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Observational Study
. 2023 May;30(5):1281-1292.
doi: 10.1111/ene.15733. Epub 2023 Feb 24.

Two-Year observational study of autonomic skin function in patients with Parkinson's disease compared to healthy individuals

Timo Siepmann  1 , Martin Arndt  1 , Annahita Sedghi  1 , Szabolcs Szatmári Jr  2 , Tamás Horváth  3 , Annamária Takáts  2 , Dániel Bereczki  2 , Mats Leif Moskopp  4   5 , Sylvia Buchmann  6 , Cornelia Skowronek  7 , Wagner Zago  8 , Warunya Woranush  5 , Razvan Lapusca  9 , Marie Luise Weidemann  1 , Christopher H Gibbons  10 , Roy Freeman  10 , Heinz Reichmann  1 , Volker Puetz  1 , Kristian Barlinn  1 , Alexandra Pintér  11 , Ben Min-Woo Illigens  10
Affiliations
Observational Study

Two-Year observational study of autonomic skin function in patients with Parkinson's disease compared to healthy individuals

Timo Siepmann et al. Eur J Neurol. 2023 May.

Abstract

Background and purpose: We characterized autonomic pilomotor and sudomotor skin function in early Parkinson's disease (PD) longitudinally.

Methods: We enrolled PD patients (Hoehn and Yahr 1-2) and healthy controls from movement disorder centers in Germany, Hungary, and the United States. We evaluated axon-reflex responses in adrenergic sympathetic pilomotor nerves and in cholinergic sudomotor nerves and assessed sympathetic skin response (SSR), predominantly parasympathetic neurocardiac function via heart rate variability, and disease-related symptoms at baseline, after 2 weeks, and after 1 and 2 years.

Clinicaltrials: gov: NCT03043768.

Results: We included 38 participants: 26 PD (60% females, aged 62.4 ± 7.4 years, mean ± SD) and 12 controls (75% females, aged 59.5 ± 5.8 years). Pilomotor function was reduced in PD compared to controls at baseline when quantified via spatial axon-reflex spread (78 [43-143], median [interquartile range] mm2 vs. 175 [68-200] mm2 , p = 0.01) or erect hair follicle count in the axon-reflex region (8 [6-10] vs. 11 [6-16], p = 0.008) and showed reliability absent any changes from baseline to Week 2 (p = not significant [ns]). Between-group differences increased over the course of 2 years (p < 0.05), although no decline was observed within groups (p = ns). Pilomotor impairment in PD correlated with motor symptoms (rho = -0.59, p = 0.017) and was not lateralized (p = ns). Sudomotor axon-reflex and neurocardiac function did not differ between groups (p = ns), but SSR was reduced in PD (p = 0.0001).

Conclusions: Impairment of adrenergic sympathetic pilomotor function and SSR in evolving PD is not paralleled by changes to cholinergic sudomotor function and parasympathetic neurocardiac function, suggesting a sympathetic pathophysiology. A pilomotor axon-reflex test might be useful to monitor PD-related pathology.

Keywords: Parkinson disease; autonomic nervous system; nerve; skin; synucleinopathy.

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References

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