Sympathetic skin response in incomplete spinal cord injury with urinary incontinence

Annals of Indian Academy of Neurology, 2013 · DOI: 10.4103/0972-2327.112479 · Published: April 1, 2013

Simple Explanation

The sympathetic skin response (SSR) is a test used to evaluate the sympathetic sweat gland pathways. It has been utilized to study the central sympathetic pathways in individuals with spinal cord injuries (SCI). This study aims to assess the autonomic pathways in urinary incontinence patients with incomplete SCI, based on whether their SSR results are normal or abnormal. The study also describes recording abnormal SSR from the suprapubic area as another way to show bladder sympathetic system involvement.

Study Duration

10 months

Participants

16 urinary incontinence patients with incomplete SCI, 30 healthy controls

Evidence Level

Not specified

Key Findings

1
Recordings of SSR from incomplete SCI patients with urinary incontinence showed significantly reduced amplitudes, especially in the suprapubic area.
2
Significantly prolonged latencies in SSR were recorded from palm and plantar areas in response to suprapubic area and tibial nerve stimuli.
3
A significantly higher stimulus intensity was needed to elicit SSR in the SCI cases compared to the control group.

Research Summary

The study investigates the use of sympathetic skin response (SSR) to assess autonomic pathways in urinary incontinence patients with incomplete spinal cord injury (SCI). SSR recordings from SCI patients showed significantly reduced amplitudes, especially in the suprapubic area, and prolonged latencies in palm and plantar areas. The study also found that a higher stimulus intensity was needed to elicit SSR in SCI patients compared to healthy controls, and describes recording abnormal SSR from the suprapubic area.

Practical Implications

Diagnostic Tool

SSR, particularly suprapubic SSR, can be a useful diagnostic tool for evaluating bladder sympathetic system involvement in patients with incomplete SCI and urinary incontinence.

Understanding Autonomic Dysfunction

The study's findings contribute to a better understanding of the neurophysiological basis of urinary incontinence related to sympathetic nervous system involvement in incomplete SCI.

Guiding Treatment Strategies

Identifying abnormal SSR patterns may help guide the development of targeted treatment strategies for managing urinary incontinence in individuals with incomplete SCI.

Study Limitations

1
Relatively small sample size of 16 patients with incomplete SCI.
2
The study did not evaluate SSR in incomplete SCI patients without urinary incontinence for comparison.
3
Lack of correlation between duration from injury and SSR results might limit the understanding of the dynamic changes.

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