Tatsuya Yamamoto1, Masato Asahina2, Yoshitaka Yamanaka2, Tomoyuki Uchiyama3, Shigeki Hirano2, Miki Fuse4, Yasuko Koga5, Ryuji Sakakibara6, Satoshi Kuwabara2. 1. Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan. Electronic address: tatsuya-yamamoto@mbc.nifty.com. 2. Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan. 3. Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan; Department of Neurology, Continence Centre, Dokkyo Medical University, Tochigi, Japan. 4. Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan. 5. Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, Chiba, Japan. 6. Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan; Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
Abstract
OBJECTIVE: It is difficult to differentiate multiple system atrophy (MSA) from Parkinson's disease (PD) at least in the early stage. Urodynamic study (UDS) is useful in differentiating MSA from PD. We aimed to clarify which UDS parameter was useful in differentiating MSA from PD. METHODS: We retrospectively reviewed 273 cases and performed UDS and external anal sphincter electromyography (EAS-EMG) in patients with MSA (n=182) and PD (n=91). We analyzed the utility of UDS parameters, including postvoid residuals (PVR), detrusor overactivity (DO), degree of bladder contraction, and mean duration of motor unit potentials (MUPs) in EAS-EMG, for differentiating MSA from PD. RESULTS: PVR>150ml during free-flow study strongly indicated MSA rather than PD (OR 8.723, 95% CI 2.612-29.130, p<0.001). 'Weak detrusor' also suggested MSA, but it was not a statistically significant indicator (OR 10.598, 95% CI 0.359-312.473, p=0.172). DO and neurogenic changes in EAS-EMG (mean duration of MUPs>10ms) did not significantly contribute to the differentiation of MSA from PD. CONCLUSIONS: PVR>150ml during free-flow study might be more useful than other UDS parameters in clinically differentiating MSA from PD.
OBJECTIVE: It is difficult to differentiate multiple system atrophy (MSA) from Parkinson's disease (PD) at least in the early stage. Urodynamic study (UDS) is useful in differentiating MSA from PD. We aimed to clarify which UDS parameter was useful in differentiating MSA from PD. METHODS: We retrospectively reviewed 273 cases and performed UDS and external anal sphincter electromyography (EAS-EMG) in patients with MSA (n=182) and PD (n=91). We analyzed the utility of UDS parameters, including postvoid residuals (PVR), detrusor overactivity (DO), degree of bladder contraction, and mean duration of motor unit potentials (MUPs) in EAS-EMG, for differentiating MSA from PD. RESULTS: PVR>150ml during free-flow study strongly indicated MSA rather than PD (OR 8.723, 95% CI 2.612-29.130, p<0.001). 'Weak detrusor' also suggested MSA, but it was not a statistically significant indicator (OR 10.598, 95% CI 0.359-312.473, p=0.172). DO and neurogenic changes in EAS-EMG (mean duration of MUPs>10ms) did not significantly contribute to the differentiation of MSA from PD. CONCLUSIONS: PVR>150ml during free-flow study might be more useful than other UDS parameters in clinically differentiating MSA from PD.
Authors: Maria Teresa Pellecchia; Iva Stankovic; Alessandra Fanciulli; Florian Krismer; Wassilios G Meissner; Jose-Alberto Palma; Jalesh N Panicker; Klaus Seppi; Gregor K Wenning Journal: Mov Disord Clin Pract Date: 2020-09-03
Authors: Sabine Eschlböck; Gustav Kiss; Florian Krismer; Alessandra Fanciulli; Christine Kaindlstorfer; Cecilia Raccagni; Klaus Seppi; Stefan Kiechl; Jalesh N Panicker; Gregor K Wenning Journal: Mov Disord Clin Pract Date: 2021-07-21