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The assessment of sudomotor dysfunction in multiple system atrophy

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Abstract

We studied sudomotor function in 21 patients with multiple system atrophy and in 11 age-matched controls. The extent and severity of the sudomotor deficit was assessed using the quantitative thermoregulatory sweat test. Central sudomotor function was studied by measuring sweating in response to raising body heat and administering thyrotropin-releasing hormone. Postganglionic sudomotor function was studied using the sudomotor axon reflex test evoked by nicotine. We conclude that in multiple system atrophy, thermoregulatory sudomotor dysfunction was more severe in the lower extremities. Heat stimulation increased the frequency of sweat expulsion and sweat rate on the forearm in moderate multiple system atrophy to a similar degree as controls but failed to do so on the thigh. Thyrotropin-releasing hormone enhanced sweating in moderate multiple system atrophy and controls. Results of the sudomotor axon reflex test indicate that in multiple system atrophy there is postganglionic sudomotor dysfunction which may be due to transsynaptic changes. These results suggest that the main lesion responsible for sudomotor dysfunction in multiple system atrophy is within the intermediolateral column cells of the spinal cord.

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References

  1. Bannister R, Ardill L, Fentem P. Defective autonomic control of blood vessels in idiopathic orthostatic hypotension.Brain 1967;90: 725–746.

    PubMed  Google Scholar 

  2. Cohen J, Low P, Fealey R, Sheps S, Jiang N-S. Somatic and autonomic function in progressive autonomic failure and multiple system atrophy.Ann Neurol 1987;22: 692–699.

    PubMed  Google Scholar 

  3. Takahashi A, Takagi S, Yamamoto K, Yamada T, Ando K. Shy-Drager syndrome. Its correlation with olivo-ponto-cerebellar atrophy.Clin Neurol (Tokyo) 1969;9: 121–129.

    Google Scholar 

  4. Sobue I, Takayanagi T, Nakanishi T. Controlled trial of thyrotropin releasing hormone tartrate in ataxia of spinocerebellar degeneration.J Neurol Sci 1983;61: 235–248.

    PubMed  Google Scholar 

  5. Mitsumoto H, Salgado ED, Negroski D, Hanson MR, Salanga VD, Wilber JF, Wilbourn AJ, Breuer AC, Leatherman J. Amyotrophic lateral sclerosis: Effects of acute intravenous and chronic subcutaneous administration of thyrotropin-releasing hormone in controlled trials.Neurology 1986;36: 152–159.

    PubMed  Google Scholar 

  6. Kihara M, Watanabe H, Tomita T, Sugenoya J. A case of Shy-Drager syndrome, effectively treated with TRH, with special reference to local sweat rate.Neurol Med (Tokyo) 1986;25: 289–291.

    Google Scholar 

  7. Sandroni P, Ahlskog JE, Fealey RD, Low PA. Autonomic involvement in extrapyramidal and cerebellar system disorders.Clin Auton Res 1991;1: 147–155.

    PubMed  Google Scholar 

  8. Sugenoya J, Kihara M, Ogawa T, Takahashi A, Mitsuma M, Yamashita Y. Effects of thyrotropin releasing hormone on human sudomotor and cutaneous vasomotor activity.Eur J Appl Physiol 1988;57: 632–638.

    Google Scholar 

  9. Ogawa T, Bullard RW. Characterization of subthreshold sudomotor neural impulse.J Appl Physiol 1972;33: 300–305.

    PubMed  Google Scholar 

  10. Sugenoya J, Ogawa T. Characteristics of central sudomotor mechanism estimated by frequency of sweat expulsion.Jpn J Physiol 1985;35: 784–794.

    Google Scholar 

  11. Bini G, Hagbarth KE, Hynninem P, Wallin BG. Thermoregulatory and rhythm generating mechanisms governing the sudomotor and vasomotor outflow in human cutaneous nerves.J Physiol 1980;306: 537–552.

    PubMed  Google Scholar 

  12. Weiner JS. The regional distribution of sweating.J Physiol 1945;104: 32–40.

    Google Scholar 

  13. Metcalf G. TRH: a possible mediator of thermoregulation.Nature 1974;252: 310–311.

    PubMed  Google Scholar 

  14. Carino MA, Smith JR, Weick BG, Horita A. Effects of thyrotropinreleasing hormone (TRH) microinjected into various brain areas of conscious and pentrobarbital-pretreated rabbits.Life Sci 1976;19: 1687–1692.

    PubMed  Google Scholar 

  15. Boschi G, Nomoto T, Rips R. Thyrotropin releasing hormone-induced hyperthermia in mice: possible involvement of adrenal and pituitary gland.Br J Pharmacol 1983;80: 229–233.

    PubMed  Google Scholar 

  16. Brown MR. Thyrotropin releasing factor: a putative CNS regulator of the autonomic nervous system.Life Sci 1981;28: 1789–1795.

    PubMed  Google Scholar 

  17. Tsunoda S, Shiozawa Z, Mano T. Microneurographic analysis of thyrotropin-releasing hormone effects on sympathetic outflow in human muscle nerve.J Auton Nerv Syst 1988;23: 207–211.

    PubMed  Google Scholar 

  18. Johnson RH, Lee G de J, Oppenheime DR, Spalding JMK. Autonomic failure with orthostatic hypotension due to intermediolateral column degeneration. A report of two cases with autopsies.Q J Med 1966;35: 276–292.

    PubMed  Google Scholar 

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Author notes

  1. Mikihiro Kihara MD

    Present address: Autonomic Reflex Laboratory, Division of Clinical Neurophysiology, Department of Neurology, Mayo Clinic, 55905, Rochester, MN, USA

  2. Akira Takahashi MD

    Present address: Department of Neurology, Nagoya University School of Medicine, 466, Nagoya, Japan

Authors and Affiliations

  1. Department of Neurology, Aichi Medical University, Aichi, 480-11, Japan

    Mikihiro Kihara MD

  2. Department of Physiology, Aichi Medical University, Aichi 480-11, Japan

    Junichi Sugenoya MD

  3. Department of Neurology, Aichi Medical University, Aichi 480-11, Japan

    Akira Takahashi MD

Authors
  1. Mikihiro Kihara MD
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  2. Junichi Sugenoya MD
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  3. Akira Takahashi MD
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Kihara, M., Sugenoya, J. & Takahashi, A. The assessment of sudomotor dysfunction in multiple system atrophy. Clinical Autonomic Research 1, 297–302 (1991). https://doi.org/10.1007/BF01819835

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  • DOI: https://doi.org/10.1007/BF01819835

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