Artículo
Alterations in electrochemical skin conductance as a marker of autonomic dysfunction in multiple system atrophy
Registro en:
1353-8020
10.1016/j.parkreldis.2022.08.026
Autor
Georges, Claire
Pérez Lloret, Santiago
Ory Magne, Fabienne
Fabbri, Margherita
Foubert-Samier, Alexandra
Meissner, Wassilios G.
Rascol, Olivier
Pavy-Le Traon, Anne
Institución
Resumen
Abstract: 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.