[Sympathetic skin response and multiple sclerosis: descriptive and prospective study, and association with neuroperineal disorders].

OBJECTIVE

Describe the sympathetic skin responses (SSRs), reflecting the sweat activity mediated by the sympathetic nervous system, in patients with multiple sclerosis (MS) followed for urinary disorders and associate SSRs abnormalities with neuroperineal disorders.

METHODS

Prospective monocentric study of a population suffering from MS, who received symptom scores (Expanded Disability Status Scale [EDSS], Urinary Symptoms Profile [USP], Neurogenic Bowel Dysfunction [NBD], International Index of Erectile Function [IIEF] and Female Sexual Function Index [FSFI]) and whose SSRs were collected from the hand palm, the foot sole and the genital skin after mechanical stimulation, before and after anticholinergic drug.

RESULTS

Twenty-eight patients were included. Among them, 18 had an abolition of SSR, respectively 10, 14 and 17 at palm, perineum and foot sole. The absence of SSR was not related (P>0.05) with the duration of disease, the EDSS score, USP, IIEF15 or NBD scores. There was a statistically significant relationship between the abolition of SSR at perineum and women genitosexual disorders (P=0.01). Anticholinergic drugs remove 40 % of SSRs at hand and 67% at foot. The abolition of SSR at perineum was associated with the abolition of the SSR at sole (P=4 × 10(-5)).

CONCLUSION

In these MS patients with neuroperineal disorders, more than half showed abnormal SSR. These abnormalities did not seem associated with urinary or rectal disorders but with genitosexual disorders in women. Under anticholinergic treatment, SSR frequently disappeared at palm and foot sole.

LEVEL OF EVIDENCE: 4.