Sympathetic skin response and regeneration of sudomotor fibers after complete division of peripheral nerves

Ahčan, Uroš; Kolbl, J; Janko, M

doi:10.1016/0165-1838(95)00118-2

Cited by 6 publications

(6 citation statements)

References 18 publications

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“…It has been noted that the regeneration of digital sympathetic innervation is poor following disruption, even though there is partial recovery of sensory innervation following digital replantation [22]. In this study, significant vasodilatation accompanied by no wrinkling was observed in the replanted fingers after immersion in contrast to skin wrinkling and vasoconstriction in the normal fingers.…”

Section: Fig 3 Perfusion Units Of Normal (N) and Replanted (R) Fingersmentioning

confidence: 57%

EMLA and Water Immersion Cause Similar Vasodilatation in Replanted Fingers

Hsieh

Huang

Liliang

et al. 2007

Journal of Surgical Research

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Section: Fig 3 Perfusion Units Of Normal (N) and Replanted (R) Fingersmentioning

confidence: 57%

EMLA and Water Immersion Cause Similar Vasodilatation in Replanted Fingers

Hsieh

Huang

Liliang

et al. 2007

Journal of Surgical Research

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“…The intermediate and distal sites showed less complete return of the sympathetic skin responses. This study revealed that the regeneration of digital sympathetic innervation was poor after disruption even though there was partial recovery of sensory innervation following digital replantation [1]. Those studies also revealed that the recovery potentials of the sensory and sudomotor functions were different, and should be evaluated, respectively.…”

Section: Discussionmentioning

confidence: 79%

“…Interestingly, no wrinkling was observed in any replanted fingers in this study, with the longest followup being 28 months (mean 17.5 ± 5.2 months). In a study of median or ulnar nerve regeneration following complete severance and suture in hands of patients, Ahcan et al found that in the adult group, after an initial absence, the sympathetic skin responses appeared after about 4 months postoperatively at the most proximal site and progressed subsequently over a 14-or 16-month observation period to less than 50% of the normal side [1]. The intermediate and distal sites showed less complete return of the sympathetic skin responses.…”

Section: Discussionmentioning

confidence: 94%

Paradoxical response to water immersion in replanted fingers

et al. 2006

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When the fingers are immersed in water digital blood flow is reduced and the skin wrinkles, suggesting that vasoconstriction plays a role. However, is wrinkling due to sympathetic activation or some intrinsic property of the skin? To define the role of autonomic innervation in skin wrinkling we measured changes in blood perfusion (Laser Doppler Perfusion Imager) in 20 successfully replanted fingers (mean time after complete amputation 17.5 +/- 5.2 months). We compared responses in replanted fingers with those in corresponding contralateral normal fingers before and immediately after immersion in saline (0.5 mol/l NaCl at 40 degrees C). In the normal fingers, immersion caused a decrease in blood flow by 27.6 +/- 11.5% and skin wrinkling. However, in the replanted fingers blood flow increased by 22.8 +/- 19.6% and the skin did not wrinkle. The paradoxical cutaneous vasodilatation and absence of wrinkling in the denervated fingers suggests that sympathetic innervation is important in water-immersion skin wrinkling.

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“…The SSR test has a well-established protocol, and the results are easily-measured. The results can also be quantified and compared to an established reference range rather than a binary "present" or "absent" response [32]. It has been shown to have a detection rate of up to (96%) in diabetic patients which is higher than alternative electrophysiological measurements [33].…”

Section: Impact Of Ssrmentioning

confidence: 99%

Early Detection of Peripheral Neuropathy by Assessment of Sudomotor Function

Whaley,,

Danev,

Alexander

et al. 2024

Neuro Neurosci

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Chronic hyperglycemia in both type 1 and type 2 diabetes commonly lead to diabetic peripheral neuropathy (DPN) which commonly affects small nerve fibers, including autonomic sudomotor nerves, of the lower limbs. DPN results from nerve damage leading to gradual onset of foot pain, tingling, numbness, muscle weakness, extreme sensitivity to touch, and heat intolerance. Peripheral neuropathy is associated with increased all-cause mortality and morbidities such as foot ulcers, poor wound healing, local and systemic infection, limb amputation, and painful neuropathic symptoms. DPN is also typically diagnosed during later stages when disease progression has already led to irreversible nerve damage and associated severe symptoms. As such, early detection of peripheral neuropathy is important in implementing early interventions and can help preserve nerve function and prevent serious complications of DPN. Non-invasive methods of testing for early DPN rely on assessment of sudomotor nerve function. One method includes quantitative sudomotor axon reflex test (QSART) which measures postganglionic sympathetic function via iontophoresis which allows quantification of sweat production, and by extension, autonomic function. In general, QSART provides a non-invasive, reproducible, and precise evaluation of autonomic function in both controls and diabetics. It can be used to evaluate a large number of autonomic diseases, and the quantitative data it generates provides a measure of the extent and location of the peripheral neuropathy in each individual. Another assessment method includes the sympathetic skin response (SSR) test which measures the change in electrical potential of the skin which itself comes from activated eccrine sweat glands. The SSR test has a well-established protocol, and the results are easily-measured, and the results are quantifiable. It can be used reliably in the diagnosis of numerous autonomic disorders including DPN where a diminished or absent response correlate with sudomotor nerve damage. SudoCheck by VitalScan is an FDA-cleared, non-invasive autonomic sdomotor assessment tool that combines QSART, SSR, BIA, and EIS to provide rapid results with a specificity of 95% and a sensitivity of 80%. It was created to enable a precise evaluation of sweat gland function, and by extension, the presence and progression of diabetic peripheral neuropathy including early sub-clinical disease

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Sympathetic skin response and regeneration of sudomotor fibers after complete division of peripheral nerves

Cited by 6 publications

References 18 publications

EMLA and Water Immersion Cause Similar Vasodilatation in Replanted Fingers

EMLA and Water Immersion Cause Similar Vasodilatation in Replanted Fingers

Paradoxical response to water immersion in replanted fingers

Early Detection of Peripheral Neuropathy by Assessment of Sudomotor Function

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