Exploring hyperhidrosis and related thermoregulatory symptoms as a possible clinical identifier for the dysautonomic subtype of Parkinson’s disease
Open accessAbstract
OBJECTIVE: To identify associated (non-)motor profiles of Parkinson's disease (PD) patients with hyperhidrosis as a dominant problem. METHODS: This is a cross-sectional, exploratory, analysis of participants enrolled in the Non-motor Longitudinal International Study (NILS; UKCRN No: 10084) at the Parkinson's Centre at King's College Hospital (London, UK). Hyperhidrosis scores (yes/no) on question 28 of the Non-Motor Symptom Questionnaire were used to classify patients with normal sweat function (n = 172) and excessive sweating (n = 56) (Analysis 1; n = 228). NMS scale (NMSS) question 30 scores were used to stratify participants based on hyperhidrosis severity (Analysis 2; n = 352) using an arbitrary severity grading: absent score 0 (n = 267), mild 1-4 (n = 49), moderate 5-8 (n = 17), and severe 9-12 (n = 19). NMS burden, as well as PD sleep scale (PDSS) scores were then analysed along with other correlates. RESULTS: No differences were observed in baseline demographics between groups in either analysis. Patients with hyperhidrosis exhibited significantly higher total NMSS burden compared to those without (p < 0.001). Secondary analyses revealed higher dyskinesia scores, worse quality of life and PDSS scores, and higher anxiety and depression levels in hyperhidrosis patients (p < 0.001). Tertiary analyses revealed higher NMSS item scores for fatigue, sleep initiation, restless legs, urinary urgency, and unexplained pain (p < 0.001). CONCLUSIONS: Chronic hyperhidrosis appears to be associated with a dysautonomia dominant subtype in PD patients, which is also associated with sleep disorders and a higher rate of dyskinesia (fluctuation-related hyperhidrosis). These data should prompt the concept of hyperhidrosis being used as a simple clinical screening tool to identify PD patients with autonomic symptoms.
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In Parkinson's, the peripheral temperature trace is likely altered by episodic hyperhidrosis particularly in the dysautonomic subtype.
“In Parkinson’s, the peripheral temperature trace is likely altered by episodic hyperhidrosis39 particularly in the dysautonomic subtype42.”
From Diurnal rhythms of wrist temperature are associated with future disease risk in the UK Biobank (2023) · cites this paper as [42]
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Diurnal rhythms of wrist temperature are associated with future disease risk in the UK Biobank
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- Authors
- van Wamelen, D. J., Leta, V., Podlewska, A. M., Wan, Y.-M., Krbot, K., Jaakkola, E., Martinez-Martin, P., Rizos, A., Parry, M., Metta, V., & Ray Chaudhuri, K.
- Affiliations
- King's College London (GB)
- University of Turku (FI)
- King's College Hospital (GB)
- ORCID
- Venue
- Journal of Neurology
- Published
- 2019-04-17
- Volume
- 266
- Issue
- 7
- Pages
- 1736-1742
- ISSN
- 0012-1037 (ISSN-L)
- 0340-5354
- 1432-1459
- PMC
- PMC6586713
- OpenAlex
- W2939774210
- Cited by
- 39
- References
- 23
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 7 · 2020: 8 · 2019: 2
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Neurology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UTUPub (University of Turku) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- South London and Maudsley NHS Foundation Trust
- National Institute for Health and Care Research
- King's College London
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Physiology › Sympathectomy and Hyperhidrosis Treatments
- Keywords
- Parkinson's disease, hyperhidrosis, autonomic dysfunction, non-motor symptoms, thermoregulation, dyskinesia, sleep disorders, fatigue, restless legs syndrome, urinary urgency, anxiety and depression, quality of life, clinical screening tool
- MeSH terms
- Aged, Body Temperature Regulation, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Hyperhidrosis, Longitudinal Studies, Male, Middle Aged, Parkinson Disease, Retrospective Studies, Cohort Studies, Primary Dysautonomias
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