Characteristics of sympathetic skin response in patients with Parkinson's disease accompanied by lower limb edema

Abstract

Lower limb edema significantly impairs the quality of life of Parkinson's disease (PD) patients and impedes their nursing care. A cross-sectional study was conducted on 42 PD patients and 38 healthy controls. Hoehn & Yahr (HY) and Unified Parkinson's Disease Rating Scale part I-IV (UPDRS I-IV) scales were used to assess the severity of PD, and electromyography was used to measure the sympathetic skin response (SSR). The general clinical characteristics, medication status and assessment of other autonomic nervous functions were also recorded. Patients were classified into PDE (edema) and PDNE (non-edema) subgroups, and had similar age, disease duration, HY scale, and autonomic nervous function assessment other than SSR. However, PDE patients had higher UPDRS II and III (activities of daily living and motor examination) subscores compared to PDNE patients (P=0.004 and P=0.012, respectively). The amplitude of SSR in the lower limbs was lower and the latency prolonged in PD patients, and these changes were more pronounced in the PDE subgroup. Finally, 83% of the PDE patients were regularly taking pramipexole, compared to 25% in the PDNE group. PD patients with lower limb edema have lower SSR amplitude and longer latency. Oral intake of pramipexole may be a contributing risk factor for edema.