A Study On Sympathetic Skin Response And RRIV In Patients With Shy-Drager Syndrome

Objective:To study the association between sympathetic skin response and Shy-Drager syndrome, and explore its use as the objective base for its diagnosis.Methods:1. we collected 12 patients of Shy-Drager syndrome participating in the study,whom accepted the cure in hospital from January in 2008 to 2010, from 46 to 60 years old,average age 53.8a:5.0 years old, male 10, female 2. Average duration: 2.25a:1.8year. we also maked a normal control group, which contain 15 healthy volunteers participated in the study,from 42 to 60 years old, average age 53.0a:4.8 years old,male 12, female 3.There was no previous neurological disease,diabetes,thyroid dysfunction,alcoholism,drug toxicity,etc.There was no abnormal examination with volunteers.control group and patient group in age and gender composition was not significantly different.2.We check all objects using Keypoint.Asked a quiet examination room, the room temperature22-24℃.(1)SSRexamination:Subjects are supine,alert,relaxed,maintaining skin temperature 32-36℃。Stimulate median nerve.Ground is located at the wrist 15-20cm.We place reference electrodes on the dorsum of the hand and foot.And we also place recording electrodes on the palm and zuxin.Stimulus duration 0.1ms,band-pass 1-30Hz,analysis time 5-10s,sensitivity 0.1-0.5mV/cm.The impedance is less than 5kΩ.The standard of stimulus intensity is thumb flexion. Stimulus intensity 15-40mA,stimulation 4 times.We measure the latency and amplitudes. Averaged for the analysis of results.Each stimulus interval is greater than 1min.To avoid the habitof the results,we give irregular stimulus to all the people.Throughout the trial completed in 15 min. Second:RRIV examination:we place recording electrodes on the apical of the 5th intercostal space left sternal border.And we place reference electrodes on the sternal manubrium. Band-pass is 1-30Hz.Record RRIV parameters of quiet breathing and deep breathing 1min.Results:1. All the controls demonstrated abnormal SSR in four limbs. Four patients have no responses in SSR in both the feet and hands.2.Compared with normal controls, the amplitudes of four limbs of the Shy-Drager syndrome patients have statistical significance (P<0.001).While the latency between the tow groups has no significance (P>0.05).3.The amplitudes of the Shy-Drager syndrome patients are all exceptions.4. Compared with normal controls, the latency difference of the Shy-Drager syndrome patients has no significance (P>0.05).5. The limb abnormal rate of latency and amplitudes is related with duration (P<0.05); Age has nothing to do with the limb abnormal rate of latency and amplitudes (P>0.05).6. Compared with normal controls, the RRIV parameters of quiet breathing and deep breathing 1min have statistical significance (P<0.05)7.Comparison of nerve conduction velocity of the tow groups was not significant (P>0.05).Conclusion:1.Buy this experiment,the the disappearance of the SSR in patients is an abnormal performance.2.The latency involved of the Shy-Drager syndrome patients is later than the amplitude.3.SSR reflects the clinical symptoms can be earlier than the damage to sweat gland activity, help to identify subclinical lesions.4.Sweating abnormalities in Shy-Drager syndrome patients with limb have no significant difference.5. The longer the duration,the higher rate of abnormal latency. Age has nothing to do with latency and amplitudes.6. RRIV parameters changes confirmed the damage of the parasympathetic nervous system,such as dorsal nucleus of vagus.7. Nerve conduction velocity of the Shy-Drager syndrome patients is abnormal.