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Augmented supraorbital skin sympathetic nerve activity responses to symptom trigger events in rosacea patients.

J Neurophysiol. 2015 Jul 1;:jn.00458.2015

Authors: Metzler-Wilson K, Toma K, Sammons DL, Mann S, Jurovcik AJ, Demidova O, Wilson TE

Abstract
Facial flushing in rosacea is often induced by trigger events. However, trigger causation mechanisms are currently unclear. This study tested the central hypothesis that rosacea causes sympathetic and axon reflex mediated alterations resulting in trigger-induced symptomatology. Twenty rosacea patients and age/sex-matched controls participated in one or a combination of symptom triggering stressors. Protocol 1: Forehead skin sympathetic nerve activity (SSNA; supraorbital microneurography) was measured during sympathoexcitatory mental (2 min serial subtraction of novel numbers) and physical (2 min isometric handgrip) stress. Protocol 2: Forehead skin blood flow (laser-Doppler flowmetry) and transepithelial water loss/sweat rate (capacitance hygrometry) were measured during sympathoexcitatory heat stress (whole-body heating via perfusing 50°C water through a tube-lined suit). Protocol 3: Cheek, forehead, forearm, and palm skin blood flow were measured during non-painful local heating to induce axon reflex vasodilation. Heart rate and mean arterial pressure (MAP) were recorded via finger photoplethysmography to calculate cutaneous vascular conductance (CVC; flux*100/MAP). Higher patient transepithelial water loss was observed (rosacea=0.20±0.02 vs. control=0.10±0.01 mg/cm2/min, p<0.05). Heart rate and MAP changes were not different between groups during sympathoexcitatory stressors or local heating. SSNA during early mental (32±9 and 9±4% increase) and physical (25±4 and 5±1% increase, for rosacea and controls, respectively) stress was augmented in rosacea (both p<0.05). Heat stress induced more rapid sweating and cutaneous vasodilation onset in rosacea compared to controls. No axon reflex vasodilation differences were observed between groups. These data indicate that rosacea affects SSNA, and that hyper-responsiveness to trigger events appears to have a sympathetic component.

PMID: 26133800 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26133800?dopt=Abstract = URL to article