Neurology: Morphological and functional comparison of postganglionic ultrasonography to help early identification of multiple system atrophy (MSA-P) and Parkinson's disease (PD)!

"Parkinson's disease" defines a number of clinical symptoms, mainly associated with motor symptoms such as rigidity, tremors and bradykinesia
.

This includes primary Parkinson's disease (PD), as well as other more rare syndromes with different pathogenesis, prognosis and response to drug therapy, such as multiple system atrophy (MSA)

 "Parkinson's Syndrome"

Parkinson's disease affects about 2% of people over the age of 65
.

Lack of disease-modifying treatments can lead to severe disability, placing a heavy burden on health systems worldwide

Diagnosis of autonomic disturbances is often the main symptom in patients with Parkinson's syndrome and can be traced back many years before motor symptoms are fully developed

We assessed prospective morphological and functional autonomic assist involvement in patients with early (within 2 years of motor onset) MSA-P and PD to identify possible biomarkers that may help Biomarkers for early identification of these two diseases

The study included 100 patients with Parkinson's disease within 2 years of the onset of motor symptoms
.

At recruitment, nonmotor, autonomic, and small fiber symptoms were assessed by questionnaires, and postganglionic hypersonic function was assessed by dynamic sweat test and distal needle skin biopsy

At recruitment, nonmotor, autonomic, and small fiber symptoms were assessed by questionnaires, and postganglionic hypersonic function was assessed by dynamic sweat test and distal needle skin biopsy

• Fifty-seven PD patients (m/f = 36/21, age 63.
  5 ± 9.
  4 years) and 43 MSA-P patients (m/f = 27/16, age 62.
  3 ± 9.
  0 years) were included in the study
  .
  
• Clinical scales and questionnaires showed that MSA-P patients had more severe clinical symptoms than PD patients
  .
  
• Sweat volume and intraepidermal, hair motor, and supramotor densities were lower in both groups compared to controls, but were greater in MSA-P patients
  .
  
• Hair motor nerve and hyperlong motor nerve density are associated with sweating function and non-motor clinical symptoms
  .
  
• The arithmetic product of sweat production times sweat fiber density was defined, effectively separating the two populations, with an area under the receiver operating characteristic curve of 0.
  83
  .
  

Fifty-seven PD patients (m/f = 36/21, age 63.
5 ± 9.
4 years) and 43 MSA-P patients (m/f = 27/16, age 62.
3 ± 9.
0 years) were included in the study
.

Clinical scales and questionnaires showed that MSA-P patients had more severe clinical symptoms than PD patients
.

Sweat volume and intraepidermal, hair motor, and supramotor densities were lower in both groups compared to controls, but were greater in MSA-P patients
.

Hair motor nerve and hyperlong motor nerve density are associated with sweating function and non-motor clinical symptoms
.

The arithmetic product of sweat production times sweat fiber density was defined, effectively separating the two populations, with an area under the receiver operating characteristic curve of 0.
83
.

The arithmetic product of sweat production times sweat fiber density was defined, effectively separating the two populations, with an area under the receiver operating characteristic curve of 0.
83
.

     The dynamic sweat test and quantification of cutaneous autonomic nerves provide a sensitive morphofunctional approach to assess components of the postganglionic sweat neural pathway, revealing a more severe involvement in MSA-P than PD early in the disease process
.

This method can be used to distinguish the two cases early

The dynamic sweat test and quantification of cutaneous autonomic nerves provide a sensitive morphofunctional approach to assess components of the postganglionic sweat neural pathway, revealing a more severe involvement in MSA-P than PD early in the disease process

Source: Provitera V, Iodice V, Manganelli F, et al.

Provitera V, Iodice V, Manganelli F, et al.
Postganglionic Sudomotor Assessment in Early Stage of Multiple System Atrophy and Parkinson Disease: A Morpho-functional Study [published online ahead of print, 2022 Jan 11].
Neurology.
2022;10.
1212/WNL .
0000000000013300.
doi:10.
1212/WNL.
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