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The quantitative sudomotor axon reflex test (QSART) was developed in 1983 by Phillip Low as a quantitative method for the identification of localized postganglionic sudomotor dysfunction. [18] Three-compartment sweat capsules are placed on the forearm, proximal and distal leg, as well as the dorsum of the foot.
The autonomic nervous system (ANS), of which sudomotor nerves are an integral part, is the primary extrinsic control mechanism regulating heart rate, blood pressure, and myocardial contractility. Cardiac autonomic neuropathy (CAN) describes a dysfunction of the ANS and its regulation of the cardiovascular system.
The neurotransmitters of postganglionic fibers differ: In the parasympathetic division , neurons are cholinergic . That is to say acetylcholine is the primary neurotransmitter responsible for the communication between neurons on the parasympathetic pathway .
In the sudomotor reflex, cholinergic agents bind to the nicotinic receptors on the sudomotor nerve terminals, evoking an impulse that travels towards the soma, or opposite of the normal impulse. At the soma of the postganglionic sympathetic sudomotor neuron, the impulse branches and travels orthodromically, or away from the soma.
There are two kinds of neurons involved in the transmission of any signal through the sympathetic system: pre-ganglionic and post-ganglionic. The shorter preganglionic neurons originate in the thoracolumbar division of the spinal cord specifically at T1 to L2~L3, and travel to a ganglion, often one of the paravertebral ganglia, where they synapse with a postganglionic neuron.
Sudomotor dysfunction is one of the most common and earliest neurophysiological manifestations of small fiber neuropathies. [3] In some instances, the small fibers of the autonomic nervous system can be affected, leading to urinary or bowel problems, episodes of rapid heartbeat (palpitations), dry eyes or mouth, or abnormal sweating.
Acquired idiopathic generalized anhidrosis appears to have a variety of etiologies. Theoretically, dysfunction or degeneration of cholinergic sympathetic nerve fibers involved in sweating (sudomotor neuropathy), dysfunction of acetylcholine receptors and/or cholinergic signals (idiopathic pure sudomotor failure may fall under this category), and primary failures of the sweat glands with ...
Ganglia within this chain are either cervical, thoracic, lumbar, or sacral. Preganglionic nerves from the spinal cord synapse at one of the chain ganglia, and the postganglionic fiber extends to an effector, a visceral organ in the thoracic cavity, abdominal cavity, or pelvic cavity.