| Title |
Bladder dysfunction as the initial presentation of multiple system atrophy: a prospective cohort study
|
|---|---|
| Published in |
Clinical Autonomic Research, July 2018
|
| DOI | 10.1007/s10286-018-0550-y |
| Pubmed ID | |
| Authors |
Ryuji Sakakibara, Jalesh Panicker, Sara Simeoni, Tomoyuki Uchiyama, Tatsuya Yamamoto, Fuyuki Tateno, Masahiko Kishi, Yosuke Aiba |
| Abstract |
Multiple system atrophy (MSA) is a disease that combines autonomic (orthostatic or bladder) with motor [parkinsonian (MSA-P) or cerebellar (MSA-C)] dysfunction. While bladder dysfunction may occur earlier than motor disorders, thus far no prospective study has been available to determine how often and how early bladder autonomic dysfunction predates motor dysfunction in MSA. Therefore, we present data from detailed history-taking in patients with MSA. This is a prospective cohort study. Detailed history-taking was performed and a questionnaire administered in 121 MSA patients (73 MSA-C, 48 MSA-P; 74 men, 47 women; age, 58 ± 8.0 years; initial recruitment period, 5 years; follow-up, 6.5 ± 4.0 years). Among the patients with MSA-C, 40 patients (55%) suffered motor dysfunction first, 22 (30%) suffered autonomic dysfunction first, and 11 (15%) initially suffered both simultaneously. Among the patients with MSA-P, 22 patients (46%) suffered motor dysfunction first, 22 (46%) suffered autonomic dysfunction first, and two (8%) initially suffered both simultaneously. Among the 'autonomic-first' subgroup of MSA-C patients, five suffered orthostatic dysfunction first, 13 suffered urinary dysfunction first, and four initially suffered both simultaneously. Among the 'autonomic-first' subgroup of MSA-P patients, six suffered orthostatic dysfunction first, nine suffered urinary dysfunction first, and seven initially suffered both simultaneously. Urinary symptoms were further preceded by erectile dysfunction in men. Overall, 18.2% of patients suffered only urinary symptoms initially, and the mean interval from the onset of urinary to the onset of motor symptoms was 2.8 years (range 1-7 years). In MSA patients, 18.2% presented with bladder dysfunction as the sole initial manifestation, and the mean interval from the onset of urinary to the onset of motor symptoms was 2.8 years. It is clinically important to avoid unnecessary prostatic surgery when MSA patients see urologists before neurologists. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Science communicators (journalists, bloggers, editors) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 31 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 31 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 16% |
| Student > Ph. D. Student | 3 | 10% |
| Other | 2 | 6% |
| Student > Doctoral Student | 2 | 6% |
| Student > Bachelor | 2 | 6% |
| Other | 3 | 10% |
| Unknown | 14 | 45% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 19% |
| Neuroscience | 5 | 16% |
| Agricultural and Biological Sciences | 1 | 3% |
| Psychology | 1 | 3% |
| Business, Management and Accounting | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 17 | 55% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 December 2020.
All research outputs
#14,358,216
of 23,096,849 outputs
Outputs from Clinical Autonomic Research
#498
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#184,678
of 329,806 outputs
Outputs of similar age from Clinical Autonomic Research
#13
of 24 outputs
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