Autonomic and Neuroendocrinological Laboratory, Department of Neurology, University of Technology Dresden, Fetscherstrasse 74, 01307 Dresden, Germany.
J Neural Transm (Vienna). 2010 Apr;117(4):475-9. doi: 10.1007/s00702-010-0375-x. Epub 2010 Feb 12.
The cold hand sign (CHS) is a distinct feature of multiple system atrophy (MSA), but its pathophysiology is poorly understood. We, therefore, conducted a study to examine the skin temperature and the skin blood flow at rest and after local heating in 6 age-matched MSA patients with CHS (MSA + CHS), 18 MSA patients without CHS (MSA - CHS) and 13 patients with idiopathic Parkinson's disease (PD). Basal skin temperature and blood flow were significantly lower in MSA + CHS patients than in MSA - CHS or PD patients. Local heating induced a greater response in terms of amplitude in MSA + CHS compared to MSA - CHS and PD. Considering kinetics, skin blood flow increment per 1 degrees C was higher in MSA + CHS than MSA - CHS but was similar when compared to PD patients. Skin blood flow rate (change per second) did not differ among the groups. Our findings suggest that despite impaired basal skin perfusion, the skin vasomotor response to local heating is intact in MSA + CHS but disturbed in MSA - CHS. By measuring skin temperature and blood flow, the presence of CHS can be diagnosed in MSA patients. Further studies are necessary to understand regulation of skin perfusion in patients with extrapyramidal disease.
冷手征（CHS）是多系统萎缩（MSA）的一个显著特征，但它的病理生理学机制尚未完全清楚。因此，我们进行了一项研究，以检查 6 名年龄匹配的有 CHS 的 MSA 患者（MSA + CHS）、18 名无 CHS 的 MSA 患者（MSA - CHS）和 13 名特发性帕金森病患者（PD）在休息和局部加热后的皮肤温度和血流。与 MSA - CHS 或 PD 患者相比，MSA + CHS 患者的基础皮肤温度和血流明显较低。在幅度方面，与 MSA - CHS 和 PD 相比，局部加热在 MSA + CHS 患者中引起的反应更大。考虑到动力学，MSA + CHS 患者的每 1 摄氏度皮肤血流量增加幅度高于 MSA - CHS，但与 PD 患者相似。皮肤血流速度（每秒变化）在各组之间无差异。我们的研究结果表明，尽管基础皮肤灌注受损，但 MSA + CHS 患者的皮肤血管运动反应对局部加热是完整的，而 MSA - CHS 患者则受到干扰。通过测量皮肤温度和血流，可以在 MSA 患者中诊断出 CHS 的存在。需要进一步的研究来了解锥体外系疾病患者皮肤灌注的调节。
