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  4. Are Thermoregulatory Sweating and Active Vasodilation in Skin Controlled by Separate Nerves During Passive Heat Stress in Persons With Spinal Cord Injury?

Are Thermoregulatory Sweating and Active Vasodilation in Skin Controlled by Separate Nerves During Passive Heat Stress in Persons With Spinal Cord Injury?

Top Spinal Cord Inj Rehabil, 2022 · DOI: 10.46292/sci21-00063 · Published: October 1, 2022

Spinal Cord InjuryRehabilitation

Simple Explanation

The skin helps regulate body temperature through sweating and blood flow changes. This study investigates whether the nerves controlling sweating and blood vessel dilation in the skin are the same or different in people with spinal cord injuries. Researchers measured sweating and blood flow in individuals with tetraplegia, paraplegia, and able-bodied controls during passive heat stress to see if areas of sweating and vasodilation were in the same locations. The findings suggest that in individuals with spinal cord injuries, areas with intact sweating also have intact blood vessel dilation, indicating that these two functions are likely controlled by the same set of nerves.

Study Duration
Not specified
Participants
Nine persons with tetraplegia, 13 with paraplegia, and nine able-bodied controls
Evidence Level
Case-control study

Key Findings

  • 1
    In persons with tetraplegia, there was no sweating in any measured dermatome.
  • 2
    In persons with paraplegia, areas with intact sudomotor response correlated with areas of RBC flux change quantitatively comparable to able-bodied persons.
  • 3
    Areas without sudomotor response showed significantly less RBC flux change than areas with sudomotor response, suggesting it resulted from non-AVD mechanisms.

Research Summary

This study investigated whether thermoregulatory sweating and active vasodilation in skin are controlled by separate nerves during passive heat stress in persons with spinal cord injury (SCI). The study found that in persons with SCI under passive heat stress, areas with intact sudomotor response and active vasodilation are concordant, suggesting these two aspects of thermoregulation are controlled by a single set of nerves. The researchers used objective measurements of sudomotor responses and quantitative measurements of active vasodilation to determine whether skin surface areas of sudomotor response and active vasodilation are concordant or discordant.

Practical Implications

Clinical Practice

Clinicians should be aware that impaired heat dissipation in SCI patients results from impaired sweating and vasodilation both above and below the neurological level of injury, especially in tetraplegia.

Patient Education

Patients with SCI, particularly tetraplegia, should be educated about their impaired perception of core temperature rise and the need for proactive cooling strategies.

Future Research

Further investigation is needed to understand the non-AVD mechanisms contributing to minimal vasodilation in anhidrotic areas and the specific roles of adrenergic and cholinergic tones.

Study Limitations

  • 1
    SBF and sudomotor response were measured on separate days.
  • 2
    The laser Doppler imager measuring SBF changes is unable to penetrate the starch used for the starch iodine test to measure sudomotor response.
  • 3
    Not specified

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