Motor neuron disease (MND) O-MN001. Association of sympathetic skin response in amyotrophic lateral sclerosis

Abstract

Introduction. Amyotrophic lateral sclerosis (ALS) is the most common type of motor neuron disease. General concept is autonomic disturbances are extremely rare in ALS. Some hypotheses have put forward to see autonomic involvement in ALS. Previous studies have found an association between sympathetic skin response (SSR) and ALS as a part of autonomic involvement. The study was aimed to explore the association of SSR in ALS. Methods. This case control study was carried out in the Department of Neurology, BSMMU, Dhaka, from April 2018 to September 2019. Total 70 subjects were enrolled as study population after fulfilling inclusion and exclusion criteria. Among them, 35 were grouped as case and rest 35 were as control. All patients with ALS were diagnosed according to The Revised El Escorial diagnostic criteria fulfilling definite, probable, probable lab-supported and possible cases of ALS with no family history of ALS. Results. The study included 35 ALS patients and 35 age- and sex-matched controls. SSR was absent in 6 (17.1%) cases in upper limbs and 20 (57.1%) cases in lower limbs. In 4 patients, SSR was absent in both upper and lower limbs. Among control group SSR response was present in all population. There was significant difference in mean latency and amplitude of SSR in case and control group (p-value < 0.001). Absent SSR in ALS with bulbar palsy showed obvious difference with ALS without bulbar palsy (p-value 0.040). There was an association of SSR with severity of disease in ALS patient (p-value 0.030) but we could not establish it with duration of disease. Conclusion. In this study we found significant relationship between SSR and ALS. We noticed an association of SSR with severity of disease in ALS.