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Sympathetic and electrochemical skin responses in the assessment of sudomotor function: a comparative study.

Authors :
Idiaquez J
Casar JC
Fadic R
Iturriaga R
Source :
Neurophysiologie clinique = Clinical neurophysiology [Neurophysiol Clin] 2023 Apr; Vol. 53 (2), pp. 102840. Date of Electronic Publication: 2023 Jan 28.
Publication Year :
2023

Abstract

Objectives: The sympathetic skin response (SSR) is a well-established test, whereas the electrochemical skin conductance (ESC) is still under evaluation. Our aim was therefore to assess the diagnostic accuracy of ESC to detect abnormal sudomotor function, using SSR as a reference test.<br />Methods: A cross sectional observational study was performed of 61 neurological patients assessed for possible sudomotor dysfunction and 50 age-matched healthy controls (HC). Patients with diagnoses of vasovagal syncope (VVS, n=25), Parkinson's disease (PD, n=15), multiple system atrophy (MSA, n=11) and peripheral neuropathies (PN, n=10) were included. Sudomotor function was assessed with SSR and ESC tests in all participants. The absence of SSR in the palms or soles indicates abnormal sudomotor function. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic value of the ESC. Cardiovascular autonomic (CV-Aut) function was evaluated through the Ewing score, based on the following tests: Heart rate change with deep breathing, Valsalva ratio, 30:15 ratio, blood pressure changes on standing and during isometric exercise. A Ewing score ≥ 2 indicates the presence of CV-Aut dysfunction.<br />Results: Mean SSR amplitudes and ESC values showed differences between HC and patients with MSA or PN (p < 0.05), but not in patients with VVS or PD. Absence of SSR was associated with abnormal ESC (p < 0.05). Patients with abnormal CV-Aut dysfunction had lower ESC (p< 0.05). Palm ESC (P-ESC) and sole ESC (S-ESC) assessment had a sensitivity of 0.91 and 0.95 to predict sudomotor dysfunction, with a specificity of 0.78 and 0.85, respectively. The area under ROC curve was 0.905 and 0.98, respectively.<br />Conclusions: ESC in palms and soles has a high diagnostic accuracy for sudomotor dysfunction as detected by absent SSR in patients with MSA and PN.<br />Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interest.<br /> (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Details

Language :
English
ISSN :
1769-7131
Volume :
53
Issue :
2
Database :
MEDLINE
Journal :
Neurophysiologie clinique = Clinical neurophysiology
Publication Type :
Academic Journal
Accession number :
36716506
Full Text :
https://doi.org/10.1016/j.neucli.2022.102840