Sympathetic skin response in evaluation of autonomic nervous system functions in post-stroke patients

ABSTRACT

Strokes are the most common serious neurological disorder. They are third leading cause of death after heart disease and cancer. A wide spectrum of dysautonomic symptoms affecting different systems can occur in cerebrovascular accident patients including the cardiovascular, gastrointestinal, genitourinary, papillary, sudomotor and neuroendocrine systems. In this study, we aimed to investigate the sympathetic and parasympathetic autonomic nervous system dysfunctions in hemiplegic or hemiparetic patients after a cerebrovascular accident [CVA]. Sympathetic skin response [SSR] was done in a total 33 individuals twenty-one hemiplegic or hemiparetic patients after cerbrovascular accidents. The control group consisted of 12 apparently healthy persons. The SSR was recorded bilaterally with median nerve stimulation in both affected and non-affected sides. The mean age of the patients' group was 61.5 yr [34-77yr], nine of them were acute acute [<30 days] and 12 in the chronic stroke phase [>1month]. The control group had a mean age of 53.2 years [range 33-67 yr]. The disease duration in the stroke patients was 5.9 months [1-14 months]. There was a significant [p<0.05] low amplitude and prolonged latency of the SSR recorded in the affected side of stroke patients as compared to normals. On the other hand, there was no significant difference of both amplitudes or latencies of SSR recorded on the affected and unaffected sides. Patients with brainstem lesion showed significant [p<0.05] low amplitude and delayed latency as compared to normal, while there was no significant difference with patients having cortical and subcortical lesions. SSR is a simple, quick and non-invasive electrophysiological test to evaluate the dysfunction in the autonomic nervous system in post stroke patients. The autonomic nervous system [ANS] in post stroke patients is partially inhibited and this may be useful to predict any possible complications during the rehabilitation program