Journal of Neural Transmission

, Volume 117, Issue 4, pp 475–479

The cold hand sign in multiple system atrophy: skin perfusion revisited

Authors

  • K. Pietzarka
    • Autonomic and Neuroendocrinological Laboratory, Department of NeurologyUniversity of Technology Dresden
  • M. Reimann
    • Autonomic and Neuroendocrinological Laboratory, Department of NeurologyUniversity of Technology Dresden
    • Research Group Neuro-Metabolism, Department of Neurology and Medicine IIIUniversity of Technology Dresden
  • C. Schmidt
    • Autonomic and Neuroendocrinological Laboratory, Department of NeurologyUniversity of Technology Dresden
  • B. Herting
    • Parkinson Research Group, Department of NeurologyUniversity of Technology Dresden
  • L. Schöls
    • Department of Neurodegenerative Disorders, Hertie Institute of Clinical Brain ResearchUniversity of Tübingen
  • H. Reichmann
    • Parkinson Research Group, Department of NeurologyUniversity of Technology Dresden
  • D. Berg
    • Department of Neurodegenerative Disorders, Hertie Institute of Clinical Brain ResearchUniversity of Tübingen
  • Christoph Schrader
    • Department of NeurologyUniversity of Hannover
    • Autonomic and Neuroendocrinological Laboratory, Department of NeurologyUniversity of Technology Dresden
    • Research Group Neuro-Metabolism, Department of Neurology and Medicine IIIUniversity of Technology Dresden
Movement Disorders - Short Communication

DOI: 10.1007/s00702-010-0375-x

Cite this article as:
Pietzarka, K., Reimann, M., Schmidt, C. et al. J Neural Transm (2010) 117: 475. doi:10.1007/s00702-010-0375-x

Abstract

The cold hand sign (CHS) is a distinct feature of multiple system atrophy (MSA), but its pathophysiology is poorly understood. We, therefore, conducted a study to examine the skin temperature and the skin blood flow at rest and after local heating in 6 age-matched MSA patients with CHS (MSA + CHS), 18 MSA patients without CHS (MSA – CHS) and 13 patients with idiopathic Parkinson’s disease (PD). Basal skin temperature and blood flow were significantly lower in MSA + CHS patients than in MSA – CHS or PD patients. Local heating induced a greater response in terms of amplitude in MSA + CHS compared to MSA – CHS and PD. Considering kinetics, skin blood flow increment per 1°C was higher in MSA + CHS than MSA – CHS but was similar when compared to PD patients. Skin blood flow rate (change per second) did not differ among the groups. Our findings suggest that despite impaired basal skin perfusion, the skin vasomotor response to local heating is intact in MSA + CHS but disturbed in MSA – CHS. By measuring skin temperature and blood flow, the presence of CHS can be diagnosed in MSA patients. Further studies are necessary to understand regulation of skin perfusion in patients with extrapyramidal disease.

Keywords

Autonomic nervous systemMultiple system atrophyAutonomic dysfunctionCold hand signSkin perfusionParkinson’s disease

Copyright information

© Springer-Verlag 2010