Department of Neurology, Sixth Medical Center of Chinese PLA General Hospital, Beijing, China.
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
J Clin Neurosci. 2020 Oct;80:16-22. doi: 10.1016/j.jocn.2020.07.067. Epub 2020 Aug 15.
Clinically differentiating multiple system atrophy cerebellar type (MSA-C) and spinocerebellar ataxias (SCAs) is challenging, especially at early disease stages, because of their similarities in clinical manifestation and imaging results. The purpose of this study was to explore the value of external anal-sphincter electromyography (EAS-EMG) and urethral-sphincter electromyography (US-EMG) for distinguishing between MSA-C and SCAs.
A total of 51 subjects, including 33 MSA-C and 18 SCAs, were recruited. Average duration and amplitude of motor unit potentials (MUPs), percentage of polyphasic MUPs, amplitude during strong contraction and recruitment pattern during maximal voluntary contraction were recorded and analyzed to identify differential diagnostic results of EAS-EMG and US-EMG for MSA-C and SCAs.
Significant differences in average MUP duration, percentage of polyphasic MUPs, and ratio of simple phase and simple-mix phase using EAS-EMG were noted between patients with MSA-C and SCAs. These same parameters also differed significantly between MSA-C and SCAs male patients using US-EMG.
EAS-EMG may serve as a potential method for early differential diagnosis between patients with MSA-C and SCAs. Furthermore, US-EMG could be a supplementary method for males when EAS-EMG is not available.
多系统萎缩小脑型（MSA-C）和脊髓小脑性共济失调（SCA）在临床上难以区分，尤其是在疾病早期，因为它们在临床表现和影像学结果上存在相似性。本研究旨在探讨肛门外括约肌肌电图（EAS-EMG）和尿道括约肌肌电图（US-EMG）在区分 MSA-C 和 SCA 中的价值。
共纳入 51 例患者，其中 MSA-C 患者 33 例，SCA 患者 18 例。记录和分析运动单位电位（MUP）的平均持续时间和幅度、多相 MUP 的百分比、强收缩时的幅度以及最大随意收缩时的募集模式，以确定 EAS-EMG 和 US-EMG 对 MSA-C 和 SCA 的鉴别诊断结果。
MSA-C 和 SCA 患者的 EAS-EMG 平均 MUP 持续时间、多相 MUP 的百分比以及单纯相和单纯混合相的比例存在显著差异。US-EMG 也显示 MSA-C 和 SCA 男性患者之间存在显著差异。
EAS-EMG 可能是 MSA-C 和 SCA 患者早期鉴别诊断的一种潜在方法。此外，当无法进行 EAS-EMG 时，US-EMG 可以作为男性患者的补充方法。
