Characteristics of subthreshold sudomotor neural impulses

Elementary integrate-and-fire process underlies pulse amplitudes in Electrodermal activity

Electrodermal activity (EDA) is a direct read-out of sweat-induced changes in the skin’s electrical conductance. Sympathetically-mediated pulsatile changes in skin sweat measured as EDA resemble an integrate-and-fire process, which yields an inverse Gaussian model as the inter-pulse interval distribution. We have previously showed that the inter-pulse intervals in EDA follow an inverse Gaussian distribution. However, the statistical structure of EDA pulse amplitudes has not yet been characterized based on the physiology. Expanding upon the integrate-and-fire nature of sweat glands, we hypothesized that the amplitude of an EDA pulse is proportional to the excess volume of sweat produced compared to what is required to just reach the surface of the skin. We modeled this as the difference of two inverse Gaussian models for each pulse, one which represents the time required to produce just enough sweat to rise to the surface of the skin and one which represents the time requires to produce the actual volume of sweat. We proposed and tested a series of four simplifications of our hypothesis, ranging from a single difference of inverse Gaussians to a single simple inverse Gaussian. We also tested four additional models for comparison, including the lognormal and gamma distributions. All models were tested on EDA data from two subject cohorts, 11 healthy volunteers during 1 hour of quiet wakefulness and a different set of 11 healthy volunteers during approximately 3 hours of controlled propofol sedation. All four models which represent simplifications of our hypothesis outperformed other models across all 22 subjects, as measured by Akaike’s Information Criterion (AIC), as well as mean and maximum distance from the diagonal on a quantile-quantile plot. Our broader model set of four simplifications offered a useful framework to enhance further statistical descriptions of EDA pulse amplitudes. Some of the simplifications prioritize fit near the mode of the distribution, while others prioritize fit near the tail. With this new insight, we can summarize the physiologically-relevant amplitude information in EDA with at most four parameters. Our findings establish that physiologically based probability models provide parsimonious and accurate description of temporal and amplitude characteristics in EDA.

Electrodermal activity (EDA) is an indirect read-out of the body’s sympathetic nervous system, or fight-or-flight response, measured as sweat-induced changes in the electrical conductance properties of the skin. Interest is growing in using EDA to track physiological conditions such as stress levels, sleep quality, and emotional states. Our previous worked showed that the times in between EDA pulses obeyed a specific statistical distribution, the inverse Gaussian, that arises from the physiology of EDA production. In this work, we build on that insight to analyze the amplitudes of EDA pulses. In an analysis of EDA data recorded in 11 healthy volunteers during quiet wakefulness and 11 different healthy volunteers during controlled propofol sedation, we establish that the amplitudes of EDA pulses also have specific statistical structure, as the differences of inverse Gaussians, that arises from the physiology of sweat production. We capture that structure using a series of progressively simpler models that each prioritize different parts of the pulse amplitude distribution. Our findings show that a physiologically-based statistical model provides a parsimonious and accurate description of EDA. This enables increased reliability and robustness in analyzing EDA data collected under any circumstance.

Rapid, Large, and Synchronous Sweat and Cardiovascular Responses Upon Minor Stimuli in Healthy Subjects. Dynamics and Reproducibility

Purpose: The aim of the study was to investigate steady state levels, dynamics and reproducibility of cardiovascular variables and electrodermal activity in different skin areas in response to minor physiological and mental stimuli in healthy subjects in the thermoneutral zone, carried out in high time resolution. Methods: Thirteen healthy subjects underwent experiments on two separate days. Non-invasive electrodermal activity in five different skin areas was measured continuously using a skin conductance method, including resting supine and sitting positions, performing deep inspirations, a mental challenge and being exposed to a sudden loud sound. Blood pressure, heart rate, radial artery blood flow, and skin perfusion were measured simultaneously. Results: Electrodermal activity in the right and left palms was almost identical, with rapid and large increases within a few seconds in response to stimuli, whereas no such significant changes were seen in the face, back, and abdomen. Radial artery blood flow and palmar skin perfusion changed synchronously with electrodermal activity for each stimulus, and were correlated to changes in blood pressure and heart rate. The response patterns in each subject were very similar on the two experimental days. There was very low spontaneous electrodermal activity in the supine position, contrary to the resting sitting position. Conclusion: The electrodermal activity increased rapidly and synchronously in both palms within a few seconds as a response to minor physiological and mental stimuli, synchronous with fluctuations in radial artery blood flow, palmar skin perfusion, and cardiovascular variables. The responses are reproducible from day to day, making them a stable and constant stimuli to be used for studies in patients with hyperhidrosis.

Responses to hyperthermia. Optimizing heat dissipation by convection and evaporation: Neural control of skin blood flow and sweating in humans

Under normothermic, resting conditions, humans dissipate heat from the body at a rate approximately equal to heat production. Small discrepancies between heat production and heat elimination would, over time, lead to significant changes in heat storage and body temperature. When heat production or environmental temperature is high the challenge of maintaining heat balance is much greater. This matching of heat elimination with heat production is a function of the skin circulation facilitating heat transport to the body surface and sweating, enabling evaporative heat loss. These processes are manifestations of the autonomic control of cutaneous vasomotor and sudomotor functions and form the basis of this review. We focus on these systems in the responses to hyperthermia. In particular, the cutaneous vascular responses to heat stress and the current understanding of the neurovascular mechanisms involved. The available research regarding cutaneous active vasodilation and vasoconstriction is highlighted, with emphasis on active vasodilation as a major responder to heat stress. Involvement of the vasoconstrictor and active vasodilator controls of the skin circulation in the context of heat stress and nonthermoregulatory reflexes (blood pressure, exercise) are also considered. Autonomic involvement in the cutaneous vascular responses to direct heating and cooling of the skin are also discussed. We examine the autonomic control of sweating, including cholinergic and noncholinergic mechanisms, the local control of sweating, thermoregulatory and nonthermoregulatory reflex control and the possible relationship between sudomotor and cutaneous vasodilator function. Finally, we comment on the clinical relevance of these control schemes in conditions of autonomic dysfunction.

Regional brain responses associated with thermogenic and psychogenic sweating events in humans

Sweating events occur in response to mental stress (psychogenic) or with increased body temperature (thermogenic). We previously found that both were linked to activation of common brain stem regions, suggesting that they share the same output pathways: a putative common premotor nucleus was identified in the rostral-lateral medulla (Farrell MJ, Trevaks D, Taylor NA, McAllen RM. Am J Physiol Regul Integr Comp Physiol 304: R810-R817, 2013). We therefore looked in higher brain regions for the neural basis that differentiates the two types of sweating event. Previous work has identified hemispheric activations linked to psychogenic sweating, but no corresponding data have been reported for thermogenic sweating. Galvanic skin responses were used to measure sweating events in two groups of subjects during either psychogenic sweating (n = 11, 35.3 ± 11.8 yr) or thermogenic sweating (n = 11, 34.4 ± 10.2 yr) while regional brain activation was measured by BOLD signals in a 3-Tesla MRI scanner. Common regions activated with sweating events in both groups included the anterior and posterior cingulate cortex, insula, premotor cortex, thalamus, lentiform nuclei, and cerebellum (P(corrected) < 0.05). Psychogenic sweating events were associated with significantly greater activation in the dorsal midcingulate cortex, parietal cortex, premotor cortex, occipital cortex, and cerebellum. No hemispheric region was found to show statistically significantly greater activation with thermogenic than with psychogenic sweating events. However, a discrete cluster of activation in the anterior hypothalamus/preoptic area was seen only with thermogenic sweating events. These findings suggest that the expected association between sweating events and brain regions implicated in "arousal" may apply selectively to psychogenic sweating; the neural basis for thermogenic sweating events may be subcortical.

Brain stem representation of thermal and psychogenic sweating in humans

Functional MRI was used to identify regions in the human brain stem activated during thermal and psychogenic sweating. Two groups of healthy participants aged 34.4 ± 10.2 and 35.3 ± 11.8 years (both groups comprising 1 woman and 10 men) were either heated by a water-perfused tube suit or subjected to a Stroop test, while they lay supine with their head in a 3-T MRI scanner. Sweating events were recorded as electrodermal responses (increases in AC conductance) from the palmar surfaces of fingers. Each experimental session consisted of two 7.9-min runs, during which a mean of 7.3 ± 2.1 and 10.2 ± 2.5 irregular sweating events occurred during psychogenic (Stroop test) and thermal sweating, respectively. The electrodermal waveform was used as the regressor in each subject and run to identify brain stem clusters with significantly correlated blood oxygen level-dependent signals in the group mean data. Clusters of significant activation were found with both psychogenic and thermal sweating, but a voxelwise comparison revealed no brain stem cluster whose signal differed significantly between the two conditions. Bilaterally symmetric regions that were activated by both psychogenic and thermal sweating were identified in the rostral lateral midbrain and in the rostral lateral medulla. The latter site, between the facial nuclei and pyramidal tracts, corresponds to a neuron group found to drive sweating in animals. These studies have identified the brain stem regions that are activated with sweating in humans and indicate that common descending pathways may mediate both thermal and psychogenic sweating.

Regional variations in transepidermal water loss, eccrine sweat gland density, sweat secretion rates and electrolyte composition in resting and exercising humans

Literature from the past 168 years has been filtered to provide a unified summary of the regional distribution of cutaneous water and electrolyte losses. The former occurs via transepidermal water vapour diffusion and secretion from the eccrine sweat glands. Daily insensible water losses for a standardised individual (surface area 1.8 m2) will be 0.6-2.3 L, with the hands (80-160 g.h-1) and feet (50-150 g.h-1) losing the most, the head and neck losing intermediate amounts (40-75 g.h-1) and all remaining sites losing 15-60 g.h-1. Whilst sweat gland densities vary widely across the skin surface, this same individual would possess some 2.03 million functional glands, with the highest density on the volar surfaces of the fingers (530 glands.cm-2) and the lowest on the upper lip (16 glands.cm-2). During passive heating that results in a resting whole-body sweat rate of approximately 0.4 L.min-1, the forehead (0.99 mg.cm-2.min-1), dorsal fingers (0.62 mg.cm-2.min-1) and upper back (0.59 mg.cm-2.min-1) would display the highest sweat flows, whilst the medial thighs and anterior legs will secrete the least (both 0.12 mg.cm-2.min-1). Since sweat glands selectively reabsorb electrolytes, the sodium and chloride composition of discharged sweat varies with secretion rate. Across whole-body sweat rates from 0.72 to 3.65 mg.cm-2.min-1, sodium losses of 26.5-49.7 mmol.L-1 could be expected, with the corresponding chloride loss being 26.8-36.7 mmol.L-1. Nevertheless, there can be threefold differences in electrolyte losses across skin regions. When exercising in the heat, local sweat rates increase dramatically, with regional glandular flows becoming more homogeneous. However, intra-regional evaporative potential remains proportional to each local surface area. Thus, there is little evidence that regional sudomotor variations reflect an hierarchical distribution of sweating either at rest or during exercise.

Psychological sweating from glabrous and nonglabrous skin surfaces under thermoneutral conditions

Recent experiments revealed psychological sweating to be a ubiquitous phenomenon in passively heated individuals. Since heating potentiates sweating, and since most research into psychological sweating was not conducted in this thermal state, these observations required thermoneutral verification. Thermoneutral subjects performed mental arithmetic (at 26(o) C) with psychological sweating evaluated from nine sites (ventilated capsules, skin conductance). Discharged sweating was evident from three glabrous sites (P < .05). However, significant sweating was evident from two nonglabrous surfaces (P < .05), and skin conductance increased at the volar and dorsal finger surfaces (P < .05). Each of these changes occurred while core and skin temperatures remained stable (P > .05). These thermoneutral observations further refute the proposition that psychological sweating in humans is restricted to the glabrous skin surfaces.

Contribution of central versus sweat gland mechanisms to the seasonal change of sweating function in young sedentary males and females

In summer and winter, young, sedentary male (N = 5) and female (N = 7) subjects were exposed to heat in a climate chamber in which ambient temperature (Ta) was raised continuously from 30 to 42°C at a rate of 0.1°C min(-1) at a relative humidity of 40%. Sweat rates (SR) were measured continuously on forearm, chest and forehead together with tympanic temperature (Tty), mean skin temperature (⁻Ts) and mean body temperature ⁻Tb. The rate of sweat expulsions (Fsw) was obtained as an indicator of central sudomotor activity. Tty and ⁻Tb were significantly lower during summer compared with winter in males; SR was not significantly different between summer and winter in males, but was significantly higher during summer in females; SR during winter was higher in males compared with females. The regression line relating Fsw to ⁻Tb shifted significantly from winter to summer in males and females, but the magnitude of the shift was not significantly different between the two subject groups. The regression line relating SR to Fsw was steepened significantly from winter to summer in males and females, and the change in the slope was significantly greater in females than in males. Females showed a lower slope in winter and a similar slope in summer compared to males. It was concluded that sweating function was improved during summer mediated by central sudomotor and sweat gland mechanisms in males and females, and, although the change of sweat gland function from winter to summer was greater in females as compared with males, the level of increased sweat gland function during summer was similar between the two subject groups.

Sex-related differences in sweat gland cholinergic sensitivity exist irrespective of differences in aerobic capacity

Mechanisms accounting for sex-related differences in the sweat response remain to be elucidated. In the present study, we focused on differences in sweat gland cholinergic sensitivity between males and females. Since, males usually possess higher aerobic capacity than females, we investigated sweating in males and females grouped according to aerobic capacity (.VO(2peak)). Forty-four subjects were assigned to four groups: males with higher (MH) and lower (ML), and females with higher (FH) and lower (FL) .VO(2peak). Forearm sweating was induced by iontophoretic administration (1.5 mA, 60 muA cm(-2), 5 min) of pure water or varying concentrations of pilocarpine hydrochloride (0.125, 0.250, 0.5, 1.0 and 2.0%). Local sweat rate (absorbent paper) and the number of activated sweat glands (iodine impregnated paper) were computed. Maximal pilocarpine-induced sweat rate (SR(max)) and the pilocarpine concentration which elicited 50% of maximal sweating response (K (m)) were calculated. Sweat rate and active gland density increased in response to greater doses of pilocarpine (p < 0.05). Inter-group differences were evident: SR(max) was greatest for MH and lowest for FL (p < 0.05), but no significant differences were observed between ML and FH (p = 0.24). Higher SR(max) were observed, within-sex, for those with greater aerobic capacity (p < 0.05). Furthermore, males' K (m) values were higher than females', indicating greater sweat gland affinity for pilocarpine even for groups having similar aerobic capacity (p < 0.05). In summary, we confirmed that the human sudomotor response is affected by aerobic capacity but, also, that sex-related differences in sweat gland cholinergic sensitivity exist and are not necessarily associated with the typical differences in .VO(2peak) observed between sexes.

Low and high frequency acupuncture stimulation inhibits mental stress-induced sweating in humans via different mechanisms

The effects of acupuncture stimulation at 5 Hz and 100 Hz on mental stress-induced sweating were analyzed, and the mechanisms involved were examined using the rate of sweat expulsion as an estimate of central sudomotor outflow. Mental arithmetic was imposed on 25 young healthy volunteers for 2 min before, during and after the stimulation. Acupuncture stimulation was delivered to either the Zusanli (leg) or Hegu (hand) acupoint, and the sweat rate was measured quantitatively during mental arithmetic on the palm or the sole, respectively. When stimulation at 5 Hz was applied to the Zusanli acupoint, the palmar sweat rate (paSR), rate of sweat expulsion (Fsw) and paSR/Fsw were reduced during the stimulation, whereas when it was applied to the Hegu acupoint, plantar SR (plSR) and Fsw were reduced, but plSR/Fsw was not altered. When stimulation at 100 Hz was applied to Zusanli, paSR and paSR/Fsw were reduced, but Fsw was unchanged whereas when it was applied to Hegu, neither plSR, Fsw nor plSR/Fsw was altered. The results suggest that acupuncture stimulation at 5 Hz affects both the supraspinal rhythm-generating mechanism and the mechanisms situated below (probably the spinal cord), whereas stimulation at 100 Hz only affects the mechanisms below the rhythm-generating mechanism. Thus, acupuncture stimulation at 5 Hz and at 100 Hz may reduce mental stress-induced sweating through different mechanisms.

Effects of body posture on local sweating and sudomotor outflow as estimated using sweat expulsion

To estimate the effects of changes in body posture on sudomotor function, sweat rates on the forearm, chest and thigh, tympanic temperature (Tty), and skin temperatures were recorded in an upright sitting and a supine position under a hot environment of 40 degrees C Ta and 40% relative humidity for 60 min. Sweat expulsions were identified on sweat rate curves and their rates (Fsw) were calculated. Tty was higher, and its initial fall was greater, in the supine position than in the sitting position. On the forearm and the chest, the regression line relating sweat rate to mean body temperature (Tmb) had a gentler slope in the supine position, whereas on the thigh, it showed a steeper slope. The regression line relating Fsw to Tmb had a steeper slope in the supine position than in the sitting position, suggesting that the gain in the mechanisms for central integration and rhythm-generation was enhanced in the supine position. The parameter of sweat rate divided by Fsw was lower on the forearm and the chest, whereas it was higher on the thigh in the supine position than in the sitting position, suggesting that sudomotor outflow was modified at the spinal cord in association with skin pressure. It was concluded that body posture affects sudomotor functions through both brain and spinal mechanisms.

Muscle mechanoreceptor modulation of sweat rate during recovery from moderate exercise

The objective of this study was to identify whether muscle mechanoreceptor stimulation is capable of modulating sweat rate. Seven healthy subjects performed two 20-min bouts of supine exercise on a tandem cycle ergometer (60 rpm at 65% of maximal heart rate). After one bout, the subject stopped exercising (i.e., no pedaling), whereas, after the other bout, the subject's legs were passively cycled (at 60 rpm) via a second person cycling the tandem ergometer. This allows for mechanical stimulation of muscle with minimal activation of central command. Esophageal temperature (Tes), mean skin temperature (T̄sk), heart rate, mean arterial blood pressure, oxygen consumption, cutaneous vascular conductance (CVC), and sweat rate were not different during the two exercise bouts. Regardless of the mode of exercise recovery, there were no differences in Tes, T̄sk, or CVC. In contrast, early in the recovery period, chest and forearm sweat rate were significantly greater in the passive cycling recovery mode relative to the no-pedaling condition (chest: 0.57 ± 0.13 vs. 0.39 ± 0.14, forearm: 0.30 ± 0.05 vs. 0.12 ± 0.02 mg·cm-2·min-1; both P < 0.05). These results suggested that muscle mechanoreceptor stimulation to the previously activated muscle is capable of modulating sweat rate.

Humid heat acclimation does not elicit a preferential sweat redistribution toward the limbs

We tested the hypothesis that local sweat rates would not display a systematic postadaptation redistribution toward the limbs after humid heat acclimation. Eleven nonadapted males were acclimated over 3 wk (16 exposures), cycling 90 min/day, 6 days/wk (40°C, 60% relative humidity), using the controlled-hyperthermia acclimation technique, in which work rate was modified to achieve and maintain a target core temperature (38.5°C). Local sudomotor adaptation (forehead, chest, scapula, forearm, thigh) and onset thresholds were studied during constant work intensity heat stress tests (39.8°C, 59.2% relative humidity) conducted on days 1, 8, and 22 of acclimation. The mean body temperature (T̄b) at which sweating commenced (threshold) was reduced on days 8 and 22 ( P < 0.05), and these displacements paralleled the resting thermoneutral T̄b shift, such that the T̄b change to elicit sweating remained constant from days 1 to 22. Whole body sweat rate increased significantly from 0.87 ± 0.06 l/h on day 1 to 1.09 ± 0.08 and 1.16 ± 0.11 l/h on days 8 and 22, respectively. However, not all skin regions exhibited equivalent relative sweat rate elevations from day 1 to day 22. The relative increase in forearm sweat rate (117 ± 31%) exceeded that at the forehead (47 ± 18%; P < 0.05) and thigh (42 ± 16%; P < 0.05), while the chest sweat rate elevation (106 ± 29%) also exceeded the thigh ( P < 0.05). Two unique postacclimation observations arose from this project. First, reduced sweat thresholds appeared to be primarily related to a lower resting T̄b, and more dependent on T̄b change. Second, our data did not support the hypothesis of a generalized and preferential trunk-to-limb sweat redistribution after heat acclimation.

Occurrence of the spinal reflex due to skin pressure in sudomotor and cutaneous vasoconstrictor nerve system of humans

The effects of skin pressure applied to one side of the waist on sudomotor and vasoconstrictor nerve activity were compared with the effects on sweating and cutaneous blood flow in humans. The sweat rate and cutaneous blood flow were measured on left and right dorsal feet. Skin sympathetic nerve activity (SSNA) was recorded by microneurography from a microelectrode inserted in left and right peroneal nerves. Skin pressure was applied in a supine position to the area over the left or right anterior superior iliac spine under warm (T(a): 30-36 degrees C) and cool (T(a): 19-23 degrees C) conditions. Sudomotor and vasoconstrictor bursts were identified for quantitative analysis. The skin pressure increased the contralateral/ipsilateral ratio of the sweat rate. It also increased the contralateral/ipsilateral ratio of the cutaneous blood flow and the contralateral/ipsilateral ratio of the sudomotor burst amplitude. However, skin pressure did not induce any significant changes in the contralateral/ipsilateral ratio of the vasoconstrictor burst amplitude. The results indicate that an asymmetrical reflex effect of skin pressure on vasoconstrictor nerve activity was absent, suggesting that, whereas the ipsilateral suppression of sweating elicited by skin pressure was mediated by the sudomotor nerve system, the ipsilateral suppression of cutaneous blood flow was not mediated by the vasoconstrictor nerve system. Thus, the occurrence of the spinal reflex due to skin pressure is not uniform between the sudomotor and the vasoconstrictor nerve systems, which represent different organizations at the level of spinal cord.

Skin reactions after breast-conserving therapy and prediction of late complications using physiological functions

BACKGROUND

The temperature of the skin remains elevated long after breast-conserving treatment with irradiation, perhaps because evaporative cooling is impaired. We investigated physiological changes of the irradiated skin and reevaluated the radiosensitivity of sweat glands on a functional basis to determine whether severe complications can be predicted.

METHODS

Breast and axillary skin temperatures were measured with thermography and sweat production in response to local thermal stimuli was measured on the basis of changes in electrical skin resistance with a bridge circuit in 45 women before, during, and after breast irradiation for breast cancer.

RESULTS

Breast and axillary skin temperatures were significantly increased after irradiation. In response to cutaneous thermal stimuli, the electric skin resistance of nonirradiated areas decreased significantly because of sweating, but that of irradiated areas was unchanged.

CONCLUSION

Impairment of sweating may play an important role in skin damage after irradiation. Although glandular tissue is not usually radiosensitive, the results of our functional assessment suggest that sweat glands are more radiosensitive than expected.

Vasodilator component in sympathetic nerve activity destined for the skin of the dorsal foot of mildly heated humans

1. Skin sympathetic nerve activity (SSNA) was recorded in seven male subjects from the peroneal nerve by microneurography, and the temporal correspondence of spontaneously occurring SSNA bursts with vasodilatation and sweating responses on the dorsal foot was studied during a mild body heating at rest. 2. Some SSNA bursts were followed by a sweat expulsion with a latency of 2.4 +/- 0.4 s, and some bursts by a transient vasodilatation with a latency of 2.2 +/- 0.4 s (means +/- S.D.). SSNA bursts followed both by a sweat expulsion and by a vasodilatation response (Type 1), those followed only by a sweat expulsion (Type 2) and those followed only by a vasodilatation, response (Type 3) were 70%, 10% and 1% of the total bursts examined, respectively. 3. For Type 1 bursts, there was a significant, but weak linear relationship among the burst amplitude, the amplitude of the corresponding vasodilatation and the amplitude of the corresponding sweat expulsion. 4. It was concluded that SSNA contains vasodilatory activity which is synchronous with sudomotor nerve activity. The results suggest that such vasodilatory activity contributes to sustaining the sweat gland function by supplying sufficient blood.

Cutaneous vasodilatation responses synchronize with sweat expulsions

To examine whether cutaneous active vasodilatation is mediated by sudomotor nerve fibres we recorded cutaneous blood flow and sweat rates continuously with laser-Doppler flowmetry and capacitance hygrometry, respectively, from the dorsal and plantar aspects of the foot in 11 male subjects at varying ambient temperatures (Ta) between 22 and 40 degrees C (relative humidity 40%). In a warmer environment (Ta 29-40 degrees C), predominant responses of the blood flow curve from the sole of the foot were transient depressions (negative blood flow responses, NBR), whereas those from the dorsal foot were transient increases (positive blood flow responses, PBR). The PBR on the dorsal foot occurred spontaneously or in response to mental or sensory stimuli, and when PBR did not fuse with each other the rate of PBR was linearly related to tympanic temperature. When dorsal foot sweating was continuous, PBR on the dorsal foot almost entirely synchronized with sweat expulsion. When dorsal foot sweating was intermittent PBR sometimes occurred on the dorsal foot without corresponding sweat expulsions, but these PBR showed a complete correspondence with subthreshold sweat expulsion seen on a methacholine-treated area. The amplitude and the duration of PBR showed a significant linear relationship with the amplitude and the duration of the corresponding sweat expulsion. In a thermoneutral or cooler environment (Ta 22-29 degrees C), PBR occurred on the sole of the foot when mental or sensory stimuli elicited sweating in that area. Thus, PBR occurred when and where sweating appeared. Atropine failed to abolish PBR on the dorsal foot. Blockade of the peroneal nerve eliminated both PBR and NBR on the dorsal foot.(ABSTRACT TRUNCATED AT 250 WORDS)

Mechanisms of potentiation in sweating induced by long-term physical training

To evaluate the mechanism of potentiation of sweating after long-term physical training, we compared sweating function in trained and untrained subjects using the frequency of sweat expulsion (fsw) as an indicator of central sudomotor activity. Nine trained male subjects (trained group) and eight untrained male subjects (untrained group) performed 30-min cycle exercise at 35% maximal oxygen uptake at 25 degrees C ambient temperature and 35% relative humidity. Oesophageal temperature (T(oes)), mean body temperature (Tb), chest sweating rate (msw,chest), forearm sweating rate (msw,forearm), and fsw were measured. The slopes of the msw,chest versus body temperature (T(oes) and Tb) and versus fsw relationships in the trained group were significantly greater than those in the untrained group (both, P < 0.05), while there was no difference between the groups in the slopes of the msw,forearm versus body temperature or versus fsw relationships. Neither the body temperature threshold for initiation of chest or forearm sweating nor the slope of the fsw-Tb relationship differed between groups. We concluded that, during light exercise at moderate ambient temperature, the msw,chest in the subjects who had undergone long-term physical training was greater than that in the untrained subjects while the msw,forearm was not changed. The greater msw,chest in the trained subjects was concluded to be due to an increase of sensitivity of peripheral mechanisms.

A comparison of sweating responses during exercise and recovery in terms of sweating rate and body temperature

Based on the hypothesis that the relation between sweating rate and body temperature should be different during exercise and rest after exercise, we compared the sweating response during exercise and recovery at a similar body temperature. Healthy male subjects performed submaximal exercise (Experiment 1) and maximal exercise (Experiment 2) in a room at 27 degrees C and 35% relative humidity. During exercise and recovery of 20 min after exercise, esophageal temperature (Tes), mean skin temperature, mean body temperature (Tb), chest sweating rate (msw), and the frequency of sweat expulsion (Fsw) were measured. In both experiments, msw and Fsw were clearly higher during exercise than recovery at a similar body temperature (Tes, Tb). msw was similar during exercise and recovery, or a little less during the former, at a similar Fsw. It is concluded that the sweating rate during exercise is greater than that during recovery at the same body temperature, due to greater central sudomotor activity during exercise. The difference between the two values is thought to be related to non-thermal factors and the rate of change in mean skin temperature.

Neuro-effector characteristics of sweat glands in the human hand activated by irregular stimuli

Intraneural electrical stimulation of cutaneous fascicles in the median nerve was performed in 24 normal subjects and the effects on sweating within the innervation zone were monitored as changes of skin resistance and water vapour partial pressure (wvpp). The aims were: (1) to investigate the response variability between repeated stimulation sequences in the same skin site and between different sites and (2) to compare quantitative effects of regular and irregular stimulation on skin resistance and wvpp. Regional axillary anaesthesia of the brachial plexus eliminated spontaneous and reflex sympathetic activity. With repeated irregular stimulation sequences skin resistance responses from the same skin site varied only slightly between trials. Differences between response curves from two skin sites in the same subject or from different subjects were also small but significantly greater (P < 0.01) than differences between responses to repeated stimulation in the same site. Irregular stimulation with average frequencies of 0.49 Hz and 3.51 Hz gave greater resistance responses than if the same number of stimuli were delivered regularly (P < 0.01). The difference was most pronounced at 0.49 Hz. At an average frequency of 0.49 Hz the stimulation usually evoked no changes of wvpp whereas an average frequency of 3.51 Hz caused an increase of wvpp which was greater with irregular than with regular stimulation in all subjects. We conclude that: (1) sweat responses to sudomotor nerve traffic vary slightly due to local factors in the skin or the terminal nerve endings and (2) irregular sudomotor nerve traffic evokes more sweat than if the same impulses occur regularly.

Changes in the concentrations of Na+, K+ and Cl- in secretion from the skin during progressive increase in exercise intensity

A simple method for sampling skin secretion in 1-min periods was developed for investigating the effects of progressive increases in exercise intensity on Na+, K+ and Cl- secretions from the skin of the forearm. Ten healthy male subjects performed exercise consisting of eight stepwise increases in intensity from 50 to 225 W, with a 25-W increase at each step. Exercise at each step was for 3 min followed by a 1-min recovery period. Samples of blood and skin secretion were taken during the recovery period. Significant positive correlations were found between the mean concentrations of Na+ and Cl- and between those of K+ and Cl- in the skin secretion. The concentrations of electrolytes in the skin secretion also showed significant correlations with the blood lactate concentrations. The inflection points for secretions of Na+, K+ and Cl- were 4.04, 3.61 and 3.83 mmol.l-1 of blood lactate; 64.42, 61.96 and 62.14% of maximal oxygen consumption (VO2max); and exercise intensities of 123.01, 117.65 and 125.07 W, respectively. No significant differences were observed between the value of 67.27% of VO2max or 134.00W at the onset of blood lactate accumulation (OBLA) and the inflection points. From these results we concluded that changes in electrolyte concentrations in skin secretion during incremental exercise according to this protocol were closely related with the change in the blood lactate concentration, and that the inflection points for electrolytes may have been near the exercise intensity at OBLA.

The assessment of sudomotor dysfunction in multiple system atrophy

We studied sudomotor function in 21 patients with multiple system atrophy and in 11 age-matched controls. The extent and severity of the sudomotor deficit was assessed using the quantitative thermoregulatory sweat test. Central sudomotor function was studied by measuring sweating in response to raising body heat and administering thyrotropin-releasing hormone. Postganglionic sudomotor function was studied using the sudomotor axon reflex test evoked by nicotine. We conclude that in multiple system atrophy, thermoregulatory sudomotor dysfunction was more severe in the lower extremities. Heat stimulation increased the frequency of sweat expulsion and sweat rate on the forearm in moderate multiple system atrophy to a similar degree as controls but failed to do so on the thigh. Thyrotropin-releasing hormone enhanced sweating in moderate multiple system atrophy and controls. Results of the sudomotor axon reflex test indicate that in multiple system atrophy there is postganglionic sudomotor dysfunction which may be due to transsynaptic changes. These results suggest that the main lesion responsible for sudomotor dysfunction in multiple system atrophy is within the intermediolateral column cells of the spinal cord.

Neuroeffector characteristics of sweat glands in the human hand activated by regular neural stimuli

1. Intraneural electrical stimuli (0.3-1.2 mA, 0.2 ms) were delivered via a tungsten microelectrode inserted into a cutaneous fascicle in the median nerve at the wrist in twenty-eight normal subjects. The effects on sweat glands within the innervation zone were monitored as changes of skin resistance and water vapour partial pressure (WVPP). Regional anaesthesia of the brachial plexus in the axilla eliminated spontaneous sympathetic activity and reflex effects. 2. At stimulation frequencies of 0.1 Hz each stimulus evoked a transient skin resistance reduction, the amplitude of which varied initially but reached a steady state of less than 10 k omega after, on average, nine responses. If preceded by stimulation-free intervals of 5 min or more, up to fifteen stimuli were required before the first response occurred. With higher frequencies individual responses started to merge, skin resistance levels decreased successively and levelled off around 10 Hz. The total change of resistance (0-10 Hz) was 101 +/- 46 (n = 9) k omega and the higher the pre-stimulus level, the larger the reduction (r = 0.68, P less than 0.05). 3. Stimulus-response latencies to the onset of a skin resistance reduction (single stimuli or trains of six impulses/20 Hz given at 0.1 Hz) shortened initially but reached steady-state values after on average nine to twelve impulses. Average conduction velocity between stimulating electrode and skin resistance recording site was 0.78 m/s and average time for electrical neuroeffector transfer in sweat glands was estimated to be 348 ms. 4. In addition to direct stimulation-induced resistance responses there were also small spontaneous reductions of resistance. They were seen in all subjects and at all frequencies but were more common in some subjects and occurred predominantly at the beginning of stimulation or at changes of frequency. They occurred independently at two skin sites in the same subject and disappeared during stimulation-free periods and after atropine. 5. With train stimulation (six impulses/20 Hz) at 0.1 Hz, each train evoked transient increases of WVPP of 1 mmHg or less in some subjects (latency around 1.6 s). After averaging weak increases were seen also after single stimuli in two subjects. Increases of stimulation current or frequency led to slowly developing sustained increases of WVPP concomitant with decreases in skin resistance. 6. Responses in skin resistance and WVPP to train stimulation at 0.1 Hz were suppressed in a dose-dependent way by I.V. injections of atropine.(ABSTRACT TRUNCATED AT 400 WORDS)

Identification of sudomotor activity in cutaneous sympathetic nerves using sweat expulsion as the effector response

In a warm environment at ambient temperatures between 25 degrees and 38 degrees C (relative humidity 50%-60%) the relationship between sympathetic activity in cutaneous nerves (SSA) and pulses of sweat expulsion was investigated in five young male subjects. The SSA was recorded from the peroneal nerve using a micro-electrode. Sweat expulsion was identified on the sweat rate records obtained from skin areas on the dorsal side of the foot, for spontaneous sweating and drug-induced sweating, using capacitance hygrometry. Sweat expulsion was always preceded by bursts of SSA with latencies of 2.4-3.0 s. This temporal relationship between bursts of SSA and sweat expulsion was noted not only in various degrees of thermal sweating but also in the sweating evoked by arousal stimuli, or by painful electric stimulation. The amplitude of the sudomotor burst was linearly related to the maximal rate of increase of the corresponding sweat expulsion, the amplitude of the expulsion and the integrated amount of sweat produced for the duration of the expulsion. The results provide direct evidence that sweat expulsion reflects directly centrally-derived sudomotor activity.

Dependence on exercise intensity of changes in electrolyte secretion from the skin sampled by a simple method

Secreta from the palm and forearm was sampled for 1-min periods by a new technique, using a glass cylinder. Subjects exercised for 10-min periods at successive intensities of 40%, 50% and 65% VO2max with a leg ergometer operated in the supine position. Changes in the concentrations (values) of Na+, K+ and Cl- in their secreta during exercise were investigated. Significant positive correlations were found between the values of any two electrolytes in samples from the palm or the forearm, but the correlations between values for any one of the three electrolytes from the two sites were not significant. Values for concentrations of the electrolytes were significantly higher in samples from the palm than in those from the forearm at rest, 10 min after the beginning of exercise and at the end of exercise. No significant correlation was found between values for electrolytes in samples from the palm and the exercise intensity, but values for Na+ in samples from the forearm increased stepwise with increase in exercise intensity, and similar tendencies were observed for values of K+ and Cl-. The values for the three electrolytes in samples from the forearm, but not the palm, were significantly correlated with values for blood lactate, the percentage of VO2max and the heart rate. These results suggest that the present technique is suitable for successive samplings of secreta from the forearm, and that values for the electrolytes in samples are useful indices of exercise intensity.

Effects of thyrotropin releasing hormone on human sudomotor and cutaneous vasomotor activities

At an ambient temperature of 34-41 degrees C (rh = 40%) forearm sweat rates were measured by capacitance hygrometry in 9 male volunteers. Thyrotropin releasing hormone (TRH) was infused intravenously at 0.1 mg.min-1 for 20 to 30 min. Sweat rate increased rapidly within a minute after initiation of TRH infusion, decreased rapidly after the peak sweat rate was attained in 2-5 min of TRH infusion, and then levelled off in 6-10 min near the level before TRH infusion. Core temperature (Tre, Tty) started to decline at the time of the peak sweat rate and levelled off almost coincidentally with the levelling off in sweat rate. Average values for the rate of sweat expulsions (Fsw), sweat rate and mean body temperature (Tb) were obtained from the data of the last 10 min period of TRH infusion. The regression line for the relationship of Fsw to Tb shifted during the TRH infusion to the left of the line for the control; that of sweat rate to Fsw hardly shifted. At an ambient temperature of 24-27 degrees C TRH produced vasodilation as evidenced by an increase in skin blood flow (measured by means of thermal distribution), an increase in amplitude of the photoelectric plethysmogram and an elevation of skin temperature in the finger tips. It is suggested that TRH may act, either directly or indirectly, on the central thermoregulatory mechanism (or on the thermoreceptive mechanism) to lower the reference temperature for heat dissipation.