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Related Experiment Videos

Somatic and autonomic function in progressive autonomic failure and multiple system atrophy.

J Cohen1, P Low, R Fealey

  • 1Mayo Foundation, Rochester, MN 55905.

Annals of Neurology
|December 1, 1987
PubMed
Summary

Progressive autonomic failure (PAF) and multiple system atrophy (MSA) share similar sudomotor dysfunction. However, PAF involves adrenergic failure, while MSA shows preganglionic involvement and less adrenergic denervation.

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Area of Science:

  • Neurology
  • Autonomic Neuroscience

Background:

  • Progressive autonomic failure (PAF) and multiple system atrophy (MSA) are debilitating neurological disorders.
  • Understanding the distinct and overlapping autonomic dysfunction in PAF and MSA is crucial for diagnosis and management.

Purpose of the Study:

  • To compare the patterns of postganglionic sudomotor and vasomotor dysfunction in patients with PAF and MSA.
  • To investigate the involvement of preganglionic neurons and somatic neuropathy in these conditions.

Main Methods:

  • Quantitative sudomotor axon reflex test and supine plasma norepinephrine measurements.
  • Thermoregulatory sweat test, heart rate variability, and blood pressure recordings.
  • Assessment of peripheral somatic neuropathy.

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Main Results:

  • Severe anhidrosis was prevalent in both PAF and MSA patients.
  • Postganglionic sudomotor failure affected 50% of patients at the forearm and over 65% at the foot in both groups.
  • Preganglionic lesions were indicated in some cases, particularly in MSA.
  • Reduced plasma norepinephrine was significant in PAF but not MSA at rest, though reduced upon standing in both.
  • Somatic neuropathy was observed in a subset of patients.

Conclusions:

  • PAF is characterized by combined postganglionic sudomotor and adrenergic failure.
  • MSA exhibits similar postganglionic sudomotor failure but uncommon postganglionic adrenergic denervation.
  • Preganglionic neurons are involved in both disorders, more severely in MSA.
  • Somatic neuropathy can occur in both PAF and MSA.