5. Postganglionic sudomotor involvement in central neurodegenerative disorders

Abstract

Sudomotor function is often impaired in peripheral (PNSd) and central nervous system disorders (CNSd). Mechanisms underlying sudomotor failure in CNSd are not always clear. However, recently an involvement of peripheral nervous system in central neurodegenerative diseases has been observed. Objective of this study is to try of clarifying the involvement of postganglionic sudomotor pathway in CNSd. We studied the peripheral portion of the sudomotor pathway in 22 patients affected by CNSd and 26 patients affected by PNSd, comparing our results to the data from our control group. Sweating at distal leg was evaluated by the dynamic sweat test, a technique able to assess postganglionic sudomotor function by evaluating gland density and sweat production. We observed an impairment of sudomotor function in both groups of patients compared to controls. The density of activated sweat glands per cm2 was 59.7 ± 29.8 in PNSd patients and 49.6 ± 19.6 in CNSd patients. Average sweat volume per single gland was 5.3 ± 3.6 nl in PNSd patients and 3.8 ± 1.5 in CNSd patients. Our data suggest that the peripheral portion of sudomotor pathway is impaired also in patients affected by CNSd.