Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative Diseases, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative Diseases, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Parkinsonism Relat Disord. 2024 Sep;126:107046. doi: 10.1016/j.parkreldis.2024.107046. Epub 2024 Jun 24.
Early differentiation between Parkinson's disease (PD) and Multiple system atrophy (MSA), particularly the parkinsonian subtypes (MSA-P), is challenging due to similar clinical symptoms. We aimed to evaluate Sympathetic skin response (SSR) and Cutaneous silent period (CSP) parameters in patients with MSA-P and PD to identify possible biomarkers that could distinguish the two groups of patients in early stage.
22 individuals with early-stage MSA-P, 29 with early-stage PD, and 28 healthy controls were recruited from Guangdong Provincial People's Hospital. Demographic data was collected for all participants. Their SSR and CSP were evaluated using clinical electromyography equipment. Data were compared between different groups. The diagnostic accuracy of SSR and CSP parameters was calculated using the ROC curve. Logistic regression was used to produce an integration model to enhance diagnostic utility.
Foot amplitude, CSP end latency and duration distinguished MSA-P from PD with the area under the curve (AUC) 0.770, 0.806, and 0.776, respectively. Foot and hand SSR amplitude distinguished PD from HC with the AUC 0.871 and 0.768, respectively. Foot SSR amplitude, hand SSR amplitude, and CSP end latency distinguished MSA-P from HC with the AUC 0.964, 0.872, and 0.812, respectively. The combination of SSR and CSP parameters differentiation between MSA-P and PD, PD and HC with the AUC 0.829 and 0.879, respectively.
Analysis of SSR and CSP parameters showed excellent diagnostic accuracy in discriminating patients with early-stage MSA-P from HC and good diagnostic accuracy in discriminating patients with MSA-P from PD with early stages.
由于帕金森病（PD）和多系统萎缩（MSA）的临床症状相似，因此早期区分它们，尤其是帕金森亚型（MSA-P），具有挑战性。我们旨在评估 MSA-P 和 PD 患者的交感皮肤反应（SSR）和皮肤静止期（CSP）参数，以确定可能的生物标志物，以便在早期区分这两组患者。
从广东省人民医院招募了 22 名早期 MSA-P 患者、29 名早期 PD 患者和 28 名健康对照者。所有参与者均收集了人口统计学数据。使用临床肌电图设备评估他们的 SSR 和 CSP。比较不同组之间的数据。使用 ROC 曲线计算 SSR 和 CSP 参数的诊断准确性。使用逻辑回归生成综合模型以提高诊断效用。
足幅、CSP 末端潜伏期和持续时间区分 MSA-P 与 PD 的曲线下面积（AUC）分别为 0.770、0.806 和 0.776。足和手 SSR 振幅区分 PD 与 HC 的 AUC 分别为 0.871 和 0.768。足 SSR 振幅、手 SSR 振幅和 CSP 末端潜伏期区分 MSA-P 与 HC 的 AUC 分别为 0.964、0.872 和 0.812。SSR 和 CSP 参数的组合区分 MSA-P 和 PD、PD 和 HC 的 AUC 分别为 0.829 和 0.879。
SSR 和 CSP 参数分析在区分早期 MSA-P 患者与 HC 患者以及区分早期 MSA-P 患者与 PD 患者方面具有出色的诊断准确性。
