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Objectives@#To explore the critical values of temperature perception in various mucosa sites of oral cavity and to draw the perceptive temperature threshold maps in healthy volunteers. To observe the interrelationship between subjective cognitive perception and sympathetic skin response (SSR) under various levels of thermal stimuli.@*Methods@#Forty-two healthy volunteers (recruited from the students of Tianjin Medical University, 16 females and 26 males) were enrolled in the present study. The whole oral mucosa of each subject was divided into multiple partitions according to the mucosa type as well as tooth position. Peltier patch (commodity name) semiconductor chip was placed in the central part of each subarea of the mucosa. The stimulus was increased or decreased at 1 ℃ each time from a baseline temperature of 37 ℃. Warm (WT) and cold (CT) perception thresholds were measured thereafter respectively. A topographic temperature map of the oral mucosa for each subject was drew. Furthermore, the SSR was elicited and recorded at three temperature levels of 50 ℃, 55 ℃, 60 ℃ respectively. Analog test with visual analogue scale (VAS) and McGill scales were also performed. Data were statistically analyzed with variance and generalized estimation equation.@*Results@#The tip of the tongue was the most sensitive area with both WT [(38.8±2.1) ℃, P<0.05] and CT [(23.5±4.2) ℃, P<0.05]. The highest heat threshold of gingival mucosa was in the left lower posterior teeth area [(49.9±3.7) ℃, P<0.05], and the highest cold threshold of gingival mucosa was in the left upper posterior teeth area [(15.9±5.5) ℃, P<0.05]. The perceptive temperature threshold increased gradually from the midline to both left and right sides were observed symmetrically and bilaterally. There was no statistically significant differences in temperature perception threshold between males and females [WT, male (44.8±3.1) ℃, female (44.8±3.2) ℃, OR=1.100, P=0.930; CT, Male (18.4±4.9) ℃, female (20.8±4.8) ℃, OR=0.157, P=0.210]. The SSR amplitude at sites of the tongue tip and the lower lip were increased with the rise of temperature [tongue tip (4.58±4.04) mv, P<0.05, lower lip (2.89±3.01) mv, P<0.05]. However, SSR amplitude values had no significant differences between males and females [tongue tip, male (2.00±2.16) mv, female (1.89±1.20) mv, P=0.890; lower lip, male (0.94±0.82) mv, female (0.85±0.68) mv, P=0.887]. Nevertheless, the amplitude of SSR and the VAS score of subjects showed a similar trend.@*Conclusions@#The temperature perception levels were different amongst sites of lip, buccal mucosa, tongue dorsal mucosa and gingival mucosa. SSR amplitude values could reflect the responses of the mouth to the thermal stimuli.
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The nerve electrophysiological tests may differentiate the treatment of primary premature ejaculation (PPE) in our previous studies. However, no study verifies if the results will be affected by abstinence time. From January to December in 2016, fifty PPE patients ejaculated within 2 min and 28 control subjects were enrolled. The nerve electrophysiological tests, including dorsal nerve somatosensory evoked potential (DNSEP), glans penis somatosensory evoked potential (GPSEP), and penile sympathetic skin response (PSSR), were recorded before and immediately after ejaculation. The abstinence day was not correlated with the latencies of SEPs or PSSR neither in PE group (P = 0.170, 0.064, and 0.122, respectively) nor in control group (P = 0.996, 0.475, and 0.904, respectively). No statistically differences were found in the latencies of SEPs and PSSR before and after ejaculation in PE patients (P = 0.439, 0.537, and 0.576, respectively) or control subjects (P = 0.102, 0.198, and 0.363, respectively). Thus, abstinence time does not interfere with the nerve electrophysiological test, which is stable in determining the nerve function of PPE patients.
Subject(s)
Adult , Humans , Male , Middle Aged , Young Adult , Ejaculation , Electric Stimulation , Electrophysiological Phenomena , Evoked Potentials, Somatosensory , Penis/physiopathology , Premature Ejaculation/physiopathology , Prospective Studies , Sexual Abstinence , Skin/innervation , Sympathetic Nervous System/physiopathologyABSTRACT
Objective To evaluate the value of heart rate variability (HRV ) and sympathetic skin response (SSR) in differential diagnosis of Parkinson's disease (PD) .Methods We selected 36 PD ,17 essential tremor (ET) and 59 Parkinsonism-Plus (PD-plus) patients diagnosed in our department .We recorded HRV during the period of quiet breath ,deep breath and Vasaval as well as SSR incubation period of the upper limbs and lower limbs . Results ① During the period of quiet breath ,HRV decreased significantly in PD group compared with that in ET group (P< 0 .05) ,and abnormality rate of HRV in PD group was higher than that in ET group .HRV did not significantly differ between PD and PD-plus .HRV did not significantly differ among the three groups during the period of deep breath and Vasaval .② SSR incubation period showed no significant difference among PD ,PD-plus and ET groups .③ The specificity and sensibility of HRV in PD and PD-plus differential diagnosis were 22 .8% and 82 .6% , while for PD and ET differential diagnosis the values were 66 .9% and 82 .6% . The specificity and sensibility of SSR in PD and PD-plus differential diagnosis were 39 .0% and 52 .6% , 29 .4% and 52 .6% , respectively ,for PD and ET differential diagnosis .Conclusion Compared with those in ET patients ,HRV in PD patients decreases and HRV abnormality rate increases .HRV is of great value in differential diagnosis of PD and ET but not in differential diagnosis of PD and PD-plus .Determining SSR incubation period does not have much value in differential diagnosis of PD ,PD-plus and ET .
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The nerve electrophysiological tests may differentiate the treatment of primary premature ejaculation (PPE) in our previous studies. However, no study verifies if the results will be affected by abstinence time. From January to December in 2016, fifty PPE patients ejaculated within 2 min and 28 control subjects were enrolled. The nerve electrophysiological tests, including dorsal nerve somatosensory evoked potential (DNSEP), glans penis somatosensory evoked potential (GPSEP), and penile sympathetic skin response (PSSR), were recorded before and immediately after ejaculation. The abstinence day was not correlated with the latencies of SEPs or PSSR neither in PE group (P = 0.170, 0.064, and 0.122, respectively) nor in control group (P = 0.996, 0.475, and 0.904, respectively). No statistically differences were found in the latencies of SEPs and PSSR before and after ejaculation in PE patients (P = 0.439, 0.537, and 0.576, respectively) or control subjects (P = 0.102, 0.198, and 0.363, respectively). Thus, abstinence time does not interfere with the nerve electrophysiological test, which is stable in determining the nerve function of PPE patients.
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This study retrospectively reviewed 75 patients with impaired glucose tolerance(IGT)admitted in our hospital from March 2015 to October 2015.All patients underwent Toronto clinical scoring system(TCSS) evaluation.Patients with IGT were further divided into normal score group(TCSS-N, n=50)and abnormal score group(TCSS-A, n=25)according to their scoring results, and 30 healthy volunteers were served as control group.All patients and controls underwent motor and sensory nerve conduction studies, as well as sympathetic skin response(SSR)test using the Keypoint.Net(Medoc Ltd)electromyogram device.The results showed that the SSR amplitude of lower limbs was reduced [(0.61±0.44 vs 1.00±0.33)mv, P<0.05]andlatencyoflowerlimbswas extended [(1 880±282 vs 1 642±256)ms, P<0.05]in IGT group compared with control group.But median, ulnar, tibial, and peroneal nerve sensory and motor conduction revealed no difference between two groups.In TCSS-A group, the SSR amplitude of lower limbs was reduced [(0.47±0.39)mv, P<0.05], latency of lower limbs was extended [(2 062±291)ms,P<0.05]and the sensory nerve action potential(SNAP)amplitude of the tibial nerve was significantly lower compared with control group [(1.83±0.37 vs 2.07±0.30)μv, P<0.05].Compared to TCSS-N group, latency of lower limbs was extended [(2 062±291 vs 1 808±246)ms, P<0.05]in TCSS-A group.The SSR amplitude of lower limbs were reduced[(0.66±0.44)mv,P<0.05]and latency were prolonged(P<0.05)in TCSS-N group compared with control group.Pearson correlation analysis showed that the SSR amplitude and latency of the lower limbs were correlated with the postprandial blood glucose, blood glucose fluctuation, body weight, as well as body mass index.These results suggest that there exists peripheral nerve damage in the patients with IGT, mainly involving the small fiber nerve of the lower limbs.Large fibers may also be mildly affected as the disease progresses.
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Objective To evaluate the impairment of large and small fibers of peripheral nerves in patients with diabetes mellitus according to the current perception threshold ( CPT ) comparing with nerve conduction studies ( NCS) and sympathetic skin response ( SSR).Methods Fourty-nine diabetic patients were enrolled from August to December 2014 in Tianjin Third Central Hospital.The CPT was examined by the Neurometer?CPT/C in diabetic patients and 23 healthy subjects.Electrical stimulations of 2 000, 250 and 5 Hz were delivered respectively to the first toe distal section , the bottom of the knee-patella middle line and the index finger distal section.NCS and SSR were performed in diabetic patients.The patients were divided into normal NCS ( NCSN) group and abnormal NCS ( NCSA) group according to the results of the nerve conduction.According to the results of SSR , the patients were divided into normal SSR ( SSRN) group and abnormal SSR ( SSRA ) group.Results In three testing areas , the CPT in NCSN group had no significant difference compared with control group , which was tested by different frequency;NCSA group had increased CPT (393.5 ±68.4, 213.1 ±39.7, 172.5 ±52.8, 221.6 ±48.0, 91.7 ±33.1, 76.2 ±27.8, 274.0 ±48.4, 120.1 ±26.6, 75.3 ±21.9) compared with control group (278.1 ±53.6, 128.9 ±46.7, 78.7 ±28.7, 149.3 ±54.6, 52.3 ±23.2, 41.9 ±18.7, 214.2 ±46.0, 96.0 ±29.3, 48.6 ±17.0; F=36.277, 40.827, 50.301, 10.240, 12.837, 13.832, 11.749, 5.559, 17.412,all P<0.01).At the first toe section, CPT decreased in SSRN group ( 91.0 ±29.0, 55.2 ±21.3 ) compared with control group (128.9 ±46.7, 78.7 ±28.7;F=23.071, 22.646, both P<0.05), which was tested by the currents of 250 Hz and 5 Hz frequency.In three testing areas , the SSRA group had increased CPT compared with control group , which was tested by different frequency.Conclusion Hyperesthesia as an early manifestation of small fiber damage can be detected by CPT in diabetic patients; CPT has no advantage in the evaluation of large fiber damage.
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Objective To evaluate the value of united nerve electrophysiological tests in the diagnosis of diabetic peripheral neuropathy (DNP).Methods The quantitative temperature threshold (QTT), including the cold sensation threshold (CST) , thermal sensation threshold (WST), cold pain threshold (CPT) and thermal pain threshold (HPT), sympathetic skin response (SSR) and nerve conduction velocity (NCV) were measured for 85 diabetic patients.Results The abnormal rate of QTT was 84.71％ , significantly higher than that of SSR and NCV (56.47％ and 31.76％ respectively).However, no significant difference was found in the abnormal rate of QTT between the DPN asymptomatic group and DPN symptomatic group (78.85％ and 93.94％ respectively).There was significant difference in the abnormal rate of SSR (48.08％ and 69.70％ respectively) and the abnormal rate of NCV (19.23％ and 51.52％ respectively) between the above two groups(P ＜ 0.05).There was no difference in the abnormal rate of QTT for patients with short or long course of disease (77.77％ and 89.80％ respectively), but significant difference in the abnormal rate of SSR (44.44％ and 65.31％ respectively) and the abnormal rate of NCV (19.44％ and 40.82％ respectively) Conclusion The abnormal rate of QTT was highest in detecting the diabetic patients, and it is not related to clinical symptoms or disease course.However, the abnormal rates of SSR and NCV were related to clinical symptoms and course.It is more sensitive to diagnose DPN using united electrophysiological tests of QTT, SSR and NCV.
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This descriptive study was undertaken to investigate the influence of menstrual cycle on sympathetic skin response (SSR) during different phases of menstrual cycle in young healthy Indian women. A comparison of SSR latencies and amplitudes were done in the follicular, ovulatory and mid luteal phases of menstrual cycle. Fifty women in age group of 18 – 25 years having regular menstrual cycles were chosen for this study. After confirming the regularity of menstrual cycle, SSR was performed on them. The recording was done under standardized conditions using standardized procedure. Amplitude of SSR was found to vary in the three phases, but the differences were statistically not significant. Latency of SSR was found to be greatest in the follicular phase (1.54 ± 0.22 s) and least in the mid-luteal phase (1.35 ± 0.18 s). Statistically significant differences were found between mean SSR latency in the follicular phase and the other two phases (p < 0.01). This study concludes that SSR is enhanced during the mid-luteal phase in women with regular menstrual cycles indicating sympathetic dominance.
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Objective To study the features and differences of electromyography of diabetic polyneuropathy (DPN) and alcoholic peripheral neuropathy (APN ), and to provide reference basis for the clinical application of electromyography.Methods 58 patients with DPN and 30 patients with APN were used as subjects. Nerve conduction studies (NCS)and sympathetic skin response (SSR)were performed in the patients, all data were analyzed.Results In the patients with DPN, the abnormalities of NCS and SSR were increased with the prolongation of the time diabetes,and the abnormality of SSR was higher than that of NCS(P<0.05).In the patients with APN, both demyelination and axonal loss in motor and sensory nerves were significantly involved, and the abnomalities of NCS and SSR were higher than those of the DPN patients (P<0.05 or P<0.01);but the proximal nerves were just involoved mildly. Conclusion Both DPN and APN have characteristic electrophysiological features.Early electromyography is useful for the early diagnosis of DPN and APN.According to the electrophysiological features of DPN and APN,the reason of peripheral neuropathy in the patients who have diabetes mellitus and alcoholism could be differentiated.
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Objective To investigate the role of activities of sympathetic nerve in the pathogenesis of shoulder-hand syndrome (SHS) by analyzing the hand sympathetic skin response (SSR) at the acute stage of SHS after stroke. Methods 50 stroke patients with SHS at the acute stage were assigned as SHS group, another 50 stroke patients without SHS as control group (N-SHS group) and 50 health volunteers as health group. Every patient was subjected to the detection of bilateral hand SSR. Results The detection rates of SSR in the SHS group and N-SHS group were significantly lower than that in the Health group (P 0 . 05 ) . In comparison with the health group , bilateral SSR latencies of the SHS group were longer than those of the health group (P<0.05) and bilateral SSR amplitudes were all lower than those of the health group (P<0.01). Conclusions The bilateral hand sympathetic skin responses could change at the acute stage of SHS after stroke, with possible presentations of central inhibition of sympathetic activity. The abnormality of SSR may be an early warning indicator in patients with hemiplegia after stroke complicated with SHS.
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BACKGROUND AND PURPOSE: Electrodiagnostic studies can be used to confirm the diagnosis of lumbosacral radiculopathies, but more sensitive diagnostic methods are often needed to measure the ensuing motor neuronal loss and sympathetic failure. METHODS: Twenty-six patients with lumbar radiculopathy and 30 controls were investigated using nerve conduction studies, motor unit number estimation (MUNE), testing of the sympathetic skin response (SSR), quantitative electromyography (QEMG), and magnetic resonance myelography (MRM). RESULTS: Using QEMG as the gold standard, the sensitivity and specificity of MUNE for the abductor hallucis longus muscle were 71.4% and 70%, respectively. While they were 75% and 68.8%, respectively, when used MRM as gold standard. The sensitivity and specificity of MUNE for the extensor digitorum brevis muscle were 100% and 84.1%, respectively, when the peroneal motor amplitude as the gold standard. The SSR latency was slightly longer in the patients than in the controls. CONCLUSIONS: MUNE is a simple and sensitive test for evaluating autonomic function and for diagnosing lumbosacral radiculopathy in patients. MUNE could be used routinely as a guide for the rehabilitation of patients with radiculopathies. SSR measurements may reveal subtle sympathetic abnormalities in patients with lumbosacral radiculopathy.
Subject(s)
Humans , Axons , Diagnosis , Electromyography , Methods , Motor Neurons , Muscles , Myelography , Neural Conduction , Radiculopathy , Rehabilitation , Sensitivity and Specificity , SkinABSTRACT
Objective To observe any therapeutic effect of transcutaneous electric nerve stimulation (TENS) on patients with shoulder-hand syndrome after stroke (SHSAS) and to examine the influence of TENS on sympathetic skin response (SSR).Methods Sixty-eight patients with SHSAS were randomly divided into a treatment group (35 cases) treated with routine rehabilitation training and TENS therapy and a control group (33 cases)treated with routine rehabilitation training only.The therapy for both groups lasted 3 weeks.The severity of pain and edema of the affected upper limb was assessed with a visual analogue scale (VAS) while sympathetic skin response was recorded from the affected upper limb before and after treatment.Results VAS scores improved significantly in the treatment group,and significantly more than in the control group.There was no significant difference in the SSR latencies,amplitudes or abnormality rates between the two groups before treatment.The latencies and abnormality rates of both groups improved significantly after treatment,but the improvement in the treatment group was more obvious.The SSR amplitudes did not change significantly after treatment in either group.There was a positive correlation between the SSR latencies and abnormality rates and the VAS scores,but no significant correlation between SSR amplitude and the VAS scores.Conclusions TENS therapy combined with routine rehabilitation training showed not only good clinical results,but also significant changes in SSR among patients with SHSAS.This indicates that SSR could be used to evaluate therapeutic effects in SHSAS patients.
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Objective To explore the value of sympathetic skin response (SSR) detection for evaluating the autonomic nervous damage in patients with cerebral infarction.Methods 56 cases with cerebral infarction within 2 weeks and 50 cases of healthy controls were detected SSR by EMG,and the results were compared.Results 18 patients with cerebral infarction did not elicit SSR and 18 patients were abnormal with the latency and amplitude of SSR,and the abnormality rate of SSR was accounting for 64.29％,which was significantly different compared with control group( t =10.66,3.83,all P ＜0.01 ).Conclusion The patients with cerebral infarction had severe autonomic dysfunction and SSR,and SSR detection was a simple,safe and noninvasive method,and could quantitatively evaluate the svmpathetic function in patients with cerebral infarction.
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Objective To explore sympathetic skin response (SSR) in the region innervated only by the median or ulnar nerve. Methods Thirty healthy volunteers, ten patients with median nerve injury, ten patients with ulnar nerve injury and three patients with both median and ulnar nerve injury were involved in the study. SSR was elicited by electrical stimulation and the latency and amplitude of the SSR were recorded in the center of the palm and on the hypothenar, and the pulps of the index and little fingers. Results After median nerve injury the SSR of the index finger pulp disappeared, the SSR amplitude of the palmar center was reduced, while the SSR amplitude of the little finger pulp was normal. In contrast, after ulnar nerve injury the SSR of the little finger pulp disappeared,the SSR amplitude of the hypothenar was reduced, while the SSR of the index finger pulp was normal. When both nerves were injured, no SSR could be elicited anywhere on the palm. Conclusions The SSR of the palmar center and hypothenar are affected by both the median and ulnar nerves. The index and little finger pulps are sites for recording SSR which represent the SSR of the median and ulnar nerve distribution, respectively. Index and little finger pulps are ideal sites for detec t ing efferent functioning of sympathetic nerves from the median and ulnar nerve paths,respectively.
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Objective To discuss the change of sympathetic skin response (SSR) in patients with cerebral thrombosis with no more than 60 years old. Method SSR was measured in four positions of the center of hand palm and foot palm of 40 normal controls ( control group ) and 56 cerebral thrombosis patients (cerebral thrombosis group) no more than 60 years old. Results SSR wave shape was all educed in control group,but 21 limbs (21/224,9.4%) were not educed in cerebral thrombosis group, SSR abnormality was 80 limbs (35.7% ). SSR's latency in cerebral thrombosis group was obviously prolonged as compared with control group,and the amplitudes of SSR of upper limps and lower limbs had significance between two groups (P< 0.05 or < 0.01). There were serious abnormity within 3 days to 2 months after cerebral thrombosis. Conclusion SSR is a sensitive diagnosis method for the autonomic neuropathy of cerebral thrombosis patients of no more than 60 years old.
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OBJECTIVE: To investigate the relationship among the alcohol drinking history, autonomic symptom scores (ASS), and the autonomic functions measured with sympathetic skin response (SSR) and heart rate variability (HRV) of alcoholic patients, and to assess the difference between the values from the autonomic function tests of patients and normal controls. METHOD: SSR and HRV were measured in 44 patients and 26 controls. ASS and Toronto clinical neuropathy scoring system (TCNSS) scores were also assessed. For the HRV, the mean heart rate, standard deviation of the NN intervals (SDNN), total power (TP), very low frequency (VLF), low frequency (LF), and high frequency (HF) in both the supine and standing positions were evaluated. For the SSR, the onset latency and amplitude of both the palm and sole were measured. RESULTS: There were no significant relationships among the alcohol history, the TCNSS, and the results of the autonomic function tests. There were, however, significant relationships among their ASS and some values from autonomic function tests [i.e., the sole amplitudes, the SDNNs (supine), and the TPs (standing)]. There were significant differences between the sole amplitudes of the patients and controls. In HRV, there were significant differences between the patients and controls with respect to their SDNNs and TPs at a standing position. CONCLUSION: Autonomic function tests such as SSR and HRV are related to ASS, but not to alcohol history and TCNSS. Moreover, the values from the autonomic function tests of the alcoholic patients decreased, unlike the normal controls.
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Humans , Alcohol Drinking , Alcoholics , Alcoholism , Equidae , Heart Rate , SkinABSTRACT
OBJECTIVE: To evaluate the autonomic nervous function in post-stroke patients. METHOD: A total of 58 subjects, 34 post-stroke patients (mean age of 61.35 years) and 24 healthy subjects (mean age of 34.42 years) were included. The sympathetic skin response (SSR), the R-R interval variation (RRIV) and orthostatic hypotension (OH) were evaluated. Bilateral sympathetic skin responses were recorded on the palm and sole with stimulation of both median and tibial nerves. The obtained SSRs were divided into normal response and abnormal response including no response. The R-R interval variations were estimated during rest, deep breathing and Valsalva maneuver respectively. RESULTS: In all healthy subjects, obtained SSRs were of normal response. Although the rate of abnormal SSR was 75.4% (205 of 272 waves) in stroke patients, the rate of abnormal SSR on affected side (81.6%, 111 of 136 waves) was significantly higher than unaffected side (69.1%, 94 of 136 waves) (p0.05). The RRIV of stroke patients with OH (1.09+/-0.06) was significantly lower than in control (1.14+/-0.05) during rest (p<0.01), and in stroke patients without OH, the RRIV (1.13+/-0.06) was also significantly lower than in control (1.27+/-0.22) during Valsalva maneuver (p<0.01). CONCLUSION: Evaluation of SSR and RRIV could be helpful in detecting dysfunction of autonomic nervous system in post-stroke patients.
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Humans , Autonomic Nervous System , Hypotension, Orthostatic , Respiration , Skin , Stroke , Tibial Nerve , Valsalva ManeuverABSTRACT
Objective To evaluate the diagnostic value of sympathetic skin response(SSR)in patients with vestibular vertigo.Methods SSR tests were performed on 1 20 patients with acute vestibular system vertigo,including 70 cases of central vertigo and 50 eases of peripherM vertigo.60 healthy subjects were also examined to serve as controls.Results In those with central vertigo,the abnormality rate in the SSR results was 87.1%(61/70).SSR latency was longer and its amplitude wag lower than in those with peripheral vertigo and in the heMthy controls.In those with peripheral vertigo the abnormality rate was 18.0%(9/50),but the average latency and amplitude were not significantly different from those of the healthy controls.Conclusion Persons with acute central vestibular vertigo may have sympathetic nerve dysfunction.SSR test results can be used as an electrophysiological index to distinguish central from peripheral vestibular vertigo.
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Objective To investigate the features of variation of sympathetic skin response(SSR)in depression patients and to clarify the correlation between SSR and the effect of antidepressant therapy in first episode depression.Methods The sample comprised 50 first visit patients,who fulfilled the ICD-10 criteria in a structured interview for depressive disorder.These 50 patients received antidepressant therapy for 6 weeks.Clinical response was defined as ≥50%reduction in total 17-item Hamilton depression rating scale(HAMD).Remission was defined as HAMD score ≤7 at week 6.SSR waveforms were classified into three patterns based on the amplitudes of positive and negative components:P pattern,N pattern and M pattern.Another 50 healthy subjects were involved in this study as controls.Results (1)SSR could be obtained in all normal subjects but couldn't be recorded in 5 of 50 patients whose HAMD scores>28.SSR waveforul patterns were analyzed in these 45 patients P pattern in 7 cases,N pattern 21,M pattern 17.(2)Depression patients had longer latency and lower amplitude than the controls(P<0.01).P pattern had shorter latency and higher amplitude than N pattern.There were no difference in age,course and HAMD scores among the patients with 3 different SSR patterns.(3)Nine of 21 patients of N pattern treated with fluoxetine were remitters.6 patients were clinical responders.These 15 patients had shorter latency and higher amplitude after treatment than that at the initial stage,but there were still differences in latency and amplitude compared with the controls.Conclusion There were significant damages on sympathetic function of depression patients.N pattern was the most SSR pattern among 45 patients recorded SSR.P pattern had shorter latency and higher amplitude than N pattern.SSR is a sensitive and feasible measure inder for neurocardiac electrophysiologic autonomic regulation examination,which could be used to measure clinical therapeutic efficacy for antideppressant in depression patients.
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The long-term effects of low-level lead intoxication are not known. The sympathetic skin response (SSR) was evaluated in a group of 60 former workers of a primary lead smelter, located in Santo Amaro, BA, Brazil. The individuals participating in the study were submitted to a clinical-epidemiological evaluation including questions related to potential risk factors for intoxication, complaints related to peripheral nervous system (PNS) involvement, neurological clinical examination, and also to electromyography and nerve conduction studies and SSR evaluation. The sample consisted of 57 men and 3 women aged 34 to 69 years (mean ± SD: 46.8 ± 6.9). The neurophysiologic evaluation showed the presence of lumbosacral radiculopathy in one of the individuals (1.7 percent), axonal sensorimotor polyneuropathy in 2 (3.3 percent), and carpal tunnel syndrome in 6 (10 percent). SSR was abnormal or absent in 12 cases, representing 20 percent of the sample. More than half of the subjects (53.3 percent) reported a history of acute abdominal pain requiring hospitalization during the period of work at the plant. A history of acute palsy of radial and peroneal nerves was reported by about 16.7 and 8.3 percent of the individuals, respectively. Mean SSR amplitude did not differ significantly between patients presenting or not the various characteristics in the current neurological situation, except for diaphoresis. The results suggest that chronic lead intoxication induces PNS damage, particularly affecting unmyelinated small fibers. Further systematic study is needed to more precisely define the role of lead in inducing PNS injury.