Polinsky R J, Brown R T, Curras M T, Baser S M, Baucom C E, Hooper D R, Marini A M
Clinical Neuropharmacology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892.
J Neurol Neurosurg Psychiatry. 1991 Sep;54(9):807-12. doi: 10.1136/jnnp.54.9.807.
Increased plasma adrenalin (A) levels following arecoline in normal subjects and patients with multiple system atrophy (MSA) may result from nicotinic adrenal stimulation. Lack of this response in patients with pure autonomic failure (PAF) is consistent with peripheral sympathetic dysfunction. The mechanisms underlying diminished plasma corticotropin (ACTH) responses to arecoline may differ in patients with autonomic failure. Hypothalamic, cholinergic degeneration could prevent the response in MSA whereas patients with PAF do not manifest the normal increase in A which may be required to elicit an ACTH response. The appearance and exacerbation of tremor, vertigo, and pathological affect in the MSA group suggest that some central cholinergic receptors remain functional.
正常受试者和多系统萎缩（MSA）患者服用槟榔碱后血浆肾上腺素（A）水平升高可能是由烟碱样肾上腺刺激引起的。纯自主神经功能衰竭（PAF）患者缺乏这种反应与外周交感神经功能障碍一致。自主神经功能衰竭患者对槟榔碱的血浆促肾上腺皮质激素（ACTH）反应减弱的潜在机制可能不同。下丘脑胆碱能变性可能会阻止MSA患者的反应，而PAF患者并未表现出正常的A增加，而这可能是引发ACTH反应所必需的。MSA组震颤、眩晕和病理性情感的出现及加重表明一些中枢胆碱能受体仍有功能。
