Uncini A, Di Muzio A, Cutarella R, Malatesta G, Lugaresi A
Laboratorio di Neurofisiologia Clinica, Università di Chieti.
Riv Neurol. 1989 May-Jun;59(3):113-20.
The sympathetic skin response (SSR) represents the momentary change in skin potential reflexively evoked by a variety of arousal stimuli. Although sudomotor unmyelinated fibres are the final efferent pathway of SSR, little is known about the afferent and central components. SSR was recorded using different classes of stimuli in 20 controls, 15 peripheral neuropathy and 13 stroke patients. In controls SSR latencies changed significantly with different recording sites but not with different stimulation sites. Additionally, ischemic conduction block of the arm abolished SSR recorded at the hand after median nerve stimulation. In 1 patient with subacute ganglionitis and in 3 with demyelinating neuropathies the SSR could be elicited with deep inspiration but not by electric stimulation. These results suggest that myelinated fibres serve as afferents for SSR. In stroke patients SSR was absent bilaterally after stimulation of the paralyzed side but present after stimulation of the normal one. Therefore in humans the cortex seems to have a suprasegmental excitatory influence on SSR. The above findings imply that an unobtainable SSR by electric stimulation may be due not only to dysfunction of the autonomic efferent nerve fibers, but also to involvement of sensory afferents or suprasegmental structures.
交感皮肤反应（SSR）代表由各种唤醒刺激反射性诱发的皮肤电位的瞬间变化。虽然汗腺运动无髓纤维是SSR的最终传出通路，但对其传入和中枢成分了解甚少。在20名对照者、15名周围神经病患者和13名中风患者中使用不同类型的刺激记录SSR。在对照者中，SSR潜伏期随记录部位不同而有显著变化，但不随刺激部位不同而变化。此外，手臂的缺血性传导阻滞消除了正中神经刺激后手部位记录的SSR。在1例亚急性神经节炎患者和3例脱髓鞘性神经病患者中，深吸气可引出SSR，但电刺激不能引出。这些结果提示有髓纤维作为SSR的传入神经。在中风患者中，刺激瘫痪侧后双侧SSR消失，但刺激正常侧后SSR存在。因此在人类，皮质似乎对SSR有节段上的兴奋性影响。上述发现提示，电刺激无法引出SSR可能不仅是由于自主传出神经纤维功能障碍，还可能是由于感觉传入或节段上结构受累。
