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Abstract：
BACKGROUND: This study aimed to explore autonomic nervous system involvement in amyotrophic lateral sclerosis (ALS) patients by evaluating sympathetic skin response (SSR).
METHODS: The study included 35 sporadic (ALS) patients (cases), and 35 healthy age and sex-matched participants (controls) aged <60 years. SSR was recorded in the electrophysiology lab of the Neurology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Patients with diseases associated with peripheral or autonomic neuropathy were excluded. Prolonged latency (delayed SSR) or an absent response was considered abnormal SSR.
RESULTS: SSR was found to be abnormal in 17 (48.6 %) ALS cases, with an absent response in the upper limbs of six cases (17.1%). Abnormal SSR was more prevalent in the lower limbs, with 33 (94.3%) and 20 (57.1%) cases having a delayed or absent response, respectively. In comparison, SSR was normal in all control participants (P-value <0.05). Abnormal SSR was significantly more common in the lower limbs of ALS cases with bulbar palsy than those without bulbar palsy (P-value=0.04). There was no association of SSR with disease severity and duration.
CONCLUSIONS: ALS is significantly associated with abnormal SSR, indicating autonomic nervous system involvement. There could also be an association between bulbar palsy and abnormal SSR among ALS patients. Further studies should be carried out to determine the association of abnormal SSR with disease severity, duration, and type.
METHODS: The study included 35 sporadic (ALS) patients (cases), and 35 healthy age and sex-matched participants (controls) aged <60 years. SSR was recorded in the electrophysiology lab of the Neurology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Patients with diseases associated with peripheral or autonomic neuropathy were excluded. Prolonged latency (delayed SSR) or an absent response was considered abnormal SSR.
RESULTS: SSR was found to be abnormal in 17 (48.6 %) ALS cases, with an absent response in the upper limbs of six cases (17.1%). Abnormal SSR was more prevalent in the lower limbs, with 33 (94.3%) and 20 (57.1%) cases having a delayed or absent response, respectively. In comparison, SSR was normal in all control participants (P-value <0.05). Abnormal SSR was significantly more common in the lower limbs of ALS cases with bulbar palsy than those without bulbar palsy (P-value=0.04). There was no association of SSR with disease severity and duration.
CONCLUSIONS: ALS is significantly associated with abnormal SSR, indicating autonomic nervous system involvement. There could also be an association between bulbar palsy and abnormal SSR among ALS patients. Further studies should be carried out to determine the association of abnormal SSR with disease severity, duration, and type.
摘要：
背景：本研究旨在通过评估交感神经皮肤反应（SSR）来探索肌萎缩侧索硬化症（ALS）患者的自主神经系统受累。
方法：本研究包括35例散发性（ALS）患者，和35名年龄<60岁的健康和性别匹配的参与者（对照）。SSR记录在BangabandhuSheikhMujib医科大学（BSMMU）神经内科的电生理实验室，达卡,孟加拉国。排除患有与周围性或自主神经病变相关的疾病的患者。潜伏期延长（延迟的SSR）或无反应被认为是异常的SSR。
结果：在17例（48.6％）ALS中发现SSR异常，6例(17.1%)上肢无反应。异常SSR在下肢更为普遍，33例（94.3%）和20例（57.1%）延迟或无反应，分别。相比之下,所有对照参与者的SSR均正常(P值<0.05)。与没有球麻痹的ALS患者相比，异常SSR在下肢明显更常见（P值=0.04）。SSR与疾病严重程度和持续时间无关。
结论：ALS与异常SSR显著相关，表明自主神经系统受累。ALS患者的延髓麻痹和异常SSR之间也可能存在关联。应进行进一步的研究，以确定异常SSR与疾病严重程度的关系，持续时间,和类型。
方法：本研究包括35例散发性（ALS）患者，和35名年龄<60岁的健康和性别匹配的参与者（对照）。SSR记录在BangabandhuSheikhMujib医科大学（BSMMU）神经内科的电生理实验室，达卡,孟加拉国。排除患有与周围性或自主神经病变相关的疾病的患者。潜伏期延长（延迟的SSR）或无反应被认为是异常的SSR。
结果：在17例（48.6％）ALS中发现SSR异常，6例(17.1%)上肢无反应。异常SSR在下肢更为普遍，33例（94.3%）和20例（57.1%）延迟或无反应，分别。相比之下,所有对照参与者的SSR均正常(P值<0.05)。与没有球麻痹的ALS患者相比，异常SSR在下肢明显更常见（P值=0.04）。SSR与疾病严重程度和持续时间无关。
结论：ALS与异常SSR显著相关，表明自主神经系统受累。ALS患者的延髓麻痹和异常SSR之间也可能存在关联。应进行进一步的研究，以确定异常SSR与疾病严重程度的关系，持续时间,和类型。
