Parkinson病の発汗機能(神経内科学教室岩田誠教授退任記念特別号)
Parkinson病の発汗機能(神経内科学教室岩田誠教授退任記念特別号)
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Original abstract
神経内科学教室岩田誠教授退任記念特別号 Controversy remains regarding the thermoregulatory sweat function in Parkinson disease (PD) patients. We herein performed both a thermoregulatory sweat test and palmar sweat test in PD patients and discuss the function of the perspiratory sympathetic nervous system. At the same time, we also carried out digital plethysmography, the head-up tilt test, [^<123>I] raeto-iodobenzylguanidine (^<123>I-MIBG) myocardium scintigraphy, cognitive tests while, in addition, discussing the spread of autonomic dysfunction and relationship between palmar sweating and cognitive function. According to the findings of the thermoregulatory sweat test, two patients demonstrated anhidrosis, while one showed partial hypohidrosis. Because one case who had anhidrosis also showed other severe autonomic dysfunctions, the dysfunction of the perspiratory nervous sytem in this case was thus considered to be severe. However, another case who had ahidrosis showed no other autonomic dysfunction. The thermoregulatory sweating in PD patients was therefore suspected to not be involved with the autonomic nervous system. On the other hand, five of nine patients showed no sweating evoked by mental and somanosensory tasks. These results were considered to not be related to the cognitive function but three of five patients showed a cardiovascular dysfunction. Depending on these results, the palmar sweating in PD patients was therefore supeculated to be caused by an invasion of sympathetic ganglions.