Tsuchiya Akari, Terayama Keiichiro, Sakakibara Ryuji, Panicker Jalesh, Tateno Fuyuki, Aiba Yosuke, Haruta Hiroyuki, Akiba Takashi, Ogawa Akihiro, Shimizu Ayami, Takahashi Osamu, Yamamoto Tatsuya, Uchiyama Tomoyuki, Suzuki Hiroyoshi, Yano Masashi
Rehabilitation Unit, Sakura Medical Center, Toho University, Sakura, Japan.
Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
J Neurol Sci. 2020 Apr 15;411:116676. doi: 10.1016/j.jns.2020.116676. Epub 2020 Jan 14.
Limited attention has been paid to the relationship between bladder dysfunction and motor disorder in multiple system atrophy (MSA).
We aimed to correlate pressure-flow urodynamic parameters with video-gait analysis parameters in MSA.
We recruited 34 patients with MSA: 20 men, 14 women; age 64.0 + - 7.9 years; disease duration 2 years (1-4 years). Nineteen cases had the cerebellar form, and 15 had the parkinsonian form; the patients were taking levodopa 300 mg/day (100-400 mg). All patients underwent pressure-flow urodynamics (parameters: detrusor overactivity [noted in 72%] and Watts factor) and video-gait analysis (parameters: time and the number of strides taken to walk 5 m (simple task) and time for timed up and go (complex task). Statistical analysis was done using Student's t-test to analyze the relation between detrusor overactivity and gait, and Spearman's rank correlation coefficient test to analyze the relation between the remaining parameters and gait.
We found no relation between filling-phase urodynamics (detrusor overactivity) and video-gait analysis parameters. Also, we found no relation between voiding-phase urodynamics (Watts factor, reflecting detrusor power) and all three video-gait analysis parameters in our MSA patients.
The fact that neither detrusor overactivity nor the Watts factor was related with motor disorders in the present study suggests that bladder dysfunction occurs independently from motor disorder in MSA.
多系统萎缩(MSA)中膀胱功能障碍与运动障碍之间的关系受到的关注有限。
我们旨在关联MSA患者压力-流率尿动力学参数与视频步态分析参数。
我们招募了34例MSA患者:20例男性,14例女性;年龄64.0±7.9岁;病程2年(1 - 4年)。19例为小脑型,15例为帕金森型;患者服用左旋多巴300mg/天(100 - 400mg)。所有患者均接受压力-流率尿动力学检查(参数:逼尿肌过度活动[72%患者存在]和瓦茨因子)以及视频步态分析(参数:行走5米[简单任务]的时间和步数以及计时起立行走[复杂任务]的时间)。采用学生t检验分析逼尿肌过度活动与步态之间的关系,采用Spearman等级相关系数检验分析其余参数与步态之间的关系。
我们发现充盈期尿动力学(逼尿肌过度活动)与视频步态分析参数之间无关联。此外,在我们的MSA患者中,排尿期尿动力学(反映逼尿肌力量的瓦茨因子)与所有三个视频步态分析参数之间也无关联。
本研究中逼尿肌过度活动和瓦茨因子均与运动障碍无关,这一事实表明MSA中膀胱功能障碍独立于运动障碍发生。