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

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.

Reproducibility of Skin Temperature Response after Cold Stress Test Using the Game Ready System: Preliminary Study

The objective of this preliminary study was to determine the reproducibility of lower limbs skin temperature after cold stress test using the Game Ready system. Skin temperature of fourteen participants was measured before and after cold stress test using the Game Ready system and it was repeated the protocol in four times: at 9:00, at 11:00, at 19:00, and at 9:00 h of the posterior day. To assess skin temperature recovery after cold stress test, a logarithmic equation for each region was calculated, and constant (β0) and slope (β1) coefficients were obtained. Intraclass correlation coefficient (ICC), standard error (SE), and within-subject coefficient of variation (CV) were determined. No differences were observed between measurement times in any of the regions for the logarithmic coefficients (p > 0.38). Anterior thigh (β0 ICC 0.33–0.47; β1 ICC 0.31–0.43) and posterior knee (β0 ICC 0.42–0.58; β1 ICC 0.28–0.57) were the regions with the lower ICCs, and the other regions presented values with a fair and good reproducibility (ICC > 0.41). Posterior leg was the region with the better reproducibility (β0 ICC 0.68–0.78; β1 ICC 0.59–0.74; SE 3–4%; within-subject CV 7–12%). In conclusion, cold stress test using Game Ready system showed a fair and good reproducibility, especially when the posterior leg was the region assessed.

Effect of a Marathon on Skin Temperature Response After a Cold-Stress Test and Its Relationship With Perceptive, Performance, and Oxidative-Stress Biomarkers

Context: Although skin-temperature assessment has received much attention in recent years as a possible internal-load measurement, scientific evidence is scarce. Purpose: To analyze baseline skin temperature and its rewarming through means of a cold-stress test before and after performing a marathon and to study the association between skin temperature and internal/external-load measurements. Methods: A total of 16 runners were measured 48 and 24 h before and 24 and 48 h after completing a marathon. The measurements on each day of testing included urine biomarkers of oxidative stress, pain and fatigue perception, skin temperature (at baseline and after a cold-stress test), and jump performance. Results: Reduced jump performance (P < .01 and effect size [ES] = 0.5) and higher fatigue and pain perception were observed 24 h after the marathon (P < .01 and ES > 0.8). Although no differences in baseline skin temperature were observed between the 4 measuring days, posterior legs presented lower constant (P < .01 and ES = 1.4) and higher slope (P = .04 and ES = 1.1) parameters in the algorithmic equations fitted for skin-temperature recovery after the cold-stress test 24 h after the marathon than on the day before the marathon. Regressions showed that skin-temperature parameters could be predicted by the ratio of ortho-tyrosine isomer to phenylalanine (oxidative stress biomarker) and body fat composition, among others. Conclusions: Although baseline skin temperature was not altered 24 or 48 h after a marathon, the application of cold stress after the marathon would appear to be a good method for providing information on vasoconstriction and a runner’s state of stress.

Neuropatia de Fibras Finas em um caso de Artrite Psoriásica

A neuropatia periférica ocorre como consequência dos distúrbios metabólicos nos pacientes com diabetes mellitus e hipotireoidismo, situações carenciais (deficiências de vitamina B12 e folato), associada a quadros clínicos tóxicos (etilismo, exposição a metais pesados), infecciosas (sífilis, HIV), entre outras causas, como medicamentos. A polineuropatia típica, associada principalmente ao diabetes é simétrica, distal e correlacionada com o dano progressivo tanto de fibras somáticas como neurovegetativas. A técnica de captação de imagens infravermelhas (termografia médica) consiste no registro da temperatura a partir da irradiação infravermelha da pele, o termograma que permite tanto uma análise qualitativa quanto quantitativa da distribuição térmica cutânea. O tônus vasomotor é regulado pelas fibras simpáticas finas tipo C e, portanto, sua disfunção pode ser identificada pela alteração de padrões de temperatura cutânea, sobretudo, sob manobras provocativas neurovegetativas, como o uso de estímulo frio (em inglês Cold Stress Test). Avaliou-se um homem de 60 anos, que procurou atendimento para tratamento de onicomicose crônica no hálux direito em uso de adalimumabe, metotrexate e deficiência de vitamina B12 através da termografia, verificando-se instabilidade vasomotora simpática anormal nas plantas dos pés.