Impairment of calcitonin gene-related peptide-induced potentiation of cholinergic sweat secretion in patients with multiple system atrophy.

Loss of sweating is a characteristic feature of multiple system atrophy (MSA) with autonomic failure, and widespread anhidrosis may lead to hyperthermia and collapse in a hot environment. Calcitonin gene-related peptide (CGRP) is present in the periglandular nerves around sweat glands and is a strong stimulant of methacholine (MCH)-mediated cholinergic sweating. The present study evaluated CGRP-related regulation of cholinergic sweating in patients with MSA. CGRP-induced potentiation of MCH-mediated cholinergic sweating was significantly reduced in MSA patients as compared with normal age-matched controls. These results suggest that regulation of sweating is extensively affected in MSA as a consequence of peptidergic dysfunction.