Vasomotor and sudomotor function in the hand after thoracoscopic transection of the sympathetic chain: Implications for choice of therapeutic strategy

Rex, Lars; G, Claes; Drott, Christer; Pegenius, Göran; Elam, Mikael

doi:10.1002/(sici)1097-4598(199811)21:11<1486::aid-mus18>3.0.co;2-z

Cited by 22 publications

(1 citation statement)

References 32 publications

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“…Our results may be compared with reports on SSR dynamics after surgical sympathectomy. Some of them come in contrast with our findings and discover little or no change in SSR after sympathectomy. These were, however, single stimulus evoked SSR.…”

Section: Discussioncontrasting

confidence: 99%

Botulinum toxin A for palmar hyperhidrosis: assessment with sympathetic skin responses evoked by train of stimuli

Al-Hashel

Youssry

Rashaed

et al. 2016

Auton Autocoid Pharmacol

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Objective assessment of the effect of botulinum toxin A (BT) treatment in primary palmar hyperhidrosis (PH) is attempted by different methods. We decided to use for this purpose sympathetic skin responses evoked by train of stimuli (TSSR). Twenty patients with severe PH (five female, median age 24, range 18-36) were examined regularly over 3 months after receiving 50 UI BT in each palm. TSSR were recorded from the palms after sensory stimulation by a train of three supramaximal electric pulses 3 millisecond apart. Results were compared to longitudinally studied TSSR of 20 healthy sex- and age-matched control subjects. All hyperhidrosis patients reported excellent improvement. TSSR amplitudes decreased at week 1 (mean 54% range 48%-67%) and over the following months in a clinically significant trend (slope R=-.82, P<.0001). TSSR in controls changed insignificantly (±13% from the baseline). The difference between patients and controls was highly significant at any time point (P<.001). This study suggests that TSSR may help in assessment of treatments in PH. It confirms objectively the efficacy of BT in PH.

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Section: Discussioncontrasting

confidence: 99%

Botulinum toxin A for palmar hyperhidrosis: assessment with sympathetic skin responses evoked by train of stimuli

Al-Hashel

Youssry

Rashaed

et al. 2016

Auton Autocoid Pharmacol

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What lies above and beyond the concept of “sympathetically maintained pain”?

Elam

2001

Clinical Autonomic Research

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Influence of thoracic sympathectomy on cardiac induced oscillations in tissue blood volume

Nitzan

Babchenko

Shemesh

et al. 2001

Med. Biol. Eng. Comput.

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The photoplethysmographic (PPG) signal, which measures cardiac-induced changes in tissue blood volume by light transmission measurements, shows spontaneous fluctuations. In this study, PPG was simultaneously measured in the right and left index fingers of 16 patients undergoing thoracic sympathectomy, and, from each PPG pulse, the amplitude of the pulse (AM) and its maximum (BL) were determined. The parameter AM/BL is proportional to the cardiac-induced blood volume increase, which depends on the arterial wall compliance. AM/BL increased after the thoracic sympathectomy treatment (for male patients, from 2.60+/-1.49% to 4.81+/-1.21%), as sympathetic denervation decreases arterial tonus in skin. The very low-frequency (VLF) fluctuations of BL or AM showed high correlation (0.90+/-0.11 and 0.92+/-0.07, respectively) between the right and left hands before the thoracic sympathectomy, and a significant decrease in the right-left correlation coefficient (to 0.54+/-0.22 and 0.76+/-0.20, respectively) after the operation. The standard deviation of the BL or AM VLF fluctuations also reduced after the treatment, indicating sympathetic mediation of the VLF PPG fluctuations. The study also shows that the analysis of the PPG signal and the VLF fluctuations of the PPG parameters enable the assessment of the change in sympathetic nervous system activity after thoracic sympathectomy.

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Vasomotor and sudomotor function in the hand after thoracoscopic transection of the sympathetic chain: Implications for choice of therapeutic strategy

Cited by 22 publications

References 32 publications

Botulinum toxin A for palmar hyperhidrosis: assessment with sympathetic skin responses evoked by train of stimuli

Botulinum toxin A for palmar hyperhidrosis: assessment with sympathetic skin responses evoked by train of stimuli

What lies above and beyond the concept of “sympathetically maintained pain”?

Influence of thoracic sympathectomy on cardiac induced oscillations in tissue blood volume

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