Side-based Activation of Sympathetic Skin Responses Recorded from the Frontal Region in Idiopathic Parkinson's Disease

Amaç:Bu çalışmada, unilateral başlangıçlı İdyopatik Parkinson Hastalığı'nda, daha fazla tutulan tarafta sempatik deri yanıtlarında diğer tarafa göre fark olup olmadığı ve sempatik deri yanıtları üzerinde kullanılan tedavilerin etkisi araştırılmış ve sağlıklı gönüllüler ile karşılaştırılmıştır. Gereç ve Yöntemler: Çalışmaya 23 hasta ve 22 sağlıklı gönüllü alınmıştır. Hastalar otonom sinir sistemi bulguları ve yüzde hiperhidrozis varlığı açısından sorgulanmıştır. Tedavi öncesi (test 1) ve tedavi sonrası (test 2) sempatik deri yanıtları iki yanlı frontal ve el bölgesinden kayıtlanarak kontrol grubuyla karşılaştırılmıştır. Bulgular: El yanıtlarında Test 1, Test 2 ve kontrol grubunda sağ ve sol taraf arasında, aynı zamanda hasta-sağlam taraf arasında istatistiksel olarak anlamlı bir farklılık göstermemiştir. İlaç tedavisi sonrasında yanıt amplitüdlerinin istatistiksel olarak anlamlı olarak düştüğü kaydedilmiştir. El yanıt amplitüdleri ile Hoehn and Yahr Staging (H&Y) skorları ve Unified Parkinson's Disease Rating Scale (UPDRS) puanları arasında hastalık ilerledikçe negatif korelasyon gözlenmiştir. Sol taraf başlangıçlı olan hastalarda hiperhidroz varlığı sağ taraf başlangıç olanlara göre istatistiksel olarak anlamlı bulunmuştur. Sonuç:Tedavi sonrasında tedavi öncesine göre el yanıtlarında amplitüdlerin düşmesi, habituasyona veya kullanılan ilaçlara bağlı olabileceği düşünülmüştür. Hastalık ilerledikçe amplitüdlerinin istatistiksel olarak anlamlı düştüğü gözlenmiştir. Hiperhidrozlu grupta sol taraf başlangıçlı hastalık olma olasılığının yüksek olması ile ilgili bu güne kadar literatürde herhangi bir bilgiye rastlanmamıştır. Bu konuda daha kapsamlı çalışmalara ihtiyaç vardır.

İdyopatik Parkinson Hastalığı'nda Frontal Bölgeden Kaydedilen Sempatik Deri Yanıtlarının Tutulum Tarafına Göre Etkilenimi

Objective: In a unilateral onset Idiopathic Parkinson disease, sympathetic skin responses elicited from previously and markedly affected and also from unaffected palm and forehead were recorded before and after the treatment. The difference (if any) in sympathetic skin responses recordings obtained from patients and control cases and the impact of Idiopathic Parkinson disease treatments on response sympathetic skin responses were investigated. Materials and Methods: A total of 23 patients and 22 healthy volunteers were included in the study. The patients were examined for autonomic nervous system involvement and the patients with facial hyperhidrosis were determined. Sympathetic skin responses of the patients were recorded twice (before and after initiation of therapy) from both sides of the forehead and both hands and compared with healthy volunteers. Results: A statistically significant difference was not detected between sympathetic skin responses amplitudes of left and right hands in Tests 1 and 2. Significantly lower sympathetic skin responses amplitudes were observed in Test 2. Correlations among amplitudes of hand sympathetic skin responses, Hoehn and Yahr Staging and Unified Parkinson's Disease Rating Scale scores demonstrated significant decreases in amplitudes of sympathetic skin responses in parallel with disease progression. Left side dominancy in patients with hyperhidrosis is statistically significant. Conclusion: Detection of lower amplitudes in hand sympathetic skin responses after therapy may be due to habituation or used drugs. Significant decreases in amplitudes of sympathetic skin responses in parallel with disease progression were observed. No data concerning left side dominancy in the patient group with hyperhidrosis have been detected so far.

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Visser M, Marinus J, Stiggelbout AM, Van Hilten JJ. Assessment of autonomic dysfunction in Parkinson's disease. Mov Disord 2004;19(11):1306-12.
Tolosa E, Gaig C, Santamaria J, Compta Y. Diagnosis and the premotor phase of Parkinson disease. Neurology 2009;72(7):12-20.
Hirashima F, Yokota T, Hayashi M. Sympathetic skin response in Parkinson's disease. Acta Neurol Scand 1996;93(2-3):127-32.
Schestatsky P, Ehlers JA, Rieder CR, Gomes I. Evaluation of sympathetic skin response in Parkinson's disease. Parkinsonism Relat Disord 2006;12(8):486-91. 5.
Meigal AI, Rissanen S, Tarvainen MP, Karjalainen PA, Iudina-Vassel IA, Airaksinen O, et al. Novel parameters of surface EMG in patients with Parkinson's disease and healthy young and old controls. J Electromyogr Kinesiol 2009;19(3):206-13.
Fusina S, Conte S, Bertolasi L, Fincati E, Nardelli E, asymmetry in early stage idiopathic Parkinson's disease. Clin Neurophysiol 1999;110(2):358-66.
Schestatsky P, Valls-Sole J, Ehlers JA, Rieder CR, Gomes I. Hyperhidrosis in Parkinson's disease. Mov Disord 2006;21(10):1744-8.
Suchowersky T, Gronseth diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006;66(7):968-75. J, Zesiewicz Parameter: Practice
Ertekin C, Santral ve Periferik EMG. Ertekin C, editör. Otonomik Sinir Sistemi (OSS). İzmir. META Basımevi; 2006: p.884-909.
Giza E, Katsarou Z, Georgiadis G, Bostantjopoulou S. Sympathetic skin response in Parkinson's disease before and after mental stress. Neurophysiol Clin 2012;42:125- 31.
Jankovic J, Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurgy Psychiatry 2008;79(4):368-76.
Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson disease. Arch Neurol 1999;56(1):33-9.
Yildiz SK, Turkoglu SA., Yildiz N, Ozturk A, Tore F, Sympathetic skin responses of the face and neck evoked by electrical stimulation. Auton Neurosci 2007;134:85- 91.
Taly AB, Muthane UB, Involvement of peripheral nervous system in juvenile Parkinson's disease. Acta Neurol Scand 1992;85(4):272-5.
Mano Y, Nakamuro T, Takayanagi T, Mayer RF, Sweat function in Parkinson's disease. J Neurol 1994;241(10):573-6.
Korczyn AD, Autonomic nervous system disturbances in Parkinson's disease. Adv Neurol 1990;53:463-8.
Wang SJ, Fuh JL, Shan DE, Liao KK, Lin KP, Tsai CP, Wu ZA. Sympathetic skin response and R-R interval variation in Parkinson's disease. Mov Disord 1993;8(2):151-7.
Braune HJ, Korchounov AM, Schipper HI, Schipper, Autonomic dysfunction in Parkinson's disease assessed by sympathetic skin response: a prospective clinical and neurophysiological trial on 50 patients. Acta Neurol Scand 1997;95(5):293-7.
Bordet R, Benhadjali J, Destee A, Hurtevent JF, Bourriez JL, Guieu JD, Et al. Sympathetic skin response and R-R interval variability in multiple system atrophy and idiopathic Parkinson's disease. Mov Disord 1996;11(3):268-72.
De Marinis M, Stocchi F, Gregori B, Accornero N, Sympathetic skin response and cardiovascular autonomic function tests in Parkinson's disease and multiple system atrophy with autonomic failure. Mov Disord 2000;15(6):1215-20.
Braak H, Sastre M, Bohl JR, de Vos RA, Del Tredici K, Parkinson's disease: lesions in dorsal horn layer I, involvement of parasympathetic and sympathetic pre- and postganglionic neurons. Acta Neuropathol 2007;113(4):421-9.
Goetz CG, Lutge W, Tanner CM, Autonomic dysfunction in Parkinson's disease. Neurology 1986;36(1):73-5.
Saito H, Kogure K, Thermal sudomotor deficits in Parkinson's disease. Rinsho Shinkeigaku 1989;29(6):734- 40.
Haapaniemi TH, Korpelainen JT, Tolonen U, Suominen K, Sotaniemi KA, Myllylä VV. Suppressed sympathetic skin response in Parkinson disease. Clin Auton Res 2000;10(6):337-42.
Kitahama K, Nagatsu I, Geffard M, Maeda T, Distribution of dopamine-immunoreactive fibers in the rat brainstem. J Chem Neuroanat 2000;18(1-2):1-9.
Goldstein DS, Robertson D, Esler M, Straus SE, Eisenhofer G, Dysautonomias: clinical disorders of the autonomic nervous system. Ann Intern Med 2002;137(9):753-63.
Sharabi Y, Imrich R, Holmes C, Pechnik S, Goldstein DS, Generalized and neurotransmitter-selective noradrenergic denervation in Parkinson's disease with orthostatic hypotension. Mov Disord 2008;23(12):1725- 32.