Sympathetic skin response in myelopathies

Area of Science:

• Neuroscience
• Clinical Electrophysiology
• Autonomic Nervous System Research

Background:

• Autonomic dysfunctions are common and serious complications in spinal cord disorders, impacting patient morbidity and mortality.
• Sympathetic skin response (SSR) is a noninvasive electrophysiological test that can assess sympathetic nervous system function.
• Evaluating SSR in myelopathy patients may offer insights into autonomic impairment and clinical outcomes.

Purpose of the Study:

• To investigate the utility of Sympathetic Skin Response (SSR) in patients diagnosed with myelopathy.
• To correlate SSR findings with clinical characteristics, lesion severity, somatosensory evoked potentials (SSEP), and patient outcomes.
• To determine if SSR can serve as a prognostic indicator in spinal cord disorders.

Main Methods:

• Thirty myelopathy patients underwent electrophysiological assessments, including SSR and SSEP.
• SSR was recorded from palm and sole following stimulation of the supraorbital, median, and posterior tibial nerves.
• SSEP was recorded from the scalp after median and posterior tibial nerve stimulation.

Main Results:

• Absent SSR from the sole was observed in 25 patients, and from the palm in 10 patients.
• Absent SSR from the palm correlated with poorer outcomes, while preserved palmar SSR with posterior tibial nerve stimulation indicated better outcomes and bladder sensation.
• Absent SSR from the sole did not show significant correlation with clinical features, bladder dysfunction, or prognosis.

Conclusions:

• Sympathetic skin response is frequently abnormal in patients with myelopathies, indicating autonomic pathway involvement.
• Preserved palmar SSR following posterior tibial nerve stimulation may be a valuable predictor of good motor recovery and preserved bladder sensation.
• SSR serves as a useful adjunct tool for evaluating patients with spinal cord disorders and predicting outcomes.