Bordet R, Benhadjali J, Destee A, Hurtevent J F, Bourriez J L, Guieu J D
Service de Neurologie A, CH et U de Lille, France.
Mov Disord. 1996 May;11(3):268-72. doi: 10.1002/mds.870110309.
We compared autonomic function in patients with multiple system atrophy (MSA) or with idiopathic Parkinson's disease (IPD) by measuring sympathetic skin response (SSR) and R-R interval variability (RRIV). SSR was investigated in 26 patients (13 with MSA and 13 patients with IPD). RRIV during deep breathing, Valsalva maneuver, and on standing was investigated in 20 patients (nine with MSA and 11 with IPD). MSA and IPD patients had similar age, illness duration, and therapy. Abnormal SSR was more frequent in MSA (69%) than in IPD (7.7%; x2, 10.4; p < 0.002). RRIV during deep breathing and the Valsalva maneuver was lower in MSA than in IPD (p = 0.02). RRIV during standing up was not significantly different in IPD and MSA. These differences between MSA and IPD may be due to more severe and widespread autonomic disturbance in MSA, related to more severe neuropathologic involvement of the autonomic nervous system. SSR and RRIV may aid in the differential diagnosis of parkinsonism and help to exclude from clinical trials MSA patients clinically misdiagnosed as having IPD.
我们通过测量交感神经皮肤反应（SSR）和R-R间期变异性（RRIV），比较了多系统萎缩（MSA）患者和特发性帕金森病（IPD）患者的自主神经功能。对26例患者（13例MSA患者和13例IPD患者）进行了SSR研究。对20例患者（9例MSA患者和11例IPD患者）进行了深呼吸、瓦尔萨尔瓦动作及站立时的RRIV研究。MSA和IPD患者的年龄、病程及治疗情况相似。MSA患者中异常SSR的发生率（69%）高于IPD患者（7.7%；χ²=10.4；p<0.002）。MSA患者深呼吸和瓦尔萨尔瓦动作时的RRIV低于IPD患者（p=0.02）。IPD和MSA患者站立时的RRIV无显著差异。MSA和IPD之间的这些差异可能是由于MSA中更严重、更广泛的自主神经紊乱，这与自主神经系统更严重的神经病理累及有关。SSR和RRIV可能有助于帕金森综合征的鉴别诊断，并有助于在临床试验中排除临床误诊为IPD的MSA患者。
