Excitability recovery curve of the sympathetic skin response in healthy volunteers and patients with palmar hyperhidrosis

Manca, Davide; Valls‐Solé, Josep; Callejas, M.A.

doi:10.1016/s1388-2457(00)00394-1

Cited by 46 publications

(23 citation statements)

References 10 publications

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“…In agreement with previous studies [7], the excitability recovery of sympathetic skin response that was observed was 40% faster in patients with hyperhidrosis. The sample size was calculated with sufficient power to detect such a difference, assuming that α00.05 and β0 0.10, two tailed.…”

Section: Sample Size Calculationsupporting

confidence: 93%

Preservation of Alpha-3 Neuronal Nicotinic Acetylcholine Receptor Expression in Sympathetic Ganglia After Brain Death

et al. 2012

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The goal of this study was to evaluate if the immunohistochemical expression of alpha-3 neuronal nicotinic acetylcholine receptor subunit in sympathetic ganglia remains stable after brain death, determining the possible use of sympathetic thoracic ganglia from subjects after brain death as study group. The third left sympathetic ganglion was resected from patients divided in two groups: BDorgan donors after brain death and CON-patients submitted to sympathectomy for hyperhidrosis (control group). Immunohistochemical staining for alpha-3 neuronal nicotinic acetylcholine receptor subunit was performed; strong and weak expression areas were quantified in both groups. The BD group showed strong alpha-3 neuronal nicotinic acetylcholine receptor expression in 6.55% of the total area, whereas the CON group showed strong expression in 5.91% (p00.78). Weak expression was found in 6.47% of brain-dead subjects and in 7.23% of control subjects (p00.31). Brain death did not affect the results of the immunohistochemical analysis of sympathetic ganglia, and its use as study group is feasible.

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Section: Sample Size Calculationsupporting

confidence: 93%

Preservation of Alpha-3 Neuronal Nicotinic Acetylcholine Receptor Expression in Sympathetic Ganglia After Brain Death

et al. 2012

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“…No consistent results have been reported in this condition with SSR, with occasionally absent palmar response [32], or instead enhanced amplitude and sometimes doublepeak responses to single median nerve stimuli [97]. Excitability recovery curves in palmar hyperhydrosis patients showed an interstimulus interval of SSR recovery onset of 1.5 s, compared to 2.5 s in control subjects [106], suggesting enhanced excitability of the sweating circuit. Botulinum toxin (BTX) blocks the release of Ach in the neuromuscular junction and inhibits cholinergic transmission in postganglionic sympathetic cholinergic fibers to sweat glands [1].…”

Section: Ssr: Clinical Applicationsmentioning

confidence: 85%

“…In normal subjects, the second stimulus gives no response when the ISI is between 0.5 and 1.5 s, excitability of the SSR being fully recovered at ISIs of 3.5 s. That the onset of excitability recovery takes longer than the duration of the action potential itself was taken as an indication that an active process of inhibition takes place at the level of the CNS. The conditioning stimulus would thus cause initial excitation followed by a period of active inhibition, in the SSR circuit [106].The SSR excitability recovery curve has been proposed as a useful indicator of excitability changes at the level of the CNS structures which integrate the response.…”

Section: Recording the Ssr: Methods And Proceduresmentioning

confidence: 99%

Sympathetic skin response

et al. 2003

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Sympathetic skin response (SSR), defined as the momentary change of the electrical potential of the skin, may be spontaneous or reflexively evoked by a variety of internal or by externally applied arousal stimuli. Although the suprasegmental structures influencing the SSR in humans are not well known, SSR has been proposed as a non-invasive approach to investigate the function of the sympathetic system. SSR is easy to apply but current procedures are not sufficiently reliable for diagnostic purposes, and show imperfect correlations both with clinical features and other measurements of autonomic, in particular, sudomotor dysfunction.

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“…Sempatik sinir sisteminin bilinmeyen bir nedene bağlı olarak aşırı çalışması en çok suçlanan mekanizmadır (3,12). Ayrıca, ekrin ter bezlerinin emosyonel strese ve/veya fiziksel aktivite ve ısı gibi tüm sempatik uyaranlara karşı yanıtı-nın arttığı ileri sürülmüştür (3,13). Olguların %44'ünde aile öyküsünün olması kalıtım şekli belli olmamakla birlikte genetik yatkınlığın da rol oynayabileceğini düşündürmüştür (14).…”

Section: Hiperhidroz Ve Başlıca Tedavi Seçenekleri Etiyolojiunclassified

Hyperhidrosis and Its Treatment: A Safe and Effective Alternative in the Treatment of Palmoplantar Hyperhidrosis, Iontophoresis

Özcan¹,

Güleç²

2011

Turk J Dermatol

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ÖzetPrimer hiperhidroz sebebi bilinmeyen, en sık palmar, plantar ve aksiller bölgede ortaya çıkan, çoğunlukla bilateral ve simetrik olan aşırı terleme ile karakterizedir. Etkilenen bireylerde fiziksel rahatsızlıklar ve psikososyal güçlüklere yol açtığı için etkin bir şekilde tedavi edilmelidir. Ancak, patofizyolojisinin tam olarak anlaşılmaması nedeniyle tedavisi zordur. Topikal ve sistemik ajanlar ile cerrahi ve cerrahi olmayan invaziv teknikler gibi çeşitli seçenekler bulunmaktadır. İyontoforez, iyonize maddelerin elektrik akımı aracılığıyla yüzey dokulara uygulanması işlemidir. Primer hiperhidrozda invaziv olmayan, güvenli, iyi tolere edilen, etkili ve uzun dönem yan etkiler ile kompansatuvar hiperhidroza neden olmayan bir tedavi yöntemidir. Şiddetli palmar ve/veya plantar hiperhidrozda ve topikal tedaviye yanıt vermeyen orta şiddetteki olgularda ilk tedavi seçeneği olarak önerilmektedir. Aksiller hiperhidrozda ise etkinliği düşüktür ve kullanımı pratik değildir. Zaman alıcı olması ve idame tedavisinin gerekliliği ise en önemli dezavantajlarıdır. Bu makalede, hiperhidroz ve başlıca tedavi seçenekleri, iyontoforezin primer hiperhidroz tedavisindeki endikasyonları, etki mekanizması, tedavi protokolü ile yöntemi, yan etkileri ve kontrendikasyonları derlenmiştir. AbstractPrimary hyperhidrosis is characterized by excessive sweating of unknown cause which most commonly involves the palms, soles, and axillae in a bilateral and symmetrical fashion. Since it leads to physical discomfort and psychosocial difficulties in the affected individuals, it should be treated effectively. However, treatment can be challenging as its pathophysiology is poorly understood. There are several treatment options, including topical or systemic medications and surgical or non-surgical invasive techniques. Iontophoresis is the introduction of ionized substances into the surface tissues by means of an electric current. It is a non-invasive, safe, well tolerated, and effective treatment method for primary hyperhidrosis without long-term adverse effects and compensatory hyperhidrosis. Iontophoresis is suggested as a first-line therapy in severe palmoplantar hyperhidrosis and second-line therapy in milder cases that are unresponsive to topical treatments. In axillary hyperhidrosis it is less effective and not practical to use. Being time consuming and requiring maintenance therapy are its most important disadvantages. In this article, hyperhidrosis and the principal treatment options, the indications of iontophoresis for the treatment of primary hyperhidrosis, its mechanism of action, treatment protocol and procedure, adverse effects, and contraindications are reviewed. (Turk J Dermatol 2011; 5: 5-12)

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Excitability recovery curve of the sympathetic skin response in healthy volunteers and patients with palmar hyperhidrosis

Cited by 46 publications

References 10 publications

Preservation of Alpha-3 Neuronal Nicotinic Acetylcholine Receptor Expression in Sympathetic Ganglia After Brain Death

Preservation of Alpha-3 Neuronal Nicotinic Acetylcholine Receptor Expression in Sympathetic Ganglia After Brain Death

Sympathetic skin response

Hyperhidrosis and Its Treatment: A Safe and Effective Alternative in the Treatment of Palmoplantar Hyperhidrosis, Iontophoresis

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