The Sympathetic Skin Response In The Patients With Spinal Cord Injury

Objectives:The aim of this study is to find out the different features of sympathetic skin response(SSR) between the patients with spinal cord injury(SCI) and normal subjects. The SSR may be a new objective method to assess the integrity of spinal autonomic nervers (especially for sympathetic system) in the patients with SCI.Subjects and methods:Subjects Twenty chronic patients with SCI in different levels (neural level: range C5 to L3) and degrees (AIS: range A to D) were involved in the SSR testing. They were 16 male and only 4 female whose average age is 37±14(15~59) years. The duration for SCI onset was 2 weeks to 9 months. Meanwhile, 20 normal subjects(11 male and 9 female) were tested as the control group.methods All subjects lie supine on the bed with the electrical stimulation in left supra orbital, median and tibial nerve respectively. At the same time, the record electrodes were set at the bilateral palms of two hands and soles of feet. The the shape, amplitude and lantency of SSR were analyzed in each group.Results:No matter where the electrode on , the detection rate of SSR in patient with complete spinal cord injury decreased(p<0.05). SSR could not be recorded in the patients with complete SCI above level T6 by stimulating left supra orbital, median and tibial nerve, respectively. There was no significant difference between control group and complete spinal cord injury group with T6 to T11(p>0.05). The rates of response at sole-SSR decreased when stimulated left tibial nerve in the patients with incomplete SCI(p<0.05). There was a significant difference between control group and incomplete spinal cord injury group when considering about initial latency and amplitude by stimulating left median never(p<0.05). Otherwise, nearly 50 percent of the patients with abnormal palm SSRs had one autonomic dysreflexia episode history.Conclusion:SSR of the patients with chronic SCI were abnormal and even disapeared by comparing with control group. We may apply the SSR to assess the impact of the autonomic nerve system, particularly for the sympathetic systems after spinal cord injury.