Value of electrophysiological indicators in differential diagnosis of parkinson's disease and multiple system atrophy

BMC Neurol. 2023 Mar 2;23(1):94. doi: 10.1186/s12883-023-03131-8.

Abstract

Background: 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).

Methods: 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.

Results: 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.

Conclusions: Combined analysis of BCR and EAS-EMG has high sensitivity and specificity for differential diagnosis of MSA and PD.

Keywords: Bulbocavernosus reflex; External anal sphincter electromyography; Multiple system atrophy; Parkinson's disease.

MeSH terms

  • Diagnosis, Differential
  • Electromyography
  • Female
  • Humans
  • Male
  • Multiple System Atrophy* / diagnosis
  • Parkinson Disease* / diagnosis
  • Primary Dysautonomias*