Short communication| Volume 164, ISSUE 1-2, P101-104, October 28, 2011

Download started.


Sympathetic skin response. Glabella stimulation may be more useful than peripheral nerve stimulation in clinical practise


      The aim is to verify whether glabella electrical stimulation evokes sympathetic skin responses (SSR) without inter-side differences in latency and area of the responses and is more useful in mononeuropathies than peripheral nerve stimulation. SSRs were recorded in 25 healthy subjects from right palm, third (M3SSR) and fifth fingers and contralateral third finger. The inter-side differences of grand mean area and mean of largest area of M3SSR were significant only by ulnar nerve and not by glabella stimulation. Therefore glabella stimulation may be used in mononeuropathies comparing SSR area recorded from affected side with respect to contralateral healthy side.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Autonomic Neuroscience: Basic and Clinical
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Argyriou A.A.
        • Polychronopoulos P.
        • Moutopulou E.
        • Aplada M.
        • Chroni E.
        The significance of intact sympathetic skin responses in carpal tunnel syndrome.
        Eur. J. Neurol. 2006; 13: 455-459
        • Bayrak A.O.
        • Tilki H.E.
        • Coşkun M.
        Sympathetic skin response and axon count in carpal tunnel syndrome.
        J. Clin. Neurophysiol. 2007; 24: 70-75
        • Caccia M.R.
        • Galimberti V.
        • Valla P.L.
        • Salvaggio A.
        • Dezuanni E.
        • Mangoni A.
        Peripheral autonomic involvement in the carpal tunnel syndrome.
        Acta Neurol. Scand. 1993; 88: 47-50
        • Cariga P.
        • Catley M.
        • Mathias C.J.
        • Ellaway P.H.
        Characteristics of habituation of the sympathetic skin response to repeated electrical stimuli in man.
        Clin. Neurophysiol. 2001; 112: 1875-1880
        • Chroni E.
        • Argyriou A.A.
        • Polychronopoulos P.
        • Sirrou V.
        The effect of stimulation technique on sympathetic skin responses in healthy subjects.
        Clin. Auton. Res. 2006; 16: 396-400
      1. Deniz, O., Aygül, R., Kotan, D., Ozdemir, G., Odabaş, F.O., Kaya, M.D., Ulvi, H. in press. The effect of local corticosteroid injection on F-wave conduction velocity and sympathetic skin response in carpal tunnel syndrome, Rheumatol. Int.

        • Donadio V.
        • Lenzi P.
        • Montagna P.
        • Falzone F.
        • Baruzzi A.
        • Liguori R.
        Habituation of sympathetic sudomotor and vasomotor skin responses: neural and non-neural components in healthy subjects.
        Clin. Neurophysiol. 2005; 116: 2542-2549
        • Elie B.
        • Guiheneuc P.
        Sympathetic skin response: normal results in different experimental conditions.
        Electroencephalogr. Clin. Neurophysiol. 1990; 76: 258-267
        • Hay J.E.
        • Taylor P.K.
        • Nukada H.
        Auditory and inspiratory gasp-evoked sympathetic skin response: age effects.
        J. Neurol. Sci. 1997; 148: 19-23
        • Hilz M.J.
        • Azelrod F.B.
        • Schweibold G.
        • Kolodny E.H.
        Sympathetic skin response following thermal, electrical, acoustic, and inspiratory gasp stimulation in familial dysautonomia patients and healthy persons.
        Clin. Auton. Res. 1999; 9: 165-177
        • Kanzato N.
        • Komine Y.
        • Kanaya F.
        • Fukiyama K.
        Preserved sympathetic skin response at the distal phalanx in patients with carpal tunnel syndrome.
        Clin. Neurophysiol. 2000; 111: 2057-2063
        • Kira Y.
        • Ogura T.
        • Aramaki S.
        • Kubo T.
        • Hayasida T.
        • Hirasawa Y.
        Sympathetic skin response evoked by respiratory stimulation as a measure of sympathetic function.
        Clin. Neurophysiol. 2001; 112: 861-865
        • Kiylioglu N.
        • Akyol A.
        • Guney E.
        • Bicerol B.
        • Ozkul A.
        • Erturk A.
        Sympathetic skin response in idiopathic and diabetic carpal tunnel syndrome.
        Clin. Neurol. Neurosurg. 2005; 108: 1-7
        • Kucera P.
        • Goldenberg Z.
        • Kurca E.
        Sympathetic skin response: review of the method and its clinical use.
        Bratisl. Lek. Listy. 2004; 105: 108-116
        • Kumru H.
        • Vidal J.
        • Perez M.
        • Schestatsky P.
        • Valls-Solé J.
        Sympathetic skin responses evoked by different stimuli modalities in spinal cord injury patients.
        Neurorehabil. Neural Repair. 2009; 23: 553-558
        • Kuntzer T.
        Carpal tunnel syndrome in 100 patients: sensitivity, specificity of multi-neurophysiological procedures and estimation of axonal loss of motor, sensory and sympathetic median nerve fibers.
        J. Neurol. Sci. 1994; 127: 221-229
        • Maselli R.A.
        • Jaspan J.B.
        • Soliven B.C.
        • Green A.J.
        • Spire J.P.
        • Arnason B.G.
        Comparison of sympathetic skin response with quantitative sudomotor axon reflex test in diabetic neuropathy.
        Muscle Nerve. 1989; 12: 420-423
        • Matsunaga K.
        • Uozumi T.
        • Tsuji S.
        • Murai Y.
        Sympathetic skin responses evoked by magnetic stimulation of the neck.
        J. Neurol. Sci. 1995; 128: 188-194
        • Mondelli M.
        • Vecchiarelli B.
        • Reale F.
        • Marsili T.
        • Giannini F.
        Sympathetic skin response before and after surgical release of carpal tunnel syndrome.
        Muscle Nerve. 2001; 24: 130-133
        • Mondelli M.
        • de Stefano R.
        • Rossi S.
        • Aretini A.
        • Romano C.
        Sympathetic skin response in primary Raynaud's phenomenon.
        Clin. Auton. Res. 2009; 19: 355-362
        • Montagna P.
        • Liguori R.
        • Zappia M.
        Sympathetic skin response.
        J. Neurol. Neurosurg. Psychiatry. 1985; 48: 489-490
        • Reddeppa S.
        • Bulusu K.
        • Chand P.R.
        • Jacob P.C.
        • Kalappurakkal J.
        • Tharakan J.
        The sympathetic skin response in carpal tunnel syndrome.
        Auton. Neurosci. 2000; 84: 119-121
        • Rushworth G.
        Observations on blink reflexes.
        J. Neurol. Neurosurg. Psychiatry. 1962; 25: 93-108
        • Sener H.O.
        • Taşcilar N.F.
        • Balaban H.
        • Selçuki D.
        Sympathetic skin response in carpal tunnel syndrome.
        Clin. Neurophysiol. 2000; 111: 1395-1399
        • Shahani B.T.
        • Halperin J.J.
        • Boulu P.
        • Cohen J.
        Sympathetic skin response—a method of assessing unmyelinated axon dysfunction in peripheral neuropathies.
        J. Neurol. Neurosurg. Psychiatry. 1984; 47: 536-542
        • Toyokura M.
        Waveform and habituation of sympathetic skin response.
        Electroencephalogr. Clin. Neurophysiol. 1998; 109: 178-183
        • Toyokura M.
        Waveform variation and size of sympathetic skin response: regional difference between the sole and palm recordings.
        Clin. Neurophysiol. 1999; 110: 765-771
        • Toyokura M.
        Sympathetic skin responses: the influence of electrical stimulus intensity and habituation on the waveform.
        Clin. Auton. Res. 2006; 16: 130-135
        • Toyokura M.
        • Murakami K.
        Reproducibility of sympathetic skin response.
        Muscle Nerve. 1996; 19: 1481-1483
        • Toyokura M.
        • Murakami K.
        Reproducibility of sympathetic skin response (a reply).
        Muscle Nerve. 1997; 20: 1333-1334
        • Verghese J.
        • Galanopoulou A.S.
        • Herskovitz S.
        Autonomic dysfunction in idiopathic carpal tunnel syndrome.
        Muscle Nerve. 2000; 23: 1209-1213
        • Vetrugno R.
        • Liguori R.
        • Cortelli P.
        • Montagna P.
        Sympathetic skin response: basic mechanisms and clinical applications.
        Clin. Auton. Res. 2003; 13: 256-270
        • Yokota T.
        • Matsunaga T.
        • Okiyama R.
        • Hirose K.
        • Tanabe H.
        • Furukawa T.
        • Tsukagoshi H.
        Sympathetic skin response in patients with multiple sclerosis compared with patients with spinal cord transection and normal controls.
        Brain. 1991; 114: 1381-1394
        • Zyluk A.
        • Kosovets L.
        An assessment of the sympathetic function within the hand in patients with carpal tunnel syndrome.
        J. Hand Surg. Eur. 2010; 35: 402-408