Department of Rehabilitation Medicine, Ningbo Medical Center Li Huili Hospital, Zhejiang, 315000, Ningbo, China.
Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou, 310014, Zhejiang, China.
BMC Neurol. 2023 Mar 2;23(1):94. doi: 10.1186/s12883-023-03131-8.
We evaluated the value of electrophysiological indicators by external anal sphincter electromyography (EAS-EMG), sympathetic skin response (SSR), R-R interval variation (RRIV), and Bulbocavernosus Reflex (BCR) in differential diagnosis of multiple system atrophy (MSA) and Parkinson's disease (PD).
A total of 41 patients with MSA and 32 patients with PD were enrolled. The electrophysiological changes of autonomic dysfunction were assessed with BCR, EAS-EMG, SSR, and RRIV, and the abnormal rate of each indicator was calculated. The diagnostic value of each indicator was analyzed with ROC curve.
The incidence rate of autonomic dysfunction in MSA group was significantly higher than that in PD group (p < 0.05). The abnormal rates of BCR and EAS-EMG indicators in MSA group were higher than those in PD group (p < 0.05). The abnormal rates of SSR and RRIV indicators in MSA group and PD group were high; however, there was no significant difference between MSA and PD groups (p > 0.05). The sensitivity of BCR combined with EAS-EMG indicators in differential diagnosis of MSA and PD were 92.3% in males and 86.7% in females, respectively, and the specificity was 72.7% in males and 90% in females, respectively.
Combined analysis of BCR and EAS-EMG has high sensitivity and specificity for differential diagnosis of MSA and PD.
我们通过肛门外括约肌肌电图（EAS-EMG）、交感皮肤反应（SSR）、R-R 间期变化（RRIV）和球海绵体反射（BCR）评估电生理学指标在多系统萎缩（MSA）和帕金森病（PD）鉴别诊断中的价值。
共纳入 41 例 MSA 患者和 32 例 PD 患者。采用 BCR、EAS-EMG、SSR 和 RRIV 评估自主神经功能障碍的电生理变化，并计算各指标的异常率。采用 ROC 曲线分析各指标的诊断价值。
MSA 组自主神经功能障碍发生率明显高于 PD 组（p<0.05）。MSA 组 BCR 和 EAS-EMG 指标异常率高于 PD 组（p<0.05）。MSA 组和 PD 组 SSR 和 RRIV 指标异常率较高，但 MSA 组与 PD 组之间无显著差异（p>0.05）。BCR 联合 EAS-EMG 指标对 MSA 和 PD 的鉴别诊断的灵敏度在男性中分别为 92.3%和 86.7%，在女性中分别为 72.7%和 90.0%，特异度在男性中分别为 72.7%和 90.0%，在女性中分别为 90.0%和 86.7%。
BCR 和 EAS-EMG 联合分析对 MSA 和 PD 的鉴别诊断具有较高的灵敏度和特异性。
