Skip to main content
Erschienen in: Clinical Autonomic Research 1/2019

08.05.2018 | Review

Assessment of sudomotor function

verfasst von: Sylvia J. Buchmann, Ana Isabel Penzlin, Marie Luise Kubasch, Ben Min-Woo Illigens, Timo Siepmann

Erschienen in: Clinical Autonomic Research | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To review the currently available literature on clinical autonomic tests of sudomotor function.

Methods

We searched PubMED/MEDLINE for articles on technical principles and clinical applications of sudomotor tests with a focus on their drawbacks and perspectives in order to provide a narrative review.

Results

The quantitative sudomotor axon reflex sweat test (QSART) is the most widely used test of sudomotor function. The technique captures pathology with low intra- and inter-subject variability but is limited by technical demands. The thermoregulatory sweat test comprises topographic sweat pattern analysis of the ventral skin surface and allows differentiating preganglionic from postganglionic sudomotor damage when combined with a small fiber test such as QSART. The sympathetic skin response also belongs to the more established techniques and is used in lie detection systems due to its high sensitivity for sudomotor responses to emotional stimuli. However, its clinical utility is limited by high variability of measurements, both within and between subjects. Newer and, therefore, less widely established techniques include silicone impressions, quantitative direct and indirect axon reflex testing, sensitive sweat test, and measurement of electrochemical skin conductance. The spoon test does not allow a quantitative assessment of the sweat response but can be used as bedside-screening tool of sudomotor dysfunction.

Conclusion

While new autonomic sudomotor function testings have been developed and studied over the past decades, the most were well-studied and established techniques QSART and TST remain the gold standard of sudomotor assessment. Combining these techniques allows for sophisticated analysis of neurally mediated sudomotor impairment. However, newer techniques display potential to complement gold standard techniques to further improve their precision and diagnostic value.
Literatur
4.
Zurück zum Zitat Hoeldtke RD, Bryner KD, Horvath GG, Phares RW, Broy LF, Hobbs GR (2001) Redistribution of sudomotor responses is an early sign of sympathetic dysfunction in type 1 diabetes. Diabetes 50(2):436–443CrossRef Hoeldtke RD, Bryner KD, Horvath GG, Phares RW, Broy LF, Hobbs GR (2001) Redistribution of sudomotor responses is an early sign of sympathetic dysfunction in type 1 diabetes. Diabetes 50(2):436–443CrossRef
5.
Zurück zum Zitat Folk GE Jr, Semken HA Jr (1991) The evolution of sweat glands. Int J Biometeorol 35(3):180–186CrossRef Folk GE Jr, Semken HA Jr (1991) The evolution of sweat glands. Int J Biometeorol 35(3):180–186CrossRef
9.
Zurück zum Zitat Guttmann L (1947) The management of the quinizarin sweat test. Postgrad Med J 23(262):353–366CrossRef Guttmann L (1947) The management of the quinizarin sweat test. Postgrad Med J 23(262):353–366CrossRef
11.
Zurück zum Zitat Morrison SF, Nakamura K (2011) Central neural pathways for thermoregulation. Front Biosci 16:74–104CrossRef Morrison SF, Nakamura K (2011) Central neural pathways for thermoregulation. Front Biosci 16:74–104CrossRef
12.
Zurück zum Zitat Low PA, Tomalia VA, Park K-J (2013) Autonomic function tests: some clinical applications. J Clin Neurol 9(1):1–8CrossRef Low PA, Tomalia VA, Park K-J (2013) Autonomic function tests: some clinical applications. J Clin Neurol 9(1):1–8CrossRef
18.
Zurück zum Zitat Kennedy WR (2002) Usefulness of the silicon impression mold technique to evaluate sweating. Clin Auton Res 12(1):9–10CrossRef Kennedy WR (2002) Usefulness of the silicon impression mold technique to evaluate sweating. Clin Auton Res 12(1):9–10CrossRef
19.
Zurück zum Zitat Siepmann T, Pinter A, Buchmann SJ, Stibal L, Arndt M, Kubasch AS, Kubasch ML, Penzlin AI, Frenz E, Zago W, Horvath T, Szatmari S Jr, Bereczki D, Takats A, Ziemssen T, Lipp A, Freeman R, Reichmann H, Barlinn K, Illigens BM (2017) Cutaneous autonomic pilomotor testing to unveil the role of neuropathy progression in early Parkinson’s disease (CAPTURE PD): protocol for a multicenter study. Front Neurol 8:212. https://doi.org/10.3389/fneur.2017.00212 CrossRefPubMedPubMedCentral Siepmann T, Pinter A, Buchmann SJ, Stibal L, Arndt M, Kubasch AS, Kubasch ML, Penzlin AI, Frenz E, Zago W, Horvath T, Szatmari S Jr, Bereczki D, Takats A, Ziemssen T, Lipp A, Freeman R, Reichmann H, Barlinn K, Illigens BM (2017) Cutaneous autonomic pilomotor testing to unveil the role of neuropathy progression in early Parkinson’s disease (CAPTURE PD): protocol for a multicenter study. Front Neurol 8:212. https://​doi.​org/​10.​3389/​fneur.​2017.​00212 CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Dekker JM, Schouten EG, Klootwijk P, Pool J, Kromhout D (1994) Association between QT interval and coronary heart disease in middle-aged and elderly men. The Zutphen study. Circulation 90(2):779CrossRef Dekker JM, Schouten EG, Klootwijk P, Pool J, Kromhout D (1994) Association between QT interval and coronary heart disease in middle-aged and elderly men. The Zutphen study. Circulation 90(2):779CrossRef
27.
Zurück zum Zitat Shahani BT, Halperin JJ, Boulu P, Cohen J (1984) Sympathetic skin response—a method of assessing unmyelinated axon dysfunction in peripheral neuropathies. J Neurol Neurosurg Psychiatry 47(5):536CrossRef Shahani BT, Halperin JJ, Boulu P, Cohen J (1984) Sympathetic skin response—a method of assessing unmyelinated axon dysfunction in peripheral neuropathies. J Neurol Neurosurg Psychiatry 47(5):536CrossRef
34.
Zurück zum Zitat Tsementzis SA, Hitchcock ER (1985) The spoon test: a simple bedside test for assessing sudomotor autonomic failure. J Neurol Neurosurg Psychiatry 48(4):378CrossRef Tsementzis SA, Hitchcock ER (1985) The spoon test: a simple bedside test for assessing sudomotor autonomic failure. J Neurol Neurosurg Psychiatry 48(4):378CrossRef
Metadaten
Titel
Assessment of sudomotor function
verfasst von
Sylvia J. Buchmann
Ana Isabel Penzlin
Marie Luise Kubasch
Ben Min-Woo Illigens
Timo Siepmann
Publikationsdatum
08.05.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 1/2019
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-018-0530-2

Weitere Artikel der Ausgabe 1/2019

Clinical Autonomic Research 1/2019 Zur Ausgabe