Alterations in electrochemical skin conductance as a marker of autonomic dysfunction in multiple system atrophy
Parkinsonism & Related Disorders. 2022-10-01; 103: 56-59
DOI: 10.1016/j.parkreldis.2022.08.026
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Georges C(1), Lloret-Perez S(2), Ory-Magne F(1), Fabbri M(1), Foubert-Samier A(3), Meissner WG(4), Rascol O(5), Pavy-Le Traon A(6).
Author information:
(1)CHU Toulouse, Service de Neurologie, Centre de Référence de l’Atrophie
Multi-systématisée, Toulouse, France.
(2)Data Science Research Laboratory, Pontifical Catholic University, National
Research Council (UCA-CONICET), Buenos Aires, Argentina; Physiology Department,
Medicine School, University of Buenos Aires, Argentina.
(3)CHU Bordeaux, Service de Neurologie des Maladies Neurodégénératives, IMNc,
F-33000, Bordeaux, France; Univ. Bordeaux, CNRS, IMN, UMR 5293, F-33000,
Bordeaux, France.
(4)CHU Bordeaux, Service de Neurologie des Maladies Neurodégénératives, IMNc,
F-33000, Bordeaux, France; Univ. Bordeaux, CNRS, IMN, UMR 5293, F-33000,
Bordeaux, France; Dept. Medicine, University of Otago, Christchurch, and New
Zealand Brain Research Institute, Christchurch, New Zealand.
(5)CHU Toulouse, Service de Neurologie, Centre de Référence de l’Atrophie
Multi-systématisée, Toulouse, France; Centre d’investigation Clinique CIC 1436,
Service de Pharmacologie Clinique et de Neurosciences, NeuroToul Center of
Excellence in Neurodegeneration (COEN) de Toulouse, INSERM, Univ. Toulouse,
Toulouse, France.
(6)CHU Toulouse, Service de Neurologie, Centre de Référence de l’Atrophie
Multi-systématisée, Toulouse, France; Institut des Maladies Métaboliques et
Cardiovasculaires (I2MC), CHU Toulouse, INSERM UMR 1297, Toulouse, France.
Electronic address: .
BACKGROUND: Multiple System Atrophy (MSA) is a rare neurodegenerative disease
with pronounced autonomic failure (AF). Severe cardiovascular AF is associated
with poor prognosis. Since sweating dysfunction is less well known, we
investigated the interest of a quick and non-invasive assessment of sweating
using electrochemical skin conductance (ESC) as a marker for AF in MSA.
METHODS: 138 MSA patients of the French Reference center for MSA with an annual
follow-up including the Unified MSA Rating Scale (UMSARS), COMPASS (autonomic
symptoms) and measurements of foot and hand ESC (Sudoscan®) participated to this
study (age 65 ± 8 years, 66% probable MSA, 72% AMS-P). Statistical analysis
included: (i) correlations between ESC and MSA type, age, disease duration,
severity, blood pressure (BP), COMPASS, (ii) comparisons between groups with
normal or abnormal ESC, and (iii) multivariate analysis by logistic regression.
Relationships between severity progression during follow-up with ESC and other
variables were modeled by Generalized Estimating Equation.
RESULTS: Hands and feet ESCs were abnormal in 81/138 (59%) and 93/138 (67%)
cases, respectively. Abnormal ESCs were significantly correlated to disease
severity and several features of AF. ESCs worsening over time was more
pronounced than other autonomic features such as orthostatic hypotension.
Abnormal ESCs at baseline were significantly associated with a higher
progression of UMSARS’s score during follow-up.
CONCLUSION: Sweating dysfunction assessed by ESC is frequent in MSA and is
significantly related to disease severity and AF. The gradual decrease in ESC
with disease duration could be useful as a quantitative marker of autonomic
dysfunction.
Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.