title: Abnormal thermography in Parkinson's disease.
abstract: BACKGROUND
  An autonomic denervation and abnormal vasomotor reflex in the skin have been described in Parkinson's disease (PD) and might be evaluable using thermography with cold stress test.
  
  
  METHODS
  A cross-sectional pilot study was undertaken in 35 adults: 15 patients with PD and abnormal [(123)I]-metaiodobenzylguanidine cardiac scintigraphy and 20 healthy controls. Baseline thermography of both hands was obtained before immersing one in cold water (3 ± 1 °C) for 2 min. Continuous thermography was performed in: non-immersed hand (right or with lesser motor involvement) during immersion of the contralateral hand and for 6 min afterward; and contralateral immersed hand for 6 min post-immersion. The region of interest was the dorsal skin of the third finger, distal phalanx.
  
  
  RESULTS
  PD patients showed a lower mean baseline hand temperature (p = 0.037) and greater thermal difference between dorsum of wrist and third finger (p = 0.036) and between hands (p = 0.0001) versus controls, regardless of the motor laterality. Both tests evidenced an adequate capacity to differentiate between groups: in the non-immersed hand, the PD patients did not show the normal cooling pattern or final thermal overshoot observed in controls (F = 5.29; p = 0.001), and there was an AUC of 0.897 (95%CI 0.796-0.998) for this cooling; in the immersed hand, thermal recovery at 6 min post-immersion was lesser in patients (29 ± 17% vs. 55 ± 28%, p = 0.002), with an AUC of 0.810 (95%CI 0.662-0.958).
  
  
  CONCLUSIONS
  PD patients reveal abnormal skin thermal responses in thermography with cold stress test, suggesting cutaneous autonomic dysfunction. This simple technique may be useful to evaluate autonomic dysfunction in PD.
authors.affiliation: Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: isabeldeantonio@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Antonio-Rubio
authors.affiliation: Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: cjmn85@gmail.com.
authors.forename: C J
authors.initials: CJ
authors.lastname: Madrid-Navarro
authors.affiliation: CIMCYC (Centro Investigación Mente, Cerebro y Comportamiento), University of Granada, Granada, Spain. Electronic address: elvisalazar@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Salazar-López
authors.affiliation: Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: majosepnster@gmail.com.
authors.forename: M J
authors.initials: MJ
authors.lastname: Pérez-Navarro
authors.affiliation: Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: mamensaze@hotmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Sáez-Zea
authors.affiliation: CIMCYC (Centro Investigación Mente, Cerebro y Comportamiento), University of Granada, Granada, Spain. Electronic address: egomez@ugr.es.
authors.forename: E
authors.initials: E
authors.lastname: Gómez-Milán
authors.affiliation: Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: adolfo.minguez@sen.es.
authors.forename: A
authors.initials: A
authors.lastname: Mínguez-Castellanos
authors.affiliation: Department of Neurology, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: fescamilla@hotmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Escamilla-Sevilla
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology; D001833:Body Temperature Regulation / Q000502:physiology*; D003430:Cross-Sectional Studies / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D010865:Pilot Projects; D012881:Skin Temperature / Q000502:physiology*; D013817:Thermography / Q000379:methods*; D014666:Vasomotor System / Q000503:physiopathology*
keywords: Autonomic dysfunction; Cold stress test; Parkinson disease; Skin vasomotor reflex; Thermography