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Masato Asahina - One of the best experts on this subject based on the ideXlab platform.

  • Skin sympathetic function in complex regional pain syndrome type 1
    Clinical Autonomic Research, 2015
    Co-Authors: Anupama Poudel, Masato Asahina, Yoshikatsu Fujinuma, Yoshitaka Yamanaka, Akira Katagiri, Nobuyuki Araki, Shigeki Hirano, Satoshi Kuwabara
    Abstract:

    Purpose Cutaneous sympathetic pathophysiology in complex regional pain syndrome type 1 (CRPS-1) is not yet completely understood. To evaluate cutaneous sympathetic dysfunction in CRPS-1, we evaluated sympathetic sweat response (SSwR) and skin Vasomotor Reflex (SkVR) in CRPS-1 patients. Methods We studied 10 CRPS-1 patients (age 41 ± 13 years; 5 females and 5 males; disease duration 20 ± 22 months) and 10 healthy subjects (age 44 ± 13 years; 3 females and 7 males). SkVRs and SSwRs to several sympathetic activating procedures were recorded on the palms of the CRPS-1 patients (affected side) and controls (right side). Results There were no significant differences in the baselines of sweat output and skin blood flow between the CRPS-1 and control groups. SSwR and SkVR amplitudes were significantly lower in the CRPS-1 group than in the control group. There was no significant correlation between disease duration and SSwR or SkVR amplitudes among the patients. Conclusions The reduced SSwRs and SkVRs in the affected limb of our CRPS-1 patients may reflect underlying damage to the sympathetic postganglionic fibres.

  • Skin sympathetic function in complex regional pain syndrome type 1.
    Clinical Autonomic Research, 2015
    Co-Authors: Anupama Poudel, Masato Asahina, Yoshikatsu Fujinuma, Yoshitaka Yamanaka, Akira Katagiri, Nobuyuki Araki, Shigeki Hirano, Satoshi Kuwabara
    Abstract:

    Purpose Cutaneous sympathetic pathophysiology in complex regional pain syndrome type 1 (CRPS-1) is not yet completely understood. To evaluate cutaneous sympathetic dysfunction in CRPS-1, we evaluated sympathetic sweat response (SSwR) and skin Vasomotor Reflex (SkVR) in CRPS-1 patients.

  • Differences in skin sympathetic involvements between two chronic autonomic disorders: multiple system atrophy and pure autonomic failure.
    Parkinsonism & related disorders, 2008
    Co-Authors: Masato Asahina, Yoshitaka Yamanaka, Yuichi Akaogi, Yu Koyama, Takamichi Hattori
    Abstract:

    Abstract Objective Certain stimuli evoke increased sweat secretion (sympathetic sweat response; SSwR) and reduced skin blood flow (skin Vasomotor Reflex; SkVR) in the palm/sole. We evaluated SSwR and SkVR in patients with multiple system atrophy (MSA) and pure autonomic failure (PAF). Methods SSwR and SkVR on the palm in response to deep inspiration and mental arithmetic were recorded in 11 MSA patients, 11 PAF patients, and 11 healthy controls. In addition, the head-up tilt test was performed, and the coefficient of variation of R–R intervals (CV R–R ) was obtained. Results SSwR amplitudes were significantly lower in the MSA and PAF patients than the controls. SkVR amplitudes in the PAF patients were significantly lower than the controls, but preserved in the MSA patients. In head-up tilt tests, all MSA and PAF patients showed orthostatic hypotension, with similar severity. CV R–R was low in the MSA and PAF patients, but a significant difference was found only between the PAF and control groups. Conclusion In the MSA patients, SkVR was preserved, but SSwR was diminished. In the PAF patients, both SkVR and SSwR were attenuated. The combination of SkVR and SSwR tests may differentiate MSA and PAF.

  • measurements of sweat response and skin Vasomotor Reflex for assessment of autonomic dysfunction in patients with diabetes
    Journal of Diabetes and Its Complications, 2008
    Co-Authors: Masato Asahina, Yoshitaka Yamanaka, Satoshi Kuwabara, Yuichi Akaogi, Yu Koyama, Takamichi Hattori
    Abstract:

    Abstract Aims Some physical or arousal stimuli induce a rise in sweat secretion (sympathetic sweat response or SSwR) and a reduction in skin blood flow (skin Vasomotor Reflex or SkVR) to the palm. We recorded SSwRs and SkVRs in diabetic patients and assessed the usefulness of these parameters for evaluating autonomic dysfunction in diabetes. Methods We studied 42 diabetic patients (58±12 years) and 42 normal control subjects (59±11 years). Focal sweat secretion and skin blood flow were measured on the palm by a sudorometer and a Doppler flowmeter, respectively. SSwRs and SkVRs to deep inspiration, mental arithmetic, and isotonic exercise were recorded. SSwR amplitude was measured from baseline to peak, and SkVR amplitude (reduction rate) was calculated as: (blood flow reduction/basal blood flow)×100%. We also conducted head-up tilt tests and R–R interval variation tests (coefficient of variation of R–R intervals or CV R–R ). Results The SSwR or SkVR amplitudes in the diabetic group were significantly lower than those in the control group for any stimulus. CV R–R in the diabetic group was significantly less than that in the control group. The diabetic group showed a significantly greater reduction in systolic blood pressure during head-up tilt compared with the control group. In the diabetic group, there were significant correlations in SSwR or SkVR amplitudes versus blood pressure falls during the head-up tilt test, and CV R–R values. Conclusion We believe that SSwR and SkVR are useful indexes for the evaluation of autonomic involvement in diabetic patients.

  • Skin Vasomotor Reflex responses in two contrasting groups of autonomic failure: multiple system atrophy and pure autonomic failure.
    Journal of neurology, 2006
    Co-Authors: Tim M. Young, Masato Asahina, A. Nicotra, Craig. J. Mathias
    Abstract:

    Background & Aim A variety of stimuli such as deep inspiration, isometric exercise and mental arithmetic, result in a transient vasoconstriction,mediated by sympathetic efferent nerves, in the skin of the fingers and toes of healthy controls (Skin Vasomotor Reflex: SkVR). Multiple system atrophy (MSA) and pure autonomic failure (PAF) provide contrasting models of autonomic failure. In MSA the lesion is central and preganglionic, whilst in PAF the lesion site is peripheral and postganglionic. We evaluated the SkVR in response to various stimuli in MSA and PAF, to determine differences in skin Vasomotor involvement between these two patient groups.

Takamichi Hattori - One of the best experts on this subject based on the ideXlab platform.

  • Differences in skin sympathetic involvements between two chronic autonomic disorders: multiple system atrophy and pure autonomic failure.
    Parkinsonism & related disorders, 2008
    Co-Authors: Masato Asahina, Yoshitaka Yamanaka, Yuichi Akaogi, Yu Koyama, Takamichi Hattori
    Abstract:

    Abstract Objective Certain stimuli evoke increased sweat secretion (sympathetic sweat response; SSwR) and reduced skin blood flow (skin Vasomotor Reflex; SkVR) in the palm/sole. We evaluated SSwR and SkVR in patients with multiple system atrophy (MSA) and pure autonomic failure (PAF). Methods SSwR and SkVR on the palm in response to deep inspiration and mental arithmetic were recorded in 11 MSA patients, 11 PAF patients, and 11 healthy controls. In addition, the head-up tilt test was performed, and the coefficient of variation of R–R intervals (CV R–R ) was obtained. Results SSwR amplitudes were significantly lower in the MSA and PAF patients than the controls. SkVR amplitudes in the PAF patients were significantly lower than the controls, but preserved in the MSA patients. In head-up tilt tests, all MSA and PAF patients showed orthostatic hypotension, with similar severity. CV R–R was low in the MSA and PAF patients, but a significant difference was found only between the PAF and control groups. Conclusion In the MSA patients, SkVR was preserved, but SSwR was diminished. In the PAF patients, both SkVR and SSwR were attenuated. The combination of SkVR and SSwR tests may differentiate MSA and PAF.

  • measurements of sweat response and skin Vasomotor Reflex for assessment of autonomic dysfunction in patients with diabetes
    Journal of Diabetes and Its Complications, 2008
    Co-Authors: Masato Asahina, Yoshitaka Yamanaka, Satoshi Kuwabara, Yuichi Akaogi, Yu Koyama, Takamichi Hattori
    Abstract:

    Abstract Aims Some physical or arousal stimuli induce a rise in sweat secretion (sympathetic sweat response or SSwR) and a reduction in skin blood flow (skin Vasomotor Reflex or SkVR) to the palm. We recorded SSwRs and SkVRs in diabetic patients and assessed the usefulness of these parameters for evaluating autonomic dysfunction in diabetes. Methods We studied 42 diabetic patients (58±12 years) and 42 normal control subjects (59±11 years). Focal sweat secretion and skin blood flow were measured on the palm by a sudorometer and a Doppler flowmeter, respectively. SSwRs and SkVRs to deep inspiration, mental arithmetic, and isotonic exercise were recorded. SSwR amplitude was measured from baseline to peak, and SkVR amplitude (reduction rate) was calculated as: (blood flow reduction/basal blood flow)×100%. We also conducted head-up tilt tests and R–R interval variation tests (coefficient of variation of R–R intervals or CV R–R ). Results The SSwR or SkVR amplitudes in the diabetic group were significantly lower than those in the control group for any stimulus. CV R–R in the diabetic group was significantly less than that in the control group. The diabetic group showed a significantly greater reduction in systolic blood pressure during head-up tilt compared with the control group. In the diabetic group, there were significant correlations in SSwR or SkVR amplitudes versus blood pressure falls during the head-up tilt test, and CV R–R values. Conclusion We believe that SSwR and SkVR are useful indexes for the evaluation of autonomic involvement in diabetic patients.

  • Cutaneous sympathetic function in patients with multiple system atrophy.
    Clinical Autonomic Research, 2003
    Co-Authors: Masato Asahina, Yuriko Kikkawa, Atsuya Suzuki, Takamichi Hattori
    Abstract:

    Some procedures increase the sweat output (SSwR; sympathetic sweat response) and reduce the cutaneous blood flow (SVR; skin Vasomotor Reflex) in the hand. We evaluated SSwRs and SVRs to deep inspiration, mental arithmetic, exercise, and tactile stimulation in 40 MSA patients and 15 healthy controls. We also conducted head-up tilt tests and R-R interval variation tests (CVR-R).

Hidenori Terasaki - One of the best experts on this subject based on the ideXlab platform.

  • assessing the level of regional blockade under general anesthesia using the skin Vasomotor Reflex test
    Anesthesia & Analgesia, 1998
    Co-Authors: Osamu Shimoda, Yoshihiro Ikuta, Hidenori Terasaki
    Abstract:

    We investigated whether skin Vasomotor Reflex (SVmR) testing can be used to assess the sensory blockade level under light general anesthesia.In 15 patients scheduled for abdominal gynecological surgery, the SVmR was tested under inhaled isoflurane or sevoflurane (0.5%-0.6%) with nitrous oxide (50%). Seven minutes after the epidural injection (5-10 mL of 2% lidocaine), a tetanic electrical stimulus (20 mA, 2 s) was applied to the skin and repeated sequentially from the L3 dermatome in the cephalad direction. Changes in the laser Doppler skin blood flow on the index finger tip were assessed for the SVmR. If there was a positive response, SVmR testing was discontinued. The relationship between the uppermost dermatome of the negative SVmR response and the intraoperative effectiveness of the epidural block was determined. In 11 patients, we confirmed a clear boundary of skin dermatome by the SVmR test. The uppermost dermatome of the negative SVmR response at higher than the T7 level was necessary to maintain the combined epidural and light general anesthesia for the transabdominal gynecological surgery (P = 0.002). We conclude that SVmR testing is useful in estimating the blockade level of regional anesthesia under light general anesthesia. Implications: Considering "preemptive analgesia," a complete sensory blockade should be established before a skin incision. In 11 of 15 patients under epidural/general anesthesia, we confirmed a clear dermatome boundary using the skin Vasomotor Reflex test. This test could be an indicator for estimating the sensory blockade level of patients under general anesthesia. (Anesth Analg 1998;87:83-7)

  • skin Vasomotor Reflex predicts circulatory responses to laryngoscopy and intubation
    Anesthesiology, 1998
    Co-Authors: Osamu Shimoda, Yoshihiro Ikuta, Masakatsu Sakamoto, Hidenori Terasaki
    Abstract:

    BackgroundAn evaluation of autonomic reactivity may help to predict circulatory responses to intubation. The relation between the magnitude of the skin Vasomotor Reflex (SVmR) immediately before laryngoscopy and the circulatory responses to intubation was examined.MethodsForty-four adult patients (c

  • skin Vasomotor Reflex as an objective indicator to assess the level of regional anesthesia
    Anesthesia & Analgesia, 1998
    Co-Authors: Yoshihiro Ikuta, Osamu Shimoda, Kazuo Ushijima, Hidenori Terasaki
    Abstract:

    We examined whether the absence of a skin Vasomotor Reflex (SVmR), which represents a sympathetic vasoconstrictive response to various stimuli, is an objective indicator of a somatosensory blockade.Skin blood flow was measured by using a laser Doppler flowmeter on the index finger tip. The somatosen

  • skin Vasomotor Reflex induced by laryngoscopy comparison of the mccoy and macintosh blades
    BJA: British Journal of Anaesthesia, 1997
    Co-Authors: Osamu Shimoda, Yoshihiro Ikuta, Masakatsu Sakamoto, S Isayama, Hidenori Terasaki
    Abstract:

    We studied 22 female patients (ASA I or II) to investigate if laryngoscopy and intubation induced the skin Vasomotor Reflex (SVmR), and to compare the effects of the McCoy and Macintosh blades on the SVmR. Anaesthesia was induced with fentanyl, midazolam, vecuronium and nitrous oxide. In 11 patients, the vocal cords were seen for 3 s with the McCoy blade. Two minutes later, laryngoscopy was performed with the Macintosh blade and the trachea was intubated. In the other 11 patients, the first and second laryngoscopies, respectively, were performed with the Macintosh and McCoy blades. Laryngoscopy alone and intubation with laryngoscopy significantly reduced skin blood flow in the ring finger of all patients (P

Steen Petersenfelix - One of the best experts on this subject based on the ideXlab platform.

  • prediction of the haemodynamic response to tracheal intubation comparison of laser doppler skin Vasomotor Reflex and pulse wave Reflex
    BJA: British Journal of Anaesthesia, 2002
    Co-Authors: Martin Luginbuhl, F Reichlin, G H Sigurdsson, A M Zbinden, Steen Petersenfelix
    Abstract:

    Background The laser-Doppler skin Vasomotor Reflex (SVmR) caused by tetanic stimulation of the ulnar nerve may be a test that can predict the haemodynamic response to tracheal intubation. A decrease in pulse wave amplitude (pulse wave Reflex, PWR) may be an alternative index of this response. We compared the abilities of PWR and SVmR to predict the haemodynamic response to tracheal intubation and studied how alfentanil, muscle relaxation, stimulation site and stimulation pattern affected the two Reflexes. Methods Anaesthesia was induced and maintained with 2% sevoflurane and 50% nitrous oxide in two groups of 10 ASA status I patients. Tetanic stimuli were applied to the flexor muscles of the forearm and the ulnar nerve before and after administration of vecuronium. The change in skin blood flow (laser-Doppler) and pulse wave amplitude (pulse oximetry) after a 5 and 10 s stimulation was measured on the opposite hand. If skin blood flow (laser-Doppler) decreased by more than 10%, a computer-controlled infusion of alfentanil was started and the target plasma concentration was increased in steps until this response was suppressed ( Results When PWR and SVmR were suppressed, the haemodynamic response to tracheal intubation was reduced in 100 and 53% of patients respectively. PWR and SVmR responses decreased with increasing plasma alfentanil concentration. The SVmR response to muscle stimulation was reduced by muscle relaxants. The pulse wave response to both muscle and neural stimulation was reduced by relaxants. The responses to 5 and 10 s stimulations were similar. Conclusion An absent SVmR does not predict a blunted arterial pressure or heart rate response to tracheal intubation. The PWR may be a better predictor.

Yoshitaka Yamanaka - One of the best experts on this subject based on the ideXlab platform.

  • Skin sympathetic function in complex regional pain syndrome type 1
    Clinical Autonomic Research, 2015
    Co-Authors: Anupama Poudel, Masato Asahina, Yoshikatsu Fujinuma, Yoshitaka Yamanaka, Akira Katagiri, Nobuyuki Araki, Shigeki Hirano, Satoshi Kuwabara
    Abstract:

    Purpose Cutaneous sympathetic pathophysiology in complex regional pain syndrome type 1 (CRPS-1) is not yet completely understood. To evaluate cutaneous sympathetic dysfunction in CRPS-1, we evaluated sympathetic sweat response (SSwR) and skin Vasomotor Reflex (SkVR) in CRPS-1 patients. Methods We studied 10 CRPS-1 patients (age 41 ± 13 years; 5 females and 5 males; disease duration 20 ± 22 months) and 10 healthy subjects (age 44 ± 13 years; 3 females and 7 males). SkVRs and SSwRs to several sympathetic activating procedures were recorded on the palms of the CRPS-1 patients (affected side) and controls (right side). Results There were no significant differences in the baselines of sweat output and skin blood flow between the CRPS-1 and control groups. SSwR and SkVR amplitudes were significantly lower in the CRPS-1 group than in the control group. There was no significant correlation between disease duration and SSwR or SkVR amplitudes among the patients. Conclusions The reduced SSwRs and SkVRs in the affected limb of our CRPS-1 patients may reflect underlying damage to the sympathetic postganglionic fibres.

  • Skin sympathetic function in complex regional pain syndrome type 1.
    Clinical Autonomic Research, 2015
    Co-Authors: Anupama Poudel, Masato Asahina, Yoshikatsu Fujinuma, Yoshitaka Yamanaka, Akira Katagiri, Nobuyuki Araki, Shigeki Hirano, Satoshi Kuwabara
    Abstract:

    Purpose Cutaneous sympathetic pathophysiology in complex regional pain syndrome type 1 (CRPS-1) is not yet completely understood. To evaluate cutaneous sympathetic dysfunction in CRPS-1, we evaluated sympathetic sweat response (SSwR) and skin Vasomotor Reflex (SkVR) in CRPS-1 patients.

  • Differences in skin sympathetic involvements between two chronic autonomic disorders: multiple system atrophy and pure autonomic failure.
    Parkinsonism & related disorders, 2008
    Co-Authors: Masato Asahina, Yoshitaka Yamanaka, Yuichi Akaogi, Yu Koyama, Takamichi Hattori
    Abstract:

    Abstract Objective Certain stimuli evoke increased sweat secretion (sympathetic sweat response; SSwR) and reduced skin blood flow (skin Vasomotor Reflex; SkVR) in the palm/sole. We evaluated SSwR and SkVR in patients with multiple system atrophy (MSA) and pure autonomic failure (PAF). Methods SSwR and SkVR on the palm in response to deep inspiration and mental arithmetic were recorded in 11 MSA patients, 11 PAF patients, and 11 healthy controls. In addition, the head-up tilt test was performed, and the coefficient of variation of R–R intervals (CV R–R ) was obtained. Results SSwR amplitudes were significantly lower in the MSA and PAF patients than the controls. SkVR amplitudes in the PAF patients were significantly lower than the controls, but preserved in the MSA patients. In head-up tilt tests, all MSA and PAF patients showed orthostatic hypotension, with similar severity. CV R–R was low in the MSA and PAF patients, but a significant difference was found only between the PAF and control groups. Conclusion In the MSA patients, SkVR was preserved, but SSwR was diminished. In the PAF patients, both SkVR and SSwR were attenuated. The combination of SkVR and SSwR tests may differentiate MSA and PAF.

  • measurements of sweat response and skin Vasomotor Reflex for assessment of autonomic dysfunction in patients with diabetes
    Journal of Diabetes and Its Complications, 2008
    Co-Authors: Masato Asahina, Yoshitaka Yamanaka, Satoshi Kuwabara, Yuichi Akaogi, Yu Koyama, Takamichi Hattori
    Abstract:

    Abstract Aims Some physical or arousal stimuli induce a rise in sweat secretion (sympathetic sweat response or SSwR) and a reduction in skin blood flow (skin Vasomotor Reflex or SkVR) to the palm. We recorded SSwRs and SkVRs in diabetic patients and assessed the usefulness of these parameters for evaluating autonomic dysfunction in diabetes. Methods We studied 42 diabetic patients (58±12 years) and 42 normal control subjects (59±11 years). Focal sweat secretion and skin blood flow were measured on the palm by a sudorometer and a Doppler flowmeter, respectively. SSwRs and SkVRs to deep inspiration, mental arithmetic, and isotonic exercise were recorded. SSwR amplitude was measured from baseline to peak, and SkVR amplitude (reduction rate) was calculated as: (blood flow reduction/basal blood flow)×100%. We also conducted head-up tilt tests and R–R interval variation tests (coefficient of variation of R–R intervals or CV R–R ). Results The SSwR or SkVR amplitudes in the diabetic group were significantly lower than those in the control group for any stimulus. CV R–R in the diabetic group was significantly less than that in the control group. The diabetic group showed a significantly greater reduction in systolic blood pressure during head-up tilt compared with the control group. In the diabetic group, there were significant correlations in SSwR or SkVR amplitudes versus blood pressure falls during the head-up tilt test, and CV R–R values. Conclusion We believe that SSwR and SkVR are useful indexes for the evaluation of autonomic involvement in diabetic patients.