Pan Shin-Liang, Wang Yen-Ho, Hou Wen-Hsuan, Wang Chao-Min, Huang Tien-Shang
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Arch Phys Med Rehabil. 2006 Sep;87(9):1201-6. doi: 10.1016/j.apmr.2006.05.027.
To compare the excitability of the sympathetic skin response (SSR) between subjects with spinal cord injury (SCI) and healthy controls with intact supraspinal connection.
Cross-sectional survey.
Referral center.
A total of 37 men with traumatic neurologically complete SCI (26 with tetraplegia, 11 with paraplegia) and history of autonomic dysreflexia were included. Twenty age-matched healthy male controls were recruited as the control group. Subjects with SCI were at the mean age +/- standard deviation of 36.5+/-11.0 years (range, 20.1-61.3 y) and the mean injury duration was 11.3+/-9.3 years (range, 1.0-38.1 y).
Not applicable.
The SSR tests were grouped into 3 test sets according the stimulation and recording sites: (1) right supraorbital nerve stimulation with left hand recording (SH set); (2) right supraorbital nerve stimulation and left foot recording (SF set); and (3) right posterior tibial nerve stimulation and left foot recording (TF set).
In patients with tetraplegia (n=26), none showed positive SSR in the SH or the SF set, and only 5 (19.2%) showed a positive SSR in the TF set. In subjects with paraplegia (n=11), the positive response rates of SSR were 72.7% for the SH set, 0% for the SF set, and 9.1% for the TF set. Electric stimulation at high intensity (100 mA for 1 ms) was required to elicit SSR for the TF set in the patients with SCI. The SSR amplitudes in the SH and TF sets were smaller in subjects with SCI than those in controls (SH set, P=.004; TF set, P<.001). The SSR latency in the SH set was longer in patients with SCI (P=.04), whereas the SSR latency in the TF set tended to be shorter in subjects with SCI (P=.09).
The excitability of SSR was reduced in an isolated spinal cord. This suggests that excitability of sympathetic sudomotor response in subjects with an isolated spinal cord is lower than in healthy controls.
比较脊髓损伤（SCI）患者与脊髓上连接完整的健康对照者之间交感神经皮肤反应（SSR）的兴奋性。
横断面调查。
转诊中心。
共纳入37例创伤性神经完全性SCI男性患者（26例四肢瘫，11例截瘫）并有自主神经反射异常病史。招募20名年龄匹配的健康男性对照者作为对照组。SCI患者的平均年龄±标准差为36.5±11.0岁（范围20.1 - 61.3岁），平均损伤持续时间为11.3±9.3年（范围1.0 - 38.1年）。
不适用。
根据刺激和记录部位，SSR测试分为3组测试集：（1）右手记录刺激右侧眶上神经（SH组）；（2）左脚记录刺激右侧眶上神经（SF组）；（3）左脚记录刺激右侧胫后神经（TF组）。
在四肢瘫患者（n = 26）中，SH组或SF组均无SSR阳性表现，TF组仅5例（19.2%）出现SSR阳性。在截瘫患者（n = 11）中，SH组SSR阳性反应率为72.7%，SF组为0%，TF组为9.1%。SCI患者TF组需要高强度电刺激（100 mA，持续1 ms）才能引出SSR。SCI患者SH组和TF组的SSR波幅低于对照组（SH组，P = 0.004；TF组，P < 0.001）。SCI患者SH组的SSR潜伏期较长（P = 0.04），而SCI患者TF组的SSR潜伏期倾向于较短（P = 0.09）。
孤立脊髓中SSR的兴奋性降低。这表明孤立脊髓患者交感神经汗腺运动反应的兴奋性低于健康对照者。
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