Shindo Kazumasa
Department of Neurology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-city, Yamanashi 409-3898, Japan.
Brain Nerve. 2009 Mar;61(3):263-9.
Sympathetic nerve functions in patients with amyotrophic lateral sclerosis (ALS), spinocerebellar degeneration (SCD), and Parkinson disease (PD) were evaluated using microneurography. In patients with ALS, the muscle sympathetic nerve activity (MSNA) at rest was greater than that in healthy subjects and patients with other neuromuscular disorders. This finding is not observed in the advanced stages of ALS. The resting frequency of skin sympathetic nerve activity (SSNA) significantly greater in ALS patients than in healthy controls. In patients with SCD, the MSNA was slightly reduced, although these patients did not experience orthostatic dizziness or syncope, or significant fall in blood pressure during the head-up tilt test. The reflex latency of SSNA induced by electric stimulation was slightly but significantly prolonged in patients with cortical cerebellar atrophy and markedly prolonged in patients with multiple system atrophy-C (MSA-C). In patients with PD, a significantly negative correlation was observed between MSNA and age, and between MSNA and disease duration. In these patients, the resting frequency of SSNA was significantly lower than in healthy controls, while SSNA reflex latencies were similar to those in the controls. Further investigations to determine whether the autonomic nervous system was impaired are imperative for elucidating the pathogenesis of neurodegenerative disorders.
使用微神经ography评估肌萎缩侧索硬化症（ALS）、脊髓小脑变性（SCD）和帕金森病（PD）患者的交感神经功能。在ALS患者中，静息时的肌肉交感神经活动（MSNA）高于健康受试者和其他神经肌肉疾病患者。在ALS晚期未观察到这一发现。ALS患者皮肤交感神经活动（SSNA）的静息频率显著高于健康对照。在SCD患者中，MSNA略有降低，尽管这些患者在头高位倾斜试验中未出现体位性头晕或晕厥，也未出现明显的血压下降。在皮质小脑萎缩患者中，电刺激诱发的SSNA反射潜伏期略有但显著延长，在多系统萎缩-C（MSA-C）患者中则明显延长。在PD患者中，观察到MSNA与年龄之间以及MSNA与病程之间存在显著的负相关。在这些患者中，SSNA的静息频率显著低于健康对照，而SSNA反射潜伏期与对照相似。进一步研究确定自主神经系统是否受损对于阐明神经退行性疾病的发病机制至关重要。
