The Local Sweat Response to Faradic Stimulation

Wilkins, Robert W.; Newman, Henry W.; Doupe, J.

doi:10.1093/brain/61.3.290

Cited by 30 publications

(11 citation statements)

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“…Sudomotor fibers can be blocked by BoNT/A [4]. Since electrical current used in our experiments also activates peripheral sudomotor fibers and thereby induces local acetylcholine release and axon reflex sweating [45], which is similar in size and spatial extent to the neurogenic flare [33], reduction of flare could readily be explained by blocking these "vasodilatory" sudomotor fibers. However, our results clearly show that there are obvious differences in time courses of inhibition of sweating and neurogenic flare.…”

Section: S Bont/a Reduces Neurogenic Flarementioning

confidence: 75%

Botulinum Toxin A reduces neurogenic flare but has almost no effect on pain and hyperalgesia in human skin

Krämer¹,

Angerer

Erbguth

et al. 2003

Journal of Neurology

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Botulinum toxin A (BoNT/A) has been used therapeutically to treat muscular hypercontractions and sudomotor hyperactivity. There is increasing evidence that BoNT/A might also have analgesic properties, in particular in headache. In the present investigation we tested the often cited hypothesis that BoNT/A-induced analgesia can be attributed to inhibition of neuropeptide release from nociceptive nerve fibers. In 15 healthy volunteers BoNT/A (5, 10, 20 mouse units BOTOX) or saline (contralateral side) was injected intracutaneously on the volar forearm. On day zero, the day of injection, no further tests were performed. We repeatedly elicited pain, mechanical hyperalgesia and neurogenic flare by transcutaneous electrical stimulation simultaneously on the BoNT/A and saline treated side on day 1, 2, 3, 7 and 14 after injection. Before each session, sweating and local anhidrosis was assessed by iodine starch staining.BoNT/A suppressed sweating as early as from the second day after injection (p < 0.001). The size of electrically induced flare was smaller on the BoNT/A treated arm (BoNT/A side: 21.46 cm(2) +/- 3.58, saline side 24.80 +/- 3.46, p < 0.005) and BoNT/A reduced electrically-induced pain by about 10 % (p < 0.001). However, hyperalgesia to pin-prick and allodynia after electrical stimulation were unchanged. In conclusion our results indicate that peripheral neuropeptide release is attenuated by BoNT/A. In contrast, the analgesic effect of BoNT/A was very limited. Therefore we assume that other than neuropeptide mechanisms must be important for BoNT/A induced pain relief in clinical pain syndromes.

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Section: S Bont/a Reduces Neurogenic Flarementioning

confidence: 75%

Botulinum Toxin A reduces neurogenic flare but has almost no effect on pain and hyperalgesia in human skin

Krämer¹,

Angerer

Erbguth

et al. 2003

Journal of Neurology

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“…TST activates thermosensitive neurons in the ventral hypothalamus, which induce sweating via preganglionic and postganglionic sympathetic neurons [42]. The other test, QSART, is thought to involve purely postganglionic mechanisms [22,43].…”

Section: Characterization Of Sudomotor Dysfunctionmentioning

confidence: 99%

Pattern of autonomic dysfunction in time course of complex regional pain syndrome

Birklein

Riedl

Claus

et al. 1998

Clinical Autonomic Research

118

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The objective of the present investigation was to describe and localize autonomic dysfunction in acute and chronic stages of complex regional pain syndrome (CRPS). Patients were investigated twice: the first investigation was performed as soon as diagnosis was established during the acute stage of CRPS and the second investigation was performed about 2 years later. Twenty-one patients completed the follow-up investigation. The median duration of CRPS was 5 (range 2-21) weeks at first investigation and 94 weeks (22-148) at follow-up. Skin temperature was recorded by thermography, sudomotor function was assessed by thermoregulatory sweat test (TST) and quantitative sudomotor axon reflex test (QSART). Skin temperature was warmer on the affected side at the first investigation (P< 0.001) and colder at follow-up (P < 0.02) compared with the contralateral limb. Sudomotor output was enhanced after both TST (P < 0.005) and QSART (P < 0.05) at the first investigation on the affected side. However, at follow-up, sweating after TST was still increased (P < 0.04) while QSART responses were not different between the affected and unaffected limbs. As compared to controls there was no statistically significant difference, neither in skin temperature nor sweating, neither on the affected nor on the unaffected side. In conclusion, the present investigation proved that vasomotor and sudomotor control are substantially altered in CRPS. In the acute stage vasomotor control is decreased in the affected limb whereas sudomotor function is enhanced. This may be the result of disturbances of thermoregulation, but different secondary peripheral mechanisms, concerning vasomotor and sudomotor function, contribute to clinical presentation of CRPS and affect autonomic function at all stages of CRPS.

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“…It must be mentioned that when stimulation gave rise to a very slight pain without sweating or with a very slight sweating, a good response could be obtained by changing the site of the electrode by a few millimetres, as described by Wilkins, Newman and Doupe (2). Therefore, this procedure was needed especially when the effect of the blocking agents was evaluated.…”

Section: Resultsmentioning

confidence: 99%

“…In 1938 Bickford (1) and Wilkins, Newman and Doupe (2) independently found that a local sweating of axon reflex mechanism was produced by faradic stimulation of human skin. They considered that this response might be mediated through the axons of a local sympathetic plexus.…”

mentioning

confidence: 99%

Sweating Axon Reflex Produced by Faradic Stimulation and the Site of Its Initiation

Hanawoka

1958

Jpn.J.Physiol

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The Local Sweat Response to Faradic Stimulation

Cited by 30 publications

References 0 publications

Botulinum Toxin A reduces neurogenic flare but has almost no effect on pain and hyperalgesia in human skin

Botulinum Toxin A reduces neurogenic flare but has almost no effect on pain and hyperalgesia in human skin

Pattern of autonomic dysfunction in time course of complex regional pain syndrome

Sweating Axon Reflex Produced by Faradic Stimulation and the Site of Its Initiation

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