I Antonio-Rubio1, C J Madrid-Navarro2, E Salazar-López3, M J Pérez-Navarro4, C Sáez-Zea5, E Gómez-Milán6, A Mínguez-Castellanos7, F Escamilla-Sevilla8. 1. Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: isabeldeantonio@gmail.com. 2. Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: cjmn85@gmail.com. 3. CIMCYC (Centro Investigación Mente, Cerebro y Comportamiento), University of Granada, Granada, Spain. Electronic address: elvisalazar@gmail.com. 4. Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: majosepnster@gmail.com. 5. Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: mamensaze@hotmail.com. 6. CIMCYC (Centro Investigación Mente, Cerebro y Comportamiento), University of Granada, Granada, Spain. Electronic address: egomez@ugr.es. 7. Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: adolfo.minguez@sen.es. 8. Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: fescamilla@hotmail.com.
Abstract
BACKGROUND: An autonomic denervation and abnormal vasomotor reflex in the skin have been described in Parkinson's disease (PD) and might be evaluable using thermography with cold stress test. METHODS: A cross-sectional pilot study was undertaken in 35 adults: 15 patients with PD and abnormal [(123)I]-metaiodobenzylguanidine cardiac scintigraphy and 20 healthy controls. Baseline thermography of both hands was obtained before immersing one in cold water (3 ± 1 °C) for 2 min. Continuous thermography was performed in: non-immersed hand (right or with lesser motor involvement) during immersion of the contralateral hand and for 6 min afterward; and contralateral immersed hand for 6 min post-immersion. The region of interest was the dorsal skin of the third finger, distal phalanx. RESULTS: PD patients showed a lower mean baseline hand temperature (p = 0.037) and greater thermal difference between dorsum of wrist and third finger (p = 0.036) and between hands (p = 0.0001) versus controls, regardless of the motor laterality. Both tests evidenced an adequate capacity to differentiate between groups: in the non-immersed hand, the PD patients did not show the normal cooling pattern or final thermal overshoot observed in controls (F = 5.29; p = 0.001), and there was an AUC of 0.897 (95%CI 0.796-0.998) for this cooling; in the immersed hand, thermal recovery at 6 min post-immersion was lesser in patients (29 ± 17% vs. 55 ± 28%, p = 0.002), with an AUC of 0.810 (95%CI 0.662-0.958). CONCLUSIONS: PD patients reveal abnormal skin thermal responses in thermography with cold stress test, suggesting cutaneous autonomic dysfunction. This simple technique may be useful to evaluate autonomic dysfunction in PD.
BACKGROUND: An autonomic denervation and abnormal vasomotor reflex in the skin have been described in Parkinson's disease (PD) and might be evaluable using thermography with cold stress test. METHODS: A cross-sectional pilot study was undertaken in 35 adults: 15 patients with PD and abnormal [(123)I]-metaiodobenzylguanidine cardiac scintigraphy and 20 healthy controls. Baseline thermography of both hands was obtained before immersing one in cold water (3 ± 1 °C) for 2 min. Continuous thermography was performed in: non-immersed hand (right or with lesser motor involvement) during immersion of the contralateral hand and for 6 min afterward; and contralateral immersed hand for 6 min post-immersion. The region of interest was the dorsal skin of the third finger, distal phalanx. RESULTS:PDpatients showed a lower mean baseline hand temperature (p = 0.037) and greater thermal difference between dorsum of wrist and third finger (p = 0.036) and between hands (p = 0.0001) versus controls, regardless of the motor laterality. Both tests evidenced an adequate capacity to differentiate between groups: in the non-immersed hand, the PDpatients did not show the normal cooling pattern or final thermal overshoot observed in controls (F = 5.29; p = 0.001), and there was an AUC of 0.897 (95%CI 0.796-0.998) for this cooling; in the immersed hand, thermal recovery at 6 min post-immersion was lesser in patients (29 ± 17% vs. 55 ± 28%, p = 0.002), with an AUC of 0.810 (95%CI 0.662-0.958). CONCLUSIONS:PDpatients reveal abnormal skin thermal responses in thermography with cold stress test, suggesting cutaneous autonomic dysfunction. This simple technique may be useful to evaluate autonomic dysfunction in PD.
Authors: Milene R Malheiros-Lima; Washington Pires; Ivana A T Fonseca; Julliane V Joviano-Santos; Anderson J Ferreira; Cândido C Coimbra; Nilo R V Lima; Samuel P Wanner Journal: Front Physiol Date: 2018-02-20 Impact factor: 4.566
Authors: Carlos J Madrid-Navarro; Francisco Escamilla-Sevilla; Adolfo Mínguez-Castellanos; Manuel Campos; Fernando Ruiz-Abellán; Juan A Madrid; M A Rol Journal: Front Neurol Date: 2018-03-26 Impact factor: 4.003