Kihara M, Sugenoya J, Takahashi A
Department of Neurology, Aichi Medical University, Japan.
Clin Auton Res. 1991 Dec;1(4):297-302. doi: 10.1007/BF01819835.
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.
我们对21例多系统萎缩患者及11例年龄匹配的对照者的汗腺运动功能进行了研究。使用定量体温调节汗液试验评估汗腺运动功能障碍的范围和严重程度。通过测量因体温升高和给予促甲状腺激素释放激素而引起的出汗情况来研究中枢汗腺运动功能。使用尼古丁诱发的汗腺运动轴突反射试验研究节后汗腺运动功能。我们得出结论，在多系统萎缩中，体温调节性汗腺运动功能障碍在下肢更为严重。热刺激使中度多系统萎缩患者前臂的排汗频率和出汗率增加到与对照组相似的程度，但在大腿上却未能如此。促甲状腺激素释放激素可增强中度多系统萎缩患者和对照组的出汗。汗腺运动轴突反射试验结果表明，在多系统萎缩中存在节后汗腺运动功能障碍，这可能是由于跨突触变化所致。这些结果提示，多系统萎缩中导致汗腺运动功能障碍的主要病变位于脊髓的中间外侧柱细胞内。
