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Thermoregulatory Dysfunction in Parkinson’s Disease

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Parkinson’s Disease and Nonmotor Dysfunction

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Homeotherms, such as humans with Parkinson’s disease, must maintain core body temperature in a narrow range in the face of fluctuating environmental surroundings and endogenous heat production. A complex and highly integrated collection of autonomic, endocrine, and behavioral responses are involved in the maintenance of core temperature. Dopaminergic innervation of the preoptic and anterior hypothalamus plays an important role in the central nervous system’s control of body temperature. Due to a combination of central dopamine deficiency and peripheral autonomic dysfunction, individuals with Parkinson’s disease may experience heat and/or cold intolerance and paroxysmal hyperhidrosis. Sudomotor dysfunction in Parkinson’s disease can be documented with the sympathetic skin response and quantitative sudomotor axon reflex and thermoregulatory sweat tests.

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References

  1. Kelso SR, Perlmutter MN, Boulant JA. Thermosensitive single-unit activity of in vitro hypothalamic slices. Am J Physiol. 1982;242:R77–84.

    PubMed  CAS  Google Scholar 

  2. Smith JE, Jansen AS, Gilbey MP, Loewy AD. CNS cell groups projecting to sympathetic outflow of tail artery: neural circuits involved in heat loss in the rat. Brain Res. 1998;786:153–64.

    Article  PubMed  CAS  Google Scholar 

  3. Lin MT, Chandra A, Tsay BL, Chern YF. Hypothalamic and striatal dopamine receptor activation inhibits heat production in the rat. Am J Physiol. 1982;242:R471–81.

    PubMed  CAS  Google Scholar 

  4. Scott IM, Boulant JA. Dopamine effects on thermosensitive neurons in hypothalamic tissue slices. Brain Res. 1984;306:157–63.

    Article  PubMed  CAS  Google Scholar 

  5. Hasegawa H, Yazawa T, Yasumatsu M, Otokawa M, Aihara Y. Alteration in dopamine metabolism in the thermoregulatory center of exercising rats. Neurosci Lett. 2000;289:161–4.

    Article  PubMed  CAS  Google Scholar 

  6. Salmi P. Independent roles of dopamine D1 and D2/3 receptors in rat thermoregulation. Brain Res. 1998;781:188–93.

    Article  PubMed  CAS  Google Scholar 

  7. Perachon S, Betancur C, Pilon C, Rostene W, Schwartz JC, Sokoloff P. Role of dopamine D3 receptors in ­thermoregulation: a reappraisal. Neuroreport. 2000;11:221–5.

    Article  PubMed  CAS  Google Scholar 

  8. Lefrant JY, Muller L, De La Coussaye JE, et al. Temperature measurement in intensive care patients: comparison of urinary bladder, oesophageal, rectal, axillary, and inguinal methods versus pulmonary artery core method. Intensive Care Med. 2003;29:414–8.

    PubMed  Google Scholar 

  9. Fulbrook P. Core body temperature measurement: a comparison of axilla, tympanic membrane and pulmonary artery blood temperature. Intensive Crit Care Nurs. 1997;13:266–72.

    Article  PubMed  CAS  Google Scholar 

  10. Knezevic W, Bajada S. Peripheral autonomic surface potential. A quantitative technique for recording sympathetic conduction in man. J Neurol Sci. 1985;67:239–51.

    Article  PubMed  CAS  Google Scholar 

  11. Low PA, Opfer-Gehrking TL, Kihara M. In vivo studies on receptor pharmacology of the human eccrine sweat gland. Clin Auton Res. 1992;2:29–34.

    Article  PubMed  CAS  Google Scholar 

  12. Cohen J, Low P, Fealey R, Sheps S, Jiang NS. Somatic and autonomic function in progressive autonomic failure and multiple system atrophy. Ann Neurol. 1987;22:692–9.

    Article  PubMed  CAS  Google Scholar 

  13. Fealey RD, Low PA, Thomas JE. Thermoregulatory sweating abnormalities in diabetes mellitus. Mayo Clin Proc. 1989;64:617–28.

    Article  PubMed  CAS  Google Scholar 

  14. Faden AI, Chan P, Mendoza E. Progressive isolated segmental anhidrosis. Arch Neurol. 1982;39:172–5.

    Article  PubMed  CAS  Google Scholar 

  15. Kihara M, Sugenoya J, Takahashi A. The assessment of sudomotor dysfunction in multiple system atrophy. Clin Auton Res. 1991;1:297–302.

    Article  PubMed  CAS  Google Scholar 

  16. Bornmyr S, Castenfors J, Svensson H, Wroblewski M, Sundkvist G, Wollmer P. Detection of autonomic sympathetic dysfunction in diabetic patients. A study using laser Doppler imaging. Diabetes Care. 1999;22:593–7.

    Article  PubMed  CAS  Google Scholar 

  17. Stanton AW, Levick JR, Mortimer PS. Assessment of noninvasive tests of cutaneous vascular control in the forearm using a laser Doppler meter and a Finapres blood pressure monitor. Clin Auton Res. 1995;5:37–47.

    Article  PubMed  CAS  Google Scholar 

  18. Gubbay SS, Barwick DD. Two cases of accidental hypothermia in Parkinson’s disease with unusual EEG findings. J Neurol Neurosurg Psychiatry. 1966;29:459–66.

    Article  PubMed  CAS  Google Scholar 

  19. Siddiqui MF, Rast S, Lynn MJ, Auchus AP, Pfeiffer RF. Autonomic dysfunction in Parkinson’s disease: a comprehensive symptom survey. Parkinsonism Relat Disord. 2002;8:277–84.

    Article  PubMed  CAS  Google Scholar 

  20. Gowers WR. A manual of disease of nervous system. Philadelphia: Blakiston; 1888.

    Google Scholar 

  21. Charcot JM. Maladies de système nerveux, vol. 1. Paris: Battaille; 1892.

    Google Scholar 

  22. Lees AJ. When did Ray Kennedy’s Parkinson’s disease begin? Mov Disord. 1992;7:110–6.

    Article  PubMed  CAS  Google Scholar 

  23. Pursiainen V, Haapaniemi TH, Korpelainen JT, Sotaniemi KA, Myllylä VV. Sweating in Parkinsonian patients with wearing-off. Mov Disord. 2007;22:828–32.

    Article  PubMed  Google Scholar 

  24. Appenzeller O, Goss JE. Autonomic deficits in Parkinson’s disease. Arch Neurol. 1971;24:50–7.

    Article  PubMed  CAS  Google Scholar 

  25. Sage JI, Mark MH. Drenching sweats as an off phenomenon in Parkinson’s disease: treatment and relation to plasma levodopa profile. Ann Neurol. 1995;37:120–2.

    Article  PubMed  CAS  Google Scholar 

  26. Pfeiffer RF, Sucha EL. “On-off”-induced lethal hyperthermia. Mov Disord. 1989;4:338–41.

    Article  PubMed  CAS  Google Scholar 

  27. Keyser DL, Rodnitzky RL. Neuroleptic malignant syndrome in Parkinson’s disease after withdrawal or alteration of dopaminergic therapy. Arch Intern Med. 1991;151:794–6.

    Article  PubMed  CAS  Google Scholar 

  28. Gordon PH, Frucht SJ. Neuroleptic malignant syndrome in advanced Parkinson’s disease. Mov Disord. 2001;16:960–2.

    Article  PubMed  CAS  Google Scholar 

  29. Mizuta E, Yamasaki S, Nakatake M, Kuno S. Neuroleptic malignant syndrome in a parkinsonian woman during the premenstrual period. Neurology. 1993;43:1048–9.

    Article  PubMed  CAS  Google Scholar 

  30. Serrano-Duenas M. Neuroleptic malignant syndrome-like, or-dopaminergic malignant syndrome-due to levodopa therapy withdrawal. Clinical features in 11 patients. Parkinsonism Relat Disord. 2003;9:175–8.

    Article  PubMed  Google Scholar 

  31. Aminoff MJ, Wilcox CS. Assessment of autonomic function in patients with a Parkinsonian syndrome. Br Med J. 1971;4:80–4.

    Article  PubMed  CAS  Google Scholar 

  32. Goetz CG, Lutge W, Tanner CM. Autonomic dysfunction in Parkinson’s disease. Neurology. 1986;36:73–5.

    Article  PubMed  CAS  Google Scholar 

  33. Sandroni P, Ahlskog JE, Fealey RD, Low PA. Autonomic involvement in extrapyramidal and cerebellar disorders. Clin Auton Res. 1991;1:147–55.

    Article  PubMed  CAS  Google Scholar 

  34. Haapaniemi TH, Korpelainen JT, Tolonen U, Suominen K, Sotaniemi KA, Myllylä VV. Suppressed sympathetic skin response in Parkinson disease. Clin Auton Res. 2000;10:337–42.

    Article  PubMed  CAS  Google Scholar 

  35. Turkka JT, Myllylä VV. Sweating dysfunction in Parkinson’s disease. Eur Neurol. 1987;26:1–7.

    Article  PubMed  CAS  Google Scholar 

  36. Kihara M, Kihara Y, Tukamoto T, Nishimura Y, Watanabe H, Hanakago R, Takahashi A. Assessment of sudomotor dysfunction in early Parkinson’s disease. Eur Neurol. 1993;33:363–5.

    Article  PubMed  CAS  Google Scholar 

  37. Mano Y, Nakamuro T, Takayanagi T, Mayer RF. Sweat function in Parkinson’s disease. J Neurol. 1994;241:573–6.

    Article  PubMed  CAS  Google Scholar 

  38. Hirashima F, Yokota T, Hayashi M. Sympathetic skin response in Parkinson’s disease. Acta Neurol Scand. 1996;93:127–32.

    Article  PubMed  CAS  Google Scholar 

  39. De Marinis M, Stocchi F, Testa SR, DePandis F, Agnoli A. Alterations of thermoregulation in Parkinson’s disease. Funct Neurol. 1991;6:279–83.

    PubMed  Google Scholar 

  40. Korpelainen JT, Sotaniemi KA, Myllylä VV. Autonomic nervous system disorders in stroke. Clin Auton Res. 1999;9:325–33.

    Article  PubMed  CAS  Google Scholar 

  41. Ueno M, Tokunaga Y, Terachi S, Gondo K, Hara T. Asymmetric sweating in a child with multiple sclerosis. Pediatr Neurol. 2000;23:74–6.

    Article  PubMed  CAS  Google Scholar 

  42. Smith CD. A hypothalamic stroke producing recurrent hemihyperhidrosis. Neurology. 2001;56:1394–6.

    Article  PubMed  CAS  Google Scholar 

  43. Lewy FH. Paralysis agitans. I. Pathologische Anatomie. In: Lewandowsky M, editor. Handbuch der Neurologie, vol. 3. Berlin: Springer; 1912. p. 920–33.

    Google Scholar 

  44. Den Hartog Jager WA, Bethlem J. The distribution of Lewy bodies in the central and autonomic nervous systems in idiopathic paralysis agitans. J Neurol Neurosurg Psychiatry. 1960;23:283–90.

    Article  Google Scholar 

  45. Rajput AH, Rozdilsky B. Dysautonomia in Parkinsonism: a clinicopathological study. J Neurol Neurosurg Psychiatry. 1976;39:1092–100.

    Article  PubMed  CAS  Google Scholar 

  46. Forno LS, Norville RL. Ultrastructure of Lewy bodies in stellate ganglia. Acta Neuropathol. 1976;34:183–97.

    Article  PubMed  CAS  Google Scholar 

  47. Wakabayashi K, Takahashi H. Neuropathology of autonomic nervous system in Parkinson’s disease. Eur Neurol. 1997;38 suppl 2:2–7.

    Article  PubMed  Google Scholar 

  48. Wenning GK, Tison F, Ben Shlomo Y, Daniel SE, Quinn NP. Multiple system atrophy: a review of 203 pathologically proven cases. Mov Disord. 1997;12:133–47.

    Article  PubMed  CAS  Google Scholar 

  49. Wakabayashi K, Takahashi H. The intermediolateral nucleus and Clarke’s column in Parkinson’s disease. Acta Neuropathol. 1997;94:287–9.

    Article  PubMed  CAS  Google Scholar 

  50. Langston JW, Forno LS. Hypothalamus in Parkinson’s disease. Ann Neurol. 1978;3:129–33.

    Article  PubMed  CAS  Google Scholar 

  51. Dabby R, Djaldetti R, Shahmurov M, Treves TA, Gabai B, Melamed E, Sadeh M, Avinoach I. Skin biopsy for assessment of autonomic denervation in Parkinson’s disease. J Neural Transm. 2006;113:1169–76.

    Article  PubMed  CAS  Google Scholar 

  52. Kawada M, Tamada Y, Simizu H, Yanagishita T, Yamashita N, Ishida N, Watanabe D, Yoshida M, Ibi T, Sahashi K, Hashizume Y, Matsumoto Y. Reduction in QSART and vasoactive intestinal polypeptide expression in the skin of Parkinson’s disease patients and its relation to dyshidrosis. J Cutan Pathol. 2009;36:517–21.

    Article  PubMed  Google Scholar 

  53. Riley DE, Chelimsky TC. Autonomic nervous system testing may not distinguish multiple system atrophy from Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2003;74:56–60.

    Article  PubMed  CAS  Google Scholar 

  54. Thaisetthawatkul P, Boeve BF, Benarroch EE, Sandroni P, Ferman TJ, Petersen R, Low PA. Autonomic dysfunction in dementia with Lewy bodies. Neurology. 2004;62:1804–9.

    Article  PubMed  CAS  Google Scholar 

  55. Lipp A, Sandroni P, Ahlskog JE, Fealey RD, Kimpinski K, Iodice V, Gehrking TL, Weigand SD, Sletten DM, Gehrking JA, Nickander KK, Singer W, Maraganore DM, Gilman S, Wenning GK, Shults CW, Low PA. Prospective differentiation of multiple system atrophy from Parkinson disease, with and without autonomic failure. Arch Neurol. 2009;66:742–50.

    Article  PubMed  Google Scholar 

  56. Klein C, Brown R, Wenning G, Quinn N. The “cold hands sign” in multiple system atrophy. Mov Disord. 1997;12:514–8.

    Article  PubMed  CAS  Google Scholar 

  57. Low PA. Composite autonomic scoring scale for laboratory quantification of generalized autonomic failure. Mayo Clin Proc. 1993;68:748–52.

    Article  PubMed  CAS  Google Scholar 

  58. Bordet R, Benhadjali J, Destee A, Hurtevent JF, Bourriez JL, Guieu JD. Sympathetic skin response and R-R interval variability in multiple system atrophy and idiopathic Parkinson’s disease. Mov Disord. 1996;11:268–72.

    Article  PubMed  CAS  Google Scholar 

  59. De Marinis M, Stocchi F, Gregori B, Accornero N. Sympathetic skin response and cardiovascular autonomic function tests in Parkinson’s disease and ­multiple system atrophy with autonomic failure. Mov Disord. 2000;15:1215–20.

    Article  PubMed  Google Scholar 

  60. Pierangeli G, Provini F, Maltoni P, Barletta G, Contin M, Lugaresi E, Montagna P, Cortelli P. Nocturnal body core temperature falls in Parkinson’s disease but not in Multiple-System Atrophy. Mov Disord. 2001;16:226–32.

    Article  PubMed  CAS  Google Scholar 

  61. Low PA, Ahlskog JE, Petersen RC, Waring SC, Esteban-Santillan C, Kurland LT. Autonomic failure in Guamanian neurodegenerative disease. Neurology. 1997;49:1031–4.

    Article  PubMed  CAS  Google Scholar 

  62. Sanghera MK, Ward C, Stewart RM, Mewes K, Simpson RK, Lai EC. Alleviation of drenching sweats following subthalamic deep brain stimulation in a patient with Parkinson’s disease – a case report. J Neurol Sci. 2009;285:246–9.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. University of Tennessee Health Science Center, 855 Monroe Avenue, Suite 415 Link Building, Memphis, TN, 38163, USA

    Mark S. LeDoux M.D., Ph.D.

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  1. Mark S. LeDoux M.D., Ph.D.
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Correspondence to Mark S. LeDoux M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA

    Ronald F. Pfeiffer (Professor and Vice Chair) (Professor and Vice Chair)

  2. Parkinson’s Disease and Related Disorders Clinic, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Ivan Bodis-Wollner

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LeDoux, M.S. (2013). Thermoregulatory Dysfunction in Parkinson’s Disease. In: Pfeiffer, R.F., Bodis-Wollner, I. (eds) Parkinson’s Disease and Nonmotor Dysfunction. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-429-6_14

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  • DOI: https://doi.org/10.1007/978-1-60761-429-6_14

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