[Thermal sudomotor deficits in Parkinson's disease]

In order to evaluate sympathetic functions in Parkinson's disease (PD), thermal sweating was examined with colorimetric method in 50 cases of PD (22 males & 28 females, mean age at examination: 58 +/- 9.6 ys, mean duration of illness: 5.3 +/- 3.6 years, Hoehn and Yahr's stage: II-IV, patients without drugs: 15), and following results were obtained; normal sweating in 20 (A), possible generalized hyperhidrosis in 5 (B), localized hyperhidrosis in 4 (C), unilateral hypohidrosis in 7 (D), hypohidrosis over the trunk and legs in 7 (E), and anhidrosis over the trunk and lower extremities in 7 (F). In group F, acetylcholine- or pilocarpine-sweating was also defective, suggesting that postganglionic sympathetic fibers were also impaired. The results were analyzed with respect to age, duration and severity of illness, predominant somatic symptoms, postural changes of blood pressure or subjective dysuria. Abnormal sweating appeared to be related to higher age, severity of PD, and to rigid akinesia as the predominant symptoms. Group B appeared to involve relatively young patients without orthostatic hypotension or dysuria. Group B and C included 5 tremor-dominant patients. But, these features were not statistically significant. Patients in group F had rigid akinesia as the predominant feature (p less than 0.01), and showed higher incidence of dysuria (p less than 0.05). They appeared to have severe PD symptoms in spite of relatively shorter duration of the disease. An administration of drugs including anticholinergics had no significant influence upon the present results. It has been reported by several authors that the rapid progression of PD symptoms and early deterioration of mental status are related to rigid akinesia.(ABSTRACT TRUNCATED AT 250 WORDS)