A Study on Sympathetic Skin Response and RRIV in Patients with Shy-Drager Syndrome
|School||Tianjin Medical University|
|Keywords||Shy-Drager syndrome Sympathetic skin response The rate of change of the R - R interval|
Objective: To investigate the Shy-Drager syndrome characteristics of sympathetic skin response (SSR) and RR interval changes rate (RRIV), observation of the autonomic nervous system damage, and provide an objective basis for electrophysiological diagnosis of Shy-Drager syndrome early autonomic nervous . Method: 1. Subjects selected from 2008 to 2010 in the hospital of neurology inpatient and outpatient patients, male 10 cases, female two cases, 12 cases; aged 46-61 years, mean 53.8 ± 5.0 years; course of the disease 6 months to 7 years, an average of 2.25 ± 1.8 years, which course of gt; five cases, seven cases of ≤ 2 years. Control group: choose healthy adults of 15 cases, including 12 males and 3 females; age 42-60 years, mean 53.0 ± 4.8 years. Previously had no nervous system diseases, diabetes, abnormal thyroid function, such as alcoholism, drug toxicity, nor of taking nervous system drugs, no abnormal neurological examination. No significant difference between the control group and the group of patients in the age and gender composition. All objects Dundee Keypoint EMG / evoked potential checks. Examination room and requested quiet room temperature 22-24 ° C. (1) SSR determination: the the subjects supine position, awake, relax, keep the skin temperature 32-36 ° C. Stimulate wrist median nerve, ground wrist of 15-20cm at hand, the dorsum of the foot placed reference electrode, hand, foot palm record. Stimulation 0.1ms, band-pass 1-30Hz, analysis of 5-10s, sensitivity 0.1-0.5mV/cm impedance following 5kΩ, stimulus intensity so that the thumb flexion prevail, the strength of 15-40mA, stimulus 4 times measuring the onset latency and peak - peak amplitude of the average for the results of analysis, each stimulus interval 1min above, given the erratic stimulation to avoid habitual results. The entire testing process is completed within 15min. (2) RRIV determination: the recording electrode placed in the apex of the left sternal intercostal reference electrode placed in the sternum, band-pass 1-30Hz record calm breathing a 1min of RRIV and take a deep breath when the RRIV. Results: All healthy control group can elicit SSR, Shy-Drager syndrome patients in 4 cases (33.3%) did not lead to the SSR. 2.Shy-Drager syndrome the patient limbs volatility differences compared with normal group was statistically significant (P lt; 0.001), and the incubation period of no significance (P gt; 0.05). 3. Patient group SSR volatility all have different degrees of abnormality. The two sets of upper limb incubation period showed no statistical significance (P gt; 0.05), lower extremity latency difference were no statistical significance (P gt; 0.05). The course of the disease and the incubation period and amplitude of limb abnormalities rate related (P lt; 0.05); irrelevant of age and the incubation period and amplitude of limb abnormalities rate (P gt; 0.05). The two groups RRIV take a deep breath and calm respiratory parameters were statistically significant (P lt; 0.05). 7 two sets of peripheral nerve conduction velocity was not statistically significant (P gt; 0.05). Conclusion: 1. Disappear by the experimental verification of patients SSR also check exception of a performance. 2.SDS patients SSR incubation period volatility involved relatively late. Able 3.SSR earlier than clinical symptoms reflect impaired sweat gland activity, help to identify subclinical lesions. 4.SDS patients limbs sweating abnormalities usually no significant difference. 5. Course of the incubation period, volatility was positively correlated, that is, the longer the duration, the higher the latency and amplitude of limb abnormalities rate; Age latency, amplitude was no significant correlation. 6 The RRIV change from the laboratory to prove the presence of SDS patients vagus nerve dorsal nucleus of the parasympathetic nervous system damage, and at the same time the RRIV is to detect a more sensitive indicator of Shy-Drager syndrome parasympathetic dysfunction. SDS patients with peripheral nerve conduction velocity were normal.