Affiliations: Neurovascular Medicine Unit, Faculty of Medicine,
Imperial College London at St Mary's Hospital, Praed Street, London W2 1NY,
UK | Autonomic Unit, The National Hospital for Neurology
and Neurosurgery, Queen Square, London WC1N 3BG, UK | Department of Movement and Balance, Division of
Neuroscience and Mental Health, Imperial College London, Charing Cross Campus,
St Dustan's Road London W6 8RP, UK | National Spinal Injuries Centre, Stoke Mandeville
Hospital, Mandeville Road, Aylesbury, Bucks HP21 8AL, UK
Note: [] Corresponding author: Alessia Nicotra, Neurovascular Medicine
Unit, 2nd Floor Queen Elizabeth Queen Mother Wing, St Mary's Hospital, Praed
Street, London W2 1NY, UK. Tel.: +44 020 78861468; Fax: +44 020 78861540;
E-mail: a.nicotra@imperial.ac.uk
Abstract: Purpose. Sympathetic sudomotor function in chronic spinal cord
injury (SCI) has been evaluated to determine if recording the sympathetic skin
response (SSR) provides evidence of integrity of the spinal component of the
sympathetic pathways. Methods. Thirty subjects with chronic SCI and 15 healthy normal
subjects were studied. The SSR was elicited using two physiological (auditory
and inspiratory gasp) stimuli. In addition, electrical (median and peroneal
nerve) stimulation was also performed. Recordings were made from palmar and
plantar sites. Results. Palmar and plantar SSRs could be readily elicited in all
control subjects by all stimuli. In the majority of SCI subjects, the presence
or absence of the SSR was related to the American Spinal Injury Association
(ASIA) impairment scale, which incorporates only motor and sensory assessments.
The exceptions indicated preserved (or damaged) sympathetic spinal cord
pathways. Conclusions. We conclude that the SSR, using either physiological or
electrical stimuli, may be a reliable, non-invasive method of determining
integrity of sympathetic cholinergic pathways in SCI, with potential for
monitoring the effects of intervention and spinal repair.
