When is Onuf's nucleus involved in multiple system atrophy? A sphincter electromyography study

Yamamoto, Tatsuya; Sakakibara, Ryuji; Uchiyama, Tomoyuki; Liu, Z; Ito, Takashi; Awa, Yusuke; Yamamoto, Keisuke; Kinou, Mika; Yamanishi, Tomonori; Hattori, Takamichi

doi:10.1136/jnnp.2004.061036

Cited by 71 publications

(59 citation statements)

References 24 publications

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“…However, the prevalence of such abnormalities in the early stages of MSA has not been well known. In our recent study of 84 probable MSA cases, 62% exhibited neurogenic change [79]. The prevalence was relatively low presumably because up to 25% of our patients had a disease duration of 1 year or less.…”

Section: Sphincter Emg In Autonomic Disordersmentioning

confidence: 89%

Sphincter EMG as a diagnostic tool in autonomic disorders

et al. 2008

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Multiple system atrophy (MSA) is a neurodegenerative disease presenting with a combination of parkinsonian, cerebellar, and autonomic (including cardiovascular, urinary, and anorectal) dysfunction. It is pathologically defined, but at present lacks a definitive clinical diagnostic test. The majority of patients with probable MSA have an abnormal sphincter EMG. Patients with idiopathic Parkinson's disease do not show marked sphincter EMG abnormalities. Therefore, these abnormalities can be used to distinguish MSA from idiopathic Parkinson's disease in the first 5 years after disease onset. In contrast, similar sphincter EMG abnormalities are found in some, though not many, patients with dementia with Lewy bodies, pure autonomic failure, progressive supranuclear palsy, and spinocerebellar ataxia type 3. Thus, the limitations of the sphincter EMG test should also be kept in mind. Sphincter EMG and relevant sacral autonomic tests are diagnostic tools for autonomic disorders, reflecting the common and significant involvement of the sacral cord in MSA.

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Section: Sphincter Emg In Autonomic Disordersmentioning

confidence: 89%

Sphincter EMG as a diagnostic tool in autonomic disorders

et al. 2008

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“…The electromyogram of the rectal sphincter may be abnormal [24]. Involvement of Onuf's nuclei in MSA is time-dependent [25]. This may represent a somatic, but not an autonomic, dysfunction [26].…”

Section: Discussionmentioning

confidence: 98%

Is there delayed gastric emptying in patients with multiple system atrophy? An analysis using the 13C-acetate breath test

et al. 2012

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Autonomic failure is one of the criteria according to the second consensus statement for the diagnosis of multiple system atrophy (MSA). Gastrointestinal symptoms are frequent complaints in patients with MSA and may be associated with reduced gastrointestinal motility due to autonomic nervous system dysfunction. However, there are few reports on gastric emptying in patients with MSA. We investigated gastric emptying in 25 patients with MSA, 20 patients with sporadic adult-onset ataxia of unknown etiology (SAOA), and 20 healthy volunteers using the (13)C-acetate breath test. Gastric emptying function is estimated by this test as the half-emptying time (HET) and peak time of the (13)C-%-dose-excess curve (T (max)), with expirations collected for 4 h after a test meal and determination of (13)CO(2) content using an infrared (IR) spectrophotometer. The HET and T (max) of gastric emptying were significantly delayed in patients with MSA as compared to those in SAOA and controls (p < 0.01). The HET and T (max) were not significantly different between SAOA and controls. No correlation existed between the HET or T (max) and the duration or severity of the disease in MSA patients. These results suggested that gastric emptying was significantly delayed in patients with MSA, and the delay already appeared in the early stage of the disease. Delayed gastric emptying is one of the autonomic failures and may be a clinical marker of MSA.

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“…Involvement of Onuf 's nucleus in MSA is time dependent. Before the fifth year of illness, the prevalence of neurogenic change does not seem to be high, so a negative result cannot exclude the diagnosis of MSA [143]. However, anal sphincter EMG abnormalities, if present, appear to distinguish MSA from PD in the first 5 years after disease onset, and from pure autonomic failure, as well as from cerebellar ataxias, if other causes for sphincter denervation have been ruled out [135].…”

Section: Bladder Functionmentioning

confidence: 96%