Skin Temperature in Parkinson’s Disease Measured by Infrared Thermography

Background. Patients with Parkinson’s disease (PD) often show peripheral autonomic dysfunction and depositions of pathological alpha-synuclein aggregates in the skin. However, functional consequences of this skin involvement have received little attention. Objective. To determine thermographic differences in the skin between healthy controls (HCs) and PD patients on hands, feet, and trunk and to correlate findings with symptoms and signs of dysautonomia. Between-group differences in autonomic parameters and questionnaires were explored. Methods. Twenty-one PD patients and 19 HCs were examined by thermographic infrared imaging of standardized anatomical locations on the trunk and upper and lower extremities at baseline and after exposure to cold stress test (CST). Thermal recovery rates (RRs) were determined on the basis of thermograms. Correlation analyses between alterations in skin temperature and autonomic dysfunction were performed. Results. The most significant RR difference between PD patients and HCs was seen on the fifth distal phalanx 10 minutes post-CST (mean RR ± SD: 51 ± 18% vs. 70 ± 23%, p = 0.003). No between-group differences were seen in baseline or post-CST values of the feet. No correlations were seen between thermal parameters and clinical and autonomic data. In the HC group, a positive, moderate correlation was seen between post-CST recovery values on the 3rd and 5th phalanx and body mass index (BMI) (r = 0.661, p = 0.002). Conclusions. The PD patients exhibited significant reduction in RR compared to HC and patients also displayed altered thermal responses in multiple anatomical locations. Thus, infrared thermography could become an important future tool in investigation of autonomic deficiency in PD.

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Altered hypothalamic diffusivity in Parkinsonian autonomic dysfunction

10.1101/767624 ◽

2019 ◽

Author(s):

Célia Rousseau ◽

Miriam Sklerov ◽

Nina Browner ◽

Yueh Z. Lee ◽

Adrien Boucaud ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Autonomic Dysfunction ◽

Symptom Burden ◽

Group Differences ◽

Anatomical Landmarks ◽

Microstructural Properties ◽

Significant Group ◽

Autonomic Symptom ◽

Autonomic Symptoms

AbstractThe pathophysiological basis of autonomic symptoms in Parkinson’s disease remains incompletely understood. The hypothalamus plays a key regulatory role in autonomic function and has been shown to be affected in Parkinson’s disease. Here, using diffusion magnetic resonance imaging, we investigated whether microstructural properties of the hypothalamus differ in Parkinson’s disease patients with high compared to low autonomic symptom burden.Parkinson’s disease patients with low (n=25) and high (n=25) autonomic symptom burden were identified from a larger pool, based on scores from a questionnaire assessing autonomic symptoms in Parkinson’s disease (SCOPA-AUT). In each patient, we first segmented the hypothalamus manually, based on anatomical landmarks. Diffusivity measures were then extracted from the hypothalamus. Diffusivity measures calculated in the brainstem and the putamen were used to assess the specificity of the results.Relative to patients with low autonomic symptom burden, patients with high burden showed increased mean, axial, and radial diffusivity in the hypothalamus. In contrast, we did not find significant group differences in any of these measures extracted from the brainstem or the putamen.These results reveal consistent differences in the microstructural properties of the hypothalamus between patients with low and high autonomic symptom burden. Hypothalamic diffusivity properties can thus potentially be used as an imaging marker to assist in the identification of therapeutic targets for autonomic dysfunction in Parkinson’s disease.

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A Non-Invasive IR Sensor Technique to Differentiate Parkinson’s Disease from Other Neurological Disorders Using Autonomic Dysfunction as Diagnostic Criterion

Sensors ◽

10.3390/s22010266 ◽

2021 ◽

Vol 22 (1) ◽

pp. 266

Author(s):

Brindha Anbalagan ◽

Sunitha Karnam Karnam Anantha ◽

Sridhar P. Arjunan ◽

Venkatraman Balasubramanian ◽

Menaka Murugesan ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cold Stress ◽

Autonomic Dysfunction ◽

Recovery Rate ◽

Stress Test ◽

Invasive Technique ◽

Non Invasive ◽

Hand Temperature ◽

Cold Stress Test

Early diagnosis of Parkinson’s disease (PD) plays a critical role in effective disease management and delayed disease progression. This study reports a technique that could diagnose and differentiate PD from essential tremor (ET) in its earlier stage using a non-motor phenotype. Autonomic dysfunction, an early symptom in PD patients, is caused by α-synuclein pathogenesis in the central nervous system and can be diagnosed using skin vasomotor response to cold stimuli. In this study, the investigations were performed using data collected from 20 PD, 20 ET and 20 healthy subjects. Infrared thermography was used for the cold stress test to observe subjects’ hand temperature before and after cold stimuli. The results show that the recovery rate of hand temperature was significantly different between the groups. The data obtained in the cold stress test were verified using Pearson’s cross-correlation technique, which showed that few disease parameters like medication and motor rating score had an impact on the recovery rate of hand temperature in PD subjects. The characteristics of the three groups were compared and classified using the k-means clustering algorithm. The sensitivity and specificity of these techniques were analyzed using an Receiver Operating Characteristic (ROC) curve analyzer. These results show that this non-invasive technique can be used as an effective tool in the diagnosis and differentiation of PD in its early stage.

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