NeuralCipher Research overview
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ObjectiveTo explore small fiber somatosensory and sympathetic function in PD and MSA.MethodsWe recruited 20 PD patients (7 women, median age 65.5 years; IQR 54.75-70.0), 10 MSA patients (4 women; median age 68 years; IQR 66.25-74.0), and 10 healthy subjects (HC; 4 women, median age 68; IQR 59.0-71.0 years). Autonomic testing included forehead cooling, intradermal microdialysis of norepinephrine (NE; 10-5; 10-6; 10-7; and 10-8), and orthostatic hypotension (OH); somatosensory testing included quantitative sensory testing (QST) according to the protocol of the German Research Network on Neuropathic Pain (DFNS).ResultsOH occurred more frequently in PD (p = 0.018) and MSA (p = 0.002) compared to HC. Vasoconstriction responses were stronger in PD compared to MSA during forehead cooling (p = 0.044) and microdialysis of physiologically concentrated NE solutions (10-7; 10-8; p = 0.017). PD and MSA had impaired cold (PD: p ConclusionIn contrast to MSA, we found evidence of peripheral adrenoreceptor hypersensitivity in PD, probably caused by peripheral sympathetic denervation. Sensory testing revealed peripheral neuropathy and central pain sensitization in PD and MSA. Jointly, our data demonstrate autonomic and somatosensory dysfunction in PD and MSA.
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