Huang Yu-Chuan, Huang Chih-Cheng, Lai Yun-Ru, Lien Chia-Yi, Cheng Ben-Chung, Kung Chia-Te, Chiang Yi-Fang, Lu Cheng-Hsien
Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Departments of Hyperbaric Oxygen Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
J Clin Med. 2023 Feb 14;12(4):1517. doi: 10.3390/jcm12041517.
The Composite Autonomic Scoring Scale (CASS) is a quantitative scoring system that integrates the sudomotor, the cardiovagal, and the adrenergic subscores, and the Composite Autonomic Symptom Scale 31 (COMPASS 31) is based on a well-established comprehensive questionnaire designed to assess the autonomic symptoms across multiple domains. We tested the hypothesis that electrochemical skin conductance (Sudoscan) can be a substitute for the quantitative sudomotor axon reflex test (QSART) in the sudomotor domain and assessed its correlation with COMPASS 31 in patients with Parkinson's disease (PD). Fifty-five patients with PD underwent clinical assessment and cardiovascular autonomic function tests and completed the COMPASS 31 questionnaire. We compared the modified CASS (integrating the Sudoscan-based sudomotor, adrenergic, and cardiovagal subscores) and CASS subscores (the sum of the adrenergic and cardiovagal subscores). The total weighted score of COMPASS 31 was significantly correlated with both the modified CASS and the CASS subscore ( = 0.007 and = 0.019). The correlation of the total weighted score of COMPASS 31 increased from 0.316 (CASS subscores) to 0.361 (modified CASS). When we added the Sudoscan-based sudomotor subscore, the case numbers for autonomic neuropathy (AN) increased from 22 (40%, CASS subscores) to 40 (72.7%, modified CASS). The modified CASS not only better reflects the exact autonomic function, but also improves the characterization and quantification of AN in patients with PD. In areas in which a QSART facility is not easily available, Sudoscan could be a time-saving substitution.
复合自主神经评分量表（CASS）是一种定量评分系统，它整合了汗腺运动、心血管迷走神经和肾上腺素能子评分，而复合自主神经症状量表31（COMPASS 31）则基于一份成熟的综合问卷，旨在评估多个领域的自主神经症状。我们检验了这样一个假设，即在汗腺运动领域，电化学皮肤电导（Sudoscan）可以替代定量汗腺运动轴突反射试验（QSART），并评估其与帕金森病（PD）患者COMPASS 31的相关性。55例PD患者接受了临床评估和心血管自主神经功能测试，并完成了COMPASS 31问卷。我们比较了改良CASS（整合基于Sudoscan的汗腺运动、肾上腺素能和心血管迷走神经子评分）和CASS子评分（肾上腺素能和心血管迷走神经子评分之和）。COMPASS 31的总加权分数与改良CASS和CASS子评分均显著相关（分别为=0.007和=0.019）。COMPASS 31总加权分数的相关性从0.316（CASS子评分）增加到0.361（改良CASS）。当我们加入基于Sudoscan的汗腺运动子评分时，自主神经病变（AN）的病例数从22例（40%，CASS子评分）增加到40例（72.7%，改良CASS）。改良CASS不仅能更好地反映确切的自主神经功能，还能改善PD患者AN的特征描述和量化。在不容易获得QSART设备的地区，Sudoscan可能是一种节省时间的替代方法。
