Postvoid residual predicts the diagnosis of multiple system atrophy in Parkinsonian syndrome

It is difficult to differentiate multiple system atrophy (MSA) from Parkinson's disease (PD) at least in the early stage. Urodynamic study (UDS) is useful in differentiating MSA from PD. We aimed to clarify which UDS parameter was useful in differentiating MSA from PD. We retrospectively review...

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Bibliographic Details
Published in:Journal of the neurological sciences 2017-10, Vol.381, p.230-234
Main Authors: Yamamoto, Tatsuya, Asahina, Masato, Yamanaka, Yoshitaka, Uchiyama, Tomoyuki, Hirano, Shigeki, Fuse, Miki, Koga, Yasuko, Sakakibara, Ryuji, Kuwabara, Satoshi
Format: Article
Language:English
Subjects:
Aged
Anal Canal - physiopathology
Diagnosis, Differential
Electromyography
Humans
Logistic Models
Middle Aged
Multiple system atrophy
Multiple System Atrophy - complications
Multiple System Atrophy - diagnosis
Multiple System Atrophy - physiopathology
Parkinson's disease
Parkinsonian Disorders - complications
Parkinsonian Disorders - diagnosis
Parkinsonian Disorders - physiopathology
Post-void residual
Retrospective Studies
Urinary Bladder
Urodynamic study
Urodynamics
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Summary:It is difficult to differentiate multiple system atrophy (MSA) from Parkinson's disease (PD) at least in the early stage. Urodynamic study (UDS) is useful in differentiating MSA from PD. We aimed to clarify which UDS parameter was useful in differentiating MSA from PD. We retrospectively reviewed 273 cases and performed UDS and external anal sphincter electromyography (EAS-EMG) in patients with MSA (n=182) and PD (n=91). We analyzed the utility of UDS parameters, including postvoid residuals (PVR), detrusor overactivity (DO), degree of bladder contraction, and mean duration of motor unit potentials (MUPs) in EAS-EMG, for differentiating MSA from PD. PVR>150ml during free-flow study strongly indicated MSA rather than PD (OR 8.723, 95% CI 2.612–29.130, p10ms) did not significantly contribute to the differentiation of MSA from PD. PVR>150ml during free-flow study might be more useful than other UDS parameters in clinically differentiating MSA from PD. •Voiding dysfunctions of multiple system atrophy (MSA) are more severe than Parkinson’s disease (PD).•Large post-void residual (PVR) is common in MSA.•PVR>150ml during free-flow study might be more useful than other urodynamic parameters in differentiating MSA from PD.
ISSN:0022-510X
1878-5883
DOI:10.1016/j.jns.2017.08.3262