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Autonomic disturbances including impaired hand thermoregulation in multiple system atrophy and Parkinson’s disease

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Autonomic dysfunction in multiple system atrophy (MSA) comprises cardinal symptoms of orthostatic hypotension (OH) and urinary incontinence. Additionally, cardiovagal and sudomotor abnormalities can be present. Previous studies compared hand skin temperature and its response to cooling in subjects with probable MSA and Parkinson’s disease (PD). Significant differences were found indicating that disturbed thermoregulation belongs to MSA autonomic features and could be helpful in differentiation of MSA from PD. The objective of this study was to improve our knowledge about impaired thermoregulation of distal extremities in MSA with parkinsonian features (MSA-P) and PD and to assess the possible interrelations for the different subtypes of autonomic dysfunction in a large cohort of MSA-P, PD and control patients. The patients underwent a standard cooling—rewarming procedure, termed ice test (IT). Electroneurography, heart rate variability, sympathetic skin response and orthostatic tests were performed for the subdivision of the patients. The prevalence of pathological IT was slightly increased in MSA compared with PD and control groups. The presence of pathological IT was related with older patient’s age in PD and control groups significantly (p < 0.05). This relation was absent for the MSA patients, who themselves were significantly younger (p = 0.001). Significant association between the presence of pathological IT and OH was determined (p < 0.001). Defective thermoregulation of distal extremities seems to be more severe in the MSA patients. The dysfunction of preganglionic sympathetic neurons might be involved in impaired response to cooling for MSA. The results suggest pathophysiological affinity of impaired sympathetic neurovascular regulation between pathological IT and OH.

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Acknowledgements

We thank Ms. Tanja Fiesel for a kind assistance in the collection of data.

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Authors and Affiliations

  1. Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu Str. 2, 50009, Kaunas, Lithuania

    Sarunas Augustis

  2. Department of Physics, Mathematics and Biophysics, Lithuanian University of Health Sciences, 50009, Kaunas, Lithuania

    Viktoras Saferis

  3. Parkinson-Klinik Ortenau, 77709, Wolfach, Germany

    Wolfgang H. Jost

Authors
  1. Sarunas Augustis
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  2. Viktoras Saferis
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  3. Wolfgang H. Jost
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Correspondence to Sarunas Augustis.

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The authors declare that they have no conflict of interest.

This is a retrospective study; for this type of study, formal consent is not required.

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Augustis, S., Saferis, V. & Jost, W.H. Autonomic disturbances including impaired hand thermoregulation in multiple system atrophy and Parkinson’s disease. J Neural Transm 124, 965–972 (2017). https://doi.org/10.1007/s00702-016-1665-8

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  • DOI: https://doi.org/10.1007/s00702-016-1665-8

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