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Vocal cord electromyographic correlates of stridor in multiple system atrophy phenotypes.
Parkinsonism & Related Disorders ( IF 4.1 ) Pub Date : 2019-11-27 , DOI: 10.1016/j.parkreldis.2019.11.025 Massimiliano Todisco 1 , Enrico Alfonsi 2 , Ioannis Ugo Isaias 3 , Roberta Zangaglia 4 , Brigida Minafra 4 , Giuseppe Cosentino 2 , Michele Terzaghi 5 , Nicoló Gabriele Pozzi 6 , Raffaele Manni 5 , Claudio Pacchetti 4
Parkinsonism & Related Disorders ( IF 4.1 ) Pub Date : 2019-11-27 , DOI: 10.1016/j.parkreldis.2019.11.025 Massimiliano Todisco 1 , Enrico Alfonsi 2 , Ioannis Ugo Isaias 3 , Roberta Zangaglia 4 , Brigida Minafra 4 , Giuseppe Cosentino 2 , Michele Terzaghi 5 , Nicoló Gabriele Pozzi 6 , Raffaele Manni 5 , Claudio Pacchetti 4
Affiliation
INTRODUCTION
Multiple system atrophy (MSA) is a neurodegenerative disorder characterized by dysautonomia in combination with parkinsonian and cerebellar signs. Stridor may also occur and it is associated with life-threatening events and poor prognosis. The pathophysiology of stridor in MSA is still debated.
OBJECTIVE
To define correlations between diurnal electromyographic (EMG) abnormalities of vocal cord muscles and stridor in MSA phenotypes.
METHODS
We recruited 60 patients with "probable" MSA (45 with parkinsonian [MSA-P] and 15 with cerebellar phenotype [MSA-C]). Nocturnal stridor was detected with video-polysomnography, whereas diurnal stridor was clinically noted when present. A diurnal kinesiologic EMG study of the adductor thyroarytenoid and the abductor posterior cricoarytenoid muscles was also performed.
RESULTS
Among subjects with nocturnal stridor, MSA-P patients predominantly showed a paradoxical burst-like activation of the adductor thyroarytenoid muscle during inspiration. This dystonic pattern was associated with nocturnal stridor in MSA-P (odds ratio [OR] = 23.64, 95% confidence interval [CI] 3.42-70.77, p < 0.001). Conversely, MSA-C patients with nocturnal stridor mainly had additional neurogenic findings of vocal cord muscles. This dystonic-plus pattern correlated with nocturnal stridor in MSA-C (OR = 17.21, 95% CI 4.17-74.92, p < 0.01). The findings of diurnal stridor paralleled the observations for nocturnal stridor.
CONCLUSIONS
The pathophysiology of stridor may differ between MSA phenotypes, possibly related to dysfunctional supranuclear mechanisms in MSA-P (dystonic pattern) and to additional nuclear damage in MSA-C (dystonic-plus pattern).
中文翻译：
多个系统萎缩表型中大跨id的声带肌电图相关性。
引言多系统萎缩症（MSA）是一种神经退行性疾病，其特征为自主神经功能减退并伴有帕金森氏症和小脑征象。也可能发生步态，并与威胁生命的事件和不良预后有关。MSA中喘鸣的病理生理学仍存在争议。目的确定MSA表型中声带肌的昼夜肌电图（EMG）异常与stridor之间的相关性。方法我们招募了60例“可能” MSA患者（其中45例为帕金森病[MSA-P]，另15例为小脑表型[MSA-C]）。通过视频多导睡眠监测仪检测到了夜间喘鸣，而临床上则发现昼夜喘鸣。还进行了内收肌和副外后环肌肉的昼夜运动肌电图研究。结果在夜间喘鸣的受试者中，MSA-P患者在吸气期间主要表现出内the性甲状腺ary肌的自相矛盾的爆发样激活。这种肌张力障碍模式与MSA-P的夜间喘鸣有关（赔率[OR] = 23.64，95％置信区间[CI] 3.42-70.77，p <0.001）。相反，MSA-C患有夜间喘鸣的患者主要有声带肌肉的其他神经源性发现。这种肌张力增加模式与MSA-C中的夜间喘鸣有关（OR = 17.21，95％CI 4.17-74.92，p <0.01）。昼夜步幅的发现与夜间步幅的观察结果相似。结论在MSA表型之间，喘鸣的病理生理可能有所不同，
更新日期：2019-11-27
中文翻译：
多个系统萎缩表型中大跨id的声带肌电图相关性。
引言多系统萎缩症（MSA）是一种神经退行性疾病，其特征为自主神经功能减退并伴有帕金森氏症和小脑征象。也可能发生步态，并与威胁生命的事件和不良预后有关。MSA中喘鸣的病理生理学仍存在争议。目的确定MSA表型中声带肌的昼夜肌电图（EMG）异常与stridor之间的相关性。方法我们招募了60例“可能” MSA患者（其中45例为帕金森病[MSA-P]，另15例为小脑表型[MSA-C]）。通过视频多导睡眠监测仪检测到了夜间喘鸣，而临床上则发现昼夜喘鸣。还进行了内收肌和副外后环肌肉的昼夜运动肌电图研究。结果在夜间喘鸣的受试者中，MSA-P患者在吸气期间主要表现出内the性甲状腺ary肌的自相矛盾的爆发样激活。这种肌张力障碍模式与MSA-P的夜间喘鸣有关（赔率[OR] = 23.64，95％置信区间[CI] 3.42-70.77，p <0.001）。相反，MSA-C患有夜间喘鸣的患者主要有声带肌肉的其他神经源性发现。这种肌张力增加模式与MSA-C中的夜间喘鸣有关（OR = 17.21，95％CI 4.17-74.92，p <0.01）。昼夜步幅的发现与夜间步幅的观察结果相似。结论在MSA表型之间，喘鸣的病理生理可能有所不同，
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