Anhidrosis in multiple system atrophy: A preganglionic sudomotor dysfunction?

Vincenzo Donadio, Maria Nolano, Mikael Elam, Pasquale Montagna, Vincenzo Provitera, Enrico Bugiardini, Agostino Baruzzi, Lucio Santoro, Rocco Liguori

Research output: Contribution to journalArticlepeer-review


Anhidrosis occurs in the majority of multiple system atrophy (MSA) patients but the underlying site of lesion is not well established. We describe three patients with long-standing MSA and anhidrosis diagnosed on the basis of a thermoregulatory sweating test. In biopsies of anhidrotic skin, immunolluorescence analysis disclosed a well preserved postganglionic sudomotor innervation in all three patients supporting the hypothesis of a preganglionic nerve fiber lesion underlying their anhidrosis. Postganglionic sudomotor fiber integrity was also confirmed by normal electrodermal responses in one patient, whereas such responses and microneurographically detectable skin sympathetic nerve activity were absent in the other two MSA patients, suggesting a functional inactivity of structurally intact postganglionic sympathetic skin fibers.

Original languageEnglish
Pages (from-to)885-888
Number of pages4
JournalMovement Disorders
Issue number6
Publication statusPublished - Apr 30 2008


  • Anhidrosis
  • Microneurography
  • Multiple system atrophy
  • Preganglionic sudomotor lesion
  • Skin biopsy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Medicine(all)

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