Shindo Kazumasa, Watanabe Harue, Ohta Emiko, Nagasaka Takamura, Shiozawa Zenji, Takiyama Yoshihisa
Department of Neurology, University of Yamanashi Hospital, Yamanashi, Japan.
Amyotroph Lateral Scler. 2011 Jan;12(1):39-44. doi: 10.3109/17482968.2010.508529. Epub 2010 Aug 25.
In patients with amyotrophic lateral sclerosis (ALS), sudomotor and vasomotor function have been considered to be impaired based on sympathetic skin response (SSR) or cutaneous blood flow measurements. We evaluated sympathetic sudomotor and vasoconstrictive neural function in ALS. We simultaneously recorded SSR, skin blood flow, and skin sympathetic nerve activity (SSNA) by microneurography in 20 patients with sporadic ALS and 20 healthy controls. Resting frequency of SSNA was significantly higher in ALS patients than in controls (p <0.05), but the increase of SSNA associated with mental arithmetic was smaller in ALS patients than controls (p <0.05). ALS patients also exhibited slight prolongation of SSNA reflex latencies compared with controls (p <0.05). In conclusion, sympathetic hyperactivity was observed in relation to sudomotor and vasoconstrictive skin responses. Since SSNA reflex latencies reflect central sympathetic function, the central autonomic pathways may be slightly impaired in patients with ALS.
在肌萎缩侧索硬化症（ALS）患者中，基于交感神经皮肤反应（SSR）或皮肤血流测量，发汗运动和血管运动功能被认为受损。我们评估了ALS患者的交感发汗运动和血管收缩神经功能。我们通过微神经ography同时记录了20例散发性ALS患者和20例健康对照者的SSR、皮肤血流和皮肤交感神经活动（SSNA）。ALS患者的SSNA静息频率显著高于对照组（p<0.05），但与对照组相比，ALS患者与心算相关的SSNA增加较小（p<0.05）。与对照组相比，ALS患者的SSNA反射潜伏期也略有延长（p<0.05）。总之，观察到与发汗运动和血管收缩性皮肤反应相关的交感神经过度活跃。由于SSNA反射潜伏期反映中枢交感神经功能，ALS患者的中枢自主神经通路可能略有受损。
