Application Of Sympathetic Skin Response In Chronic Inflammatory Demyelinating Polyradic Uloneuropathy

Objective:To investigate the diagnostic value of sympathetic skin response (SSR) in autonomic nervous system dysfunction in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).Methods:Twenty nine CIDP cases hospitalized in the Second Affiliated Hospital of Zhejiang Universtity School of Medicine between November2011and March2013were collected, and the central or peripheral nervous system damages and any other diseases with affecting autonomic nervous system were excluded. Thirty healthy people receiving regular physical examination in the same term were collected as the normal control group. SSR test and autonomic symptom profile (ASP) were performed in all participantes.Results:1. The abnormal rate of SSR(75.86%)in CIDP group was significantly higher than that of the control group (0)(p<0.01).2. The wave amplitudes of SSR in CIDP group were significantly lower than those of the control group (p<0.01). The latency between the two groups had no statistical significance (p>0.05).3. The abnormal rate of SSR had no statistical significance between the upper and lower limbs in CIDP group (p>0.05).4.The score of ASP (25.35points) and its abnormal rate (65.52%) in CIDP group were significantly higher than those of the control group (12.58points and0, respectively)(p<0.01). 5. In CIDP group, the abnormal rates of SSR (75.86%) and ASP score (65.52%) were both significantly higher than those of the autonomic symptom appearance (31.03%)(p<0.01). The abnormal rate of SSR had no statistical significance with that of ASP score (p>0.05).6. Compared the abnormal rate of SSR with autonomic symptoms subgroup (100.00%) and the one without autonomic symptoms subgroup (65.00%) in29patients with CIDP, the difference was statistically significant, and they had correlation(p<0.05). While the abnormal rate of ASP score with autonomic symptoms subgroup (77.78%) and the one without autonomic symptoms subgroup (60.00%) had no statistical significance and no correlation (p>0.05).7. In CIDP group, the results of SSR and conventional electrophysiological testing showed no correlation.8. The protein content in cerebrospinal fluid of CIDP patients was no correlation with the results of SSR.9. Compared the course of disease not less than12months subgroup and less than12months subgroup in CIDP patients, the latency and wave amplitudes of SSR of the upper and lower limbs both had no statistical significance (p<0.05).Conclusions:1. SSR can sensitively detect autonomic nerve dysfunction in CIDP patient.2. The abnormal rate of SSR has high correlation with the autonomic symptom appearance rate in CIDP patient, and SSR can be objective and quantitative. SSR can be used as a clinical reliable electrophysiological index to early detect autonomic dysfunction in patients with CIDP.