This paper presents an advanced machine learning (ML) framework for precise nerve conduction velocity (NCV) analysis, integrating multiscale signal processing with physiologically-constrained deep learning. Our approach addresses three fundamental limitations of conventional NCV techniques: (1) oversimplified nerve fiber modeling, (2) temperature sensitivity, and (3) static measurement interpretation. The proposed framework combines: (i) entropy-optimized wavelet analysis for adaptive multiscale signal decomposition, (ii) thermodynamically-regularized neural networks incorporating Arrhenius kinetics, and (iii) stochastic progression models for uncertainty-aware longitudinal tracking. Through data extracted from prior studies in this field, rigorously validated across 1,842 patients from 28 medical centers, we demonstrate significant improvements: 23.4% enhancement in motor NCV accuracy (p < 0.001) and 28.7% for sensory fibers. The framework maintains physiological interpretability while achieving superior performance through: (a) wavelet-optimized resolution scales (2-8 ms for motor, 0.5-2 ms for sensory fibers), (b) temperature compensation accurate to 0.58 ± 0.19 m/s across 20-40◦C, and (c) probabilistic progression tracking with 88.9% treatment response prediction accuracy. This work establishes new standards for ML applications in clinical neurophysiology by rigorously combining biophysical first principles with data-driven learning, offering both theoretical advances and immediate clinical utility for neuropathy diagnosis and monitoring.
