title: Comparison of sympathetic skin response with quantitative sudomotor axon reflex test in diabetic neuropathy.
abstract: The sympathetic skin response (SSR), the quantitative sudomotor axon reflex test (Q-SART), and cardiac beat-to-beat variability with respiration as measured by the expiratory/inspiratory ratio (E/I ratio) were studied in 39 patients with diabetic neuropathy of whom 33 also had one or more symptoms of autonomic involvement. In the lower extremities 87% of the patients with an absent SSR had an abnormal Q-SART (P less than 0.001), and 81% of patients with the SSR present had a normal Q-SART (P less than 0.02). The E/I ratio was abnormal in all but one of 23 patients with an absent SSR in the foot, and a normal E/I ratio was present only in those patients (n = 7) with the SSR present in hand and foot, and in an eighth patient who had SSR absent in the foot and present in the hand. A similar correlation was found between the E/I ratio and the Q-SART in the foot, although 4 of 25 patients with an abnormal foot Q-SART had a normal E/I ratio. We conclude that the concordance of results of the SSR and Q-SART supports the combined use of these tests to uncover early distal sympathetic failure in diabetic neuropathy.
authors.affiliation: Department of Neurology, University of Chicago, IL 60637.
authors.forename: R A
authors.initials: RA
authors.lastname: Maselli
authors.forename: J B
authors.initials: JB
authors.lastname: Jaspan
authors.forename: B C
authors.initials: BC
authors.lastname: Soliven
authors.forename: A J
authors.initials: AJ
authors.lastname: Green
authors.forename: J P
authors.initials: JP
authors.lastname: Spire
authors.forename: B G
authors.initials: BG
authors.lastname: Arnason
mesh_terms: D000328:Adult; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D008297:Male; D012018:Reflex / Q000502:physiology; D013545:Sweat Glands / Q000294:innervation; D013564:Sympathetic Nervous System / Q000503:physiopathology*