External anal sphincter electromyography in multiple system atrophy:implications for diagnosis,clinical correlations,and novel insights into prognosis
Massimiliano Todisco1
Giuseppe Cosentino2
Enrico Alfonsi3
1.Translational Neurophysiology Research Unit,IRCCS Mondino Foundation,Pavia,Italy;Movement Disorders Research Center,IRCCS Mondino Foundation,Pavia,Italy;Department of Brain and Behavioral Sciences,University of Pavia,Pavia,Italy2.Translational Neurophysiology Research Unit,IRCCS Mondino Foundation,Pavia,Italy;Department of Brain and Behavioral Sciences,University of Pavia,Pavia,Italy3.Translational Neurophysiology Research Unit,IRCCS Mondino Foundation,Pavia,Italy
摘要：Multiple system atrophy is a sporadic,progressive,adult-onset,neurodegenerative disorder characterized by autonomic dysfunction symptoms,parkinsonian features,and cerebellar signs in various combinations.An early diagnosis of multiple system atrophy is of utmost importance for the proper prevention and management of its potentially fatal complications leading to the poor prognosis of these patients.The current diagnostic criteria incorporate several clinical red flags and magnetic resonance imaging markers supporting diagnosis of multiple system atrophy.Nonetheless,especially in the early disease stage,it can be challenging to differentiate multiple system atrophy from mimic disorders,in particular Parkinson's disease.Electromyography of the external anal sphincter represents a useful neurophysiological tool for differential diagnosis since it can provide indirect evidence of Onuf's nucleus degeneration,which is a pathological hallmark of multiple system atrophy.However,the diagnostic value of external anal sphincter electromyography has been a matter of debate for three decades due to controversial reports in the literature.In this review,after a brief overview of the electrophysiological methodology,we first aimed to critically analyze the available knowledge on the diagnostic role of external anal sphincter electromyography.We discussed the conflicting evidence on the clinical correlations of neurogenic abnormalities found at external anal sphincter electromyography.Finally,we reported recent prognostic findings of a novel classification of electromyography patterns of the external anal sphincter that could pave the way toward the implementation of this neurophysiological technique for survival prediction in patients with multiple system atrophy.
机标关键词：insightsprognosisclinicalsystemnovelanalatrophycorrelations
论文发表日期：2023-09-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：5( 1903-1907 )
英文信息