title: Anhidrosis in multiple system atrophy: a preganglionic sudomotor dysfunction?
abstract: Anhidrosis occurs in the majority of multiple system atrophy (MSA) patients but the underlying site of lesion is not well established. We describe three patients with long-standing MSA and anhidrosis diagnosed on the basis of a thermoregulatory sweating test. In biopsies of anhidrotic skin, immunofluorescence analysis disclosed a well preserved postganglionic sudomotor innervation in all three patients supporting the hypothesis of a preganglionic nerve fiber lesion underlying their anhidrosis. Postganglionic sudomotor fiber integrity was also confirmed by normal electrodermal responses in one patient, whereas such responses and microneurographically detectable skin sympathetic nerve activity were absent in the other two MSA patients, suggesting a functional inactivity of structurally intact postganglionic sympathetic skin fibers.
authors: Department of Neurological Sciences, University of Bologna, Via U. Foscolo 7, Bologna, Italy. donadio@neuro.unibo.it
authors: Vincenzo
authors: V
authors: Donadio
authors: Maria
authors: M
authors: Nolano
authors: Mikael
authors: M
authors: Elam
authors: Pasquale
authors: P
authors: Montagna
authors: Vincenzo
authors: V
authors: Provitera
authors: Enrico
authors: E
authors: Bugiardini
authors: Agostino
authors: A
authors: Baruzzi
authors: Lucio
authors: L
authors: Santoro
authors: Rocco
authors: R
authors: Liguori
mesh_terms: D000368:Aged; D001338:Autonomic Fibers, Postganglionic / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology; D006801:Humans; D007007:Hypohidrosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000503:physiopathology*; D017779:Sympathetic Fibers, Postganglionic / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology