc1\u64258Xict of interest}\par\pard\li0\ri0\sl-346\
slmult0 \fs18\cf0\f0\charscalex100 {The authors declare no \uc1\u64257Xnancial o
r other con\uc1\u64258Xict of}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\char
scalex100 {interests.}\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-186\slmult0 \fs20\cf0\f0\charscal
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r\pard\li1013\ri0\sl-200\slmult0 \fs14\cf0\f0\charscalex100 {pentin versus carba
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f carpal tunnel syndrome.}\par\pard\li1013\ri0\sl-200\slmult0 \fs16\cf0\f0\chars
calex100 {Med Clin (Barc)}{ }\fs16\cf0\f0\charscalex100 {2008;}{ }\fs16\cf0\f0\c
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l-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\r
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lex100 {16. Duman I, Aydemir K, Ozgul A, Kalyon TA. Assessment}\par\pard\li306\r
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-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3
133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\par
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f0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3
133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li3133\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li3133\r
i0\sl-280\slmult0 \fs12\cf0\f0\charscalex100 {}{ }\fs12\cf0\f0\charscalex100 {201
0 The Author(s)}\par\pard\sect\sectd\sbknone\pgwsxn11893\pghsxn15640\marglsxn666
\margrsxn133\pard\li4360\ri0\sl-146\slmult0 \fs14\cf0\f0\charscalex100 {European
Journal of Neurology}{ }\fs14\cf0\f0\charscalex100 {}{ }\fs14\cf0\f0\charscalex1
00 {2010 EFNS}{ }\fs14\cf0\f0\charscalex100 {European Journal of Neurology}{ }\f
s14\cf0\f0\charscalex100 {18}\fs14\cf0\f0\charscalex100 {, 726\uc1\u8211X730}\pa
r\pard\sect\sectd\sbknone\pgwsxn11893\pghsxn15640\marglsxn666\margrsxn133\pard\s
ect\sectd\sbkpage\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn666\ma
rgbsxn666\pard\li53\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li53\ri0\sl-253\slmult
0 \fs24\cf0\f0\charscalex100 {Copyright of European Journal of Neurology is the
property of Wiley-Blackwell and its content may not be}\par\pard\li53\ri0\sl-360
\slmult0 \fs24\cf0\f0\charscalex100 {copied or emailed to multiple sites or post
ed to a listserv without the copyright holder's express written}\par\pard\li53\r

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