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Anhidrosis in multiple system atrophy: a preganglionic sudomotor dysfunction?

Journal article
Authors Vincenzo Donadio
Maria Nolano
Mikael Elam
Pasquale Montagna
Vincenzo Provitera
Enrico Bugiardini
Agostino Baruzzi
Lucio Santoro
Rocco Liguori
Published in Movement disorders : official journal of the Movement Disorder Society
Volume 23
Issue 6
Pages 885-8
ISSN 1531-8257
Publication year 2008
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 885-8
Language en
Links dx.doi.org/10.1002/mds.21972
Keywords Aged, Autonomic Fibers, Postganglionic, physiopathology, Autonomic Nervous System Diseases, physiopathology, Humans, Hypohidrosis, etiology, Male, Middle Aged, Multiple System Atrophy, physiopathology, Sympathetic Fibers, Postganglionic, physiopathology, Sympathetic Nervous System, physiopathology
Subject categories Medical and Health Sciences

Abstract

Anhidrosis occurs in the majority of multiple system atrophy (MSA) patients but the underlying site of lesion is not well established. We describe three patients with long-standing MSA and anhidrosis diagnosed on the basis of a thermoregulatory sweating test. In biopsies of anhidrotic skin, immunofluorescence analysis disclosed a well preserved postganglionic sudomotor innervation in all three patients supporting the hypothesis of a preganglionic nerve fiber lesion underlying their anhidrosis. Postganglionic sudomotor fiber integrity was also confirmed by normal electrodermal responses in one patient, whereas such responses and microneurographically detectable skin sympathetic nerve activity were absent in the other two MSA patients, suggesting a functional inactivity of structurally intact postganglionic sympathetic skin fibers.

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