Chen Yalan, Huang Hongyan, Zhang Peng, Xu Yanming, Chen Yangmei
Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Front Neurol. 2023 Jun 9;14:1202279. doi: 10.3389/fneur.2023.1202279. eCollection 2023.
This study aimed to investigate the prevalence and clinical characteristics of subjective constipation in Chinese patients with multiple system atrophy (MSA), as well as the timing of constipation onset relative to the occurrence of motor symptoms.
A total of 200 patients who were consecutively admitted to two large Chinese hospitals from February 2016 to June 2021 and subsequently diagnosed with probable MSA were enrolled in this cross-sectional study. Demographic and constipation-related clinical data were collected, and motor and non-motor symptoms were assessed using various scales and questionnaires. Subjective constipation was defined using ROME III criteria.
The frequency of constipation was 53.5, 59.7, and 39.3% in MSA, MSA with predominately parkinsonism (MSA-P), and MSA with predominately cerebellar ataxia (MSA-C), respectively. MSA-P subtype and high total UMSARS scores were associated with constipation in MSA. Similarly, the high total UMSARS scores were associated with constipation in MSA-P and MSA-C patients. Among the 107 patients with constipation, 59.8% began experiencing it before the onset of motor symptoms, and the interval between constipation and occurrence of motor symptoms was significantly longer in these patients than in those who experienced constipation after onset of motor symptoms.
Constipation is a highly prevalent non-motor symptom in MSA and more often occurs before the onset of motor symptoms. The results of this study may help guide future research into MSA pathogenesis in its earliest stages.
本研究旨在调查中国多系统萎缩（MSA）患者主观便秘的患病率及临床特征，以及便秘发作相对于运动症状出现的时间。
本横断面研究纳入了2016年2月至2021年6月期间连续入住两家大型中国医院并随后被诊断为可能患有MSA的200例患者。收集人口统计学和便秘相关的临床数据，并使用各种量表和问卷评估运动和非运动症状。采用罗马III标准定义主观便秘。
MSA、以帕金森综合征为主的MSA（MSA-P）和以小脑共济失调为主的MSA（MSA-C）患者的便秘发生率分别为53.5%、59.7%和39.3%。MSA-P亚型和较高的统一多系统萎缩评定量表（UMSARS）总分与MSA患者的便秘有关。同样，较高的UMSARS总分与MSA-P和MSA-C患者的便秘有关。在107例便秘患者中，59.8%在运动症状出现之前就开始出现便秘，这些患者便秘与运动症状出现之间的间隔明显长于运动症状出现后才出现便秘的患者。
便秘是MSA中一种高度常见的非运动症状，且更常出现在运动症状之前。本研究结果可能有助于指导未来对MSA发病机制最早阶段的研究。
