Meta analysis on diagnostic value of external anal sphincter electromyography in multiple system atrophy and Parkinson's disease

doi:10.3969/j.issn.1004-583X.2022.06.002

Abstract

Abstract:

Objective To evaluate the diagnostic value of external anal sphincter electromyography (EAS-EMG) in multiple system atrophy (MSA) and Parkinson’s disease (PD). Methods Computer retrieval was applied for PubMed, Web of science, Cochrane library,Embase,CBM disc,CNKI,Wanfang Data, and relevant studies on EAS-EMG in MSA and PD with the retrieval duration extending from the library setup to January 1st,2021 were selected. The literature were screened out based on the inclusion and exclusion criteria by two independent researchers. Quality of studies was assessed according to the Newcastle-Ottawa Scale(NOS). The detection on the data merger and publication bias was performed with Software Revman5.3. Results A total of 14 studies were included, including 2 cohort studies and 12 case-control studies. The NOS scores of all studies were ≥6 points. Meta analysis results showed the duration of mean motor unit potential (MUP) in MSA group was significantly longer than that in PD group (MD=2.70, 95%CI=2.07-3.34); average MUP amplitude in the MSA group was higher than that in the PD group (MD=43.21, 95%CI=-7.36-93.78); the percentage of polyphase wave in the MSA group was significantly higher than that in the PD group (MD=13.34, 95%CI=6.22-20.46); the time limit of MUP >10 ms% in the MSA group was significantly higher than that in the PD group (MD=18.88, 95%CI=4.89-32.87); and the percentage of satellite potential in the MSA group was significantly higher than that in the PD group (MD=8.36, 95%CI=3.85-12.86). The Study was found to have a slight publication bias. Conclusion EAS-EMG delivers important reference value in the differential diagnosis of MSA and PD. The duration of mean MUP, percent of multiphase wavE, MUP duration >10 ms% and satellite potential % in EAS-EMG delivers high diagnostic value, while MUP amplitude exhibits less diagnostic value. EAS-EMG may be of greater value in the differential diagnosis on MSA and early PD, and further studies are required.

Key words: external anal sphincter electromyography, multiple system atrophy, Parkinson’s disease, Meta analysis

CLC Number:

R745.7

Sun Yanan, Hao Yifeng, Li Xiaohong. Meta analysis on diagnostic value of external anal sphincter electromyography in multiple system atrophy and Parkinson's disease[J]. Clinical Focus, 2022, 37(6): 490-496.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.06.002

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I6/490

Figures/Tables 7

References 23

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纳入文献	国家	研究类型	组别	例数	平均年龄(岁)	男(%)	病程(年)	NOS评分
Linder J, 2012^[5]	瑞典	队列研究	MSA	16	74.8±2.13	75	2.12±0.81	8
			PD	100	69±7.85	63	1.21±2.45
Schwarz J, 1997^[7]	德国	病例对照研究	MSA	14	57.6±7.33	46.67	未提供	7
			PD	10	64.7±6.17	60	>5
Libelius R, 2000^[8]	瑞典	病例对照研究	MSA	13	65±5	69.23	5.5±0.83	7
			PD	66	66±7	69.7	7.8±4.67
Cao Z, 2020^[10]	中国	病例对照研究	MSA	16	57.31±7.78	56.25	3.06±1.73	7
			PD	26	56.82±6.45	46.15	2.64±1.19
Niu X, 2020^[11]	中国	病例对照研究	MSA	43	52.59±5.43	未提供	0.5-13	7
			中晚期PD	60	53.06±4.90	未提供	>5
			早期PD	60	53.45±4.88	未提供	<5
Qiu F, 2019^[12]	中国	病例对照研究	MSA	99	56±2.08	51.49	2.4±0.42	7
			PD	100	64.7±10	65	3.0±0.65
Winge K, 2010^[13]	丹麦	队列研究	MSA	14	64.4±6	57.14	4.3±1	8
			PD	6	65.6±2.67	100%	5.3±1
Yamamoto T, 2012^[14]	日本	病例对照研究	MSA	263	64±5.83	58.56	3.2	7
			PD	129	66±7	66.67	3.2
胡新颖, 2020^[15]	中国	病例对照研究	MSA	21	60.7±7.0	61.9	3.4±1.6	6
			PD	33	62.2±7.2	60.61	5.4±1.9
吴少婷, 2015^[16]	中国	病例对照研究	MSA	28	63.4±11.6	57.14	2.86±2.37	6
			PD	11	61.5±12.2	45.45	2.92±3.23
曹振汤, 2018^[17]	中国	病例对照研究	MSA	171	60.2±8.0	60.23	2.5±2.0	7
			PD	477	61.0±13.0	56.6	5.0±4.0
戚晓昆, 2011^[18]	中国	病例对照研究	MSA	88	58.5±9.0	60.23	4.0±2.75	7
			PD	69	65.8±9.0	66.67	4.2±1.93
王含, 2011^[19]	中国	病例对照研究	MSA	68	60.9±6.0	51.47	2.19±0.97	7
			PD	60	59.4±8.67	68.33	3.88±3.25
张小瑾, 2009^[20]	中国	病例对照研究	MSA	42	59.2±9.6	59.52	3.0±2.4	7
			PD	51	62.4±11.3	54.9	5.7±4.7

纳入文献	国家	研究类型	组别	例数	平均年龄(岁)	男(%)	病程(年)	NOS评分
Linder J, 2012^[5]	瑞典	队列研究	MSA	16	74.8±2.13	75	2.12±0.81	8
			PD	100	69±7.85	63	1.21±2.45
Schwarz J, 1997^[7]	德国	病例对照研究	MSA	14	57.6±7.33	46.67	未提供	7
			PD	10	64.7±6.17	60	>5
Libelius R, 2000^[8]	瑞典	病例对照研究	MSA	13	65±5	69.23	5.5±0.83	7
			PD	66	66±7	69.7	7.8±4.67
Cao Z, 2020^[10]	中国	病例对照研究	MSA	16	57.31±7.78	56.25	3.06±1.73	7
			PD	26	56.82±6.45	46.15	2.64±1.19
Niu X, 2020^[11]	中国	病例对照研究	MSA	43	52.59±5.43	未提供	0.5-13	7
			中晚期PD	60	53.06±4.90	未提供	>5
			早期PD	60	53.45±4.88	未提供	<5
Qiu F, 2019^[12]	中国	病例对照研究	MSA	99	56±2.08	51.49	2.4±0.42	7
			PD	100	64.7±10	65	3.0±0.65
Winge K, 2010^[13]	丹麦	队列研究	MSA	14	64.4±6	57.14	4.3±1	8
			PD	6	65.6±2.67	100%	5.3±1
Yamamoto T, 2012^[14]	日本	病例对照研究	MSA	263	64±5.83	58.56	3.2	7
			PD	129	66±7	66.67	3.2
胡新颖, 2020^[15]	中国	病例对照研究	MSA	21	60.7±7.0	61.9	3.4±1.6	6
			PD	33	62.2±7.2	60.61	5.4±1.9
吴少婷, 2015^[16]	中国	病例对照研究	MSA	28	63.4±11.6	57.14	2.86±2.37	6
			PD	11	61.5±12.2	45.45	2.92±3.23
曹振汤, 2018^[17]	中国	病例对照研究	MSA	171	60.2±8.0	60.23	2.5±2.0	7
			PD	477	61.0±13.0	56.6	5.0±4.0
戚晓昆, 2011^[18]	中国	病例对照研究	MSA	88	58.5±9.0	60.23	4.0±2.75	7
			PD	69	65.8±9.0	66.67	4.2±1.93
王含, 2011^[19]	中国	病例对照研究	MSA	68	60.9±6.0	51.47	2.19±0.97	7
			PD	60	59.4±8.67	68.33	3.88±3.25
张小瑾, 2009^[20]	中国	病例对照研究	MSA	42	59.2±9.6	59.52	3.0±2.4	7
			PD	51	62.4±11.3	54.9	5.7±4.7

纳入文献	组别	例数	病程 (年)	MUP时限 (ms)	平均波幅 (μV)	多相波 (%)	卫星电位 (%)	平均时限 >10 ms%
Linder J, 2012^[5]	MSA	16	2.12±0.81	9.0±1.02	575±181.17	45±8.33	30±11.67
	PD	100	1.21±2.45	8.4±1.35	549±185.17	40±15		30±13.33
Schwarz J, 1997^[7]	MSA	14	未提供	9.04±1.4		48.1±15.9		32.1±11.4
	PD	10	>5	8.1±1.45		0.5±16.7		23.5±16.2
Libelius R, 2000^[8]	MSA	13	5.5±0.83	14.2±1.9	512±135	57.7±13.6		75.4±10.5
	PD	66	7.8±4.67	9.5±2.3	550±246	33.8±18.9		35.8±25.0
Cao Z, 2020^[10]	MSA	16	3.06±1.73	11.90±1.37	590.63±158.21		10±2.5
	PD	26	2.64±1.19	10.92±1.10	570.78±108.22		5±1.67
Niu X, 2020^[11]	MSA	43	0.5~13	13.9±2.6	502±69.4	65.8±11.6	76.7(33/43)
	中晚期PD	60	>5	12.6±2.1	489±74.2	43.32±12.5	53.3(32/60)
	早期PD	60	<5	8.0±1.9	462±71.0	19.2±11.3	11.7(7/60)
Qiu F, 2019^[12]	MSA	99	2.4±0.42	12.2±0.43	465±39.83	37.1±5.47
	PD	100	3.0±0.65	9.8±0.1875	481±39.46	31.6±2.58
Winge K, 2010^[13]	MSA	14	4.3±1	16.31±2.88		22.15±11.5
	PD	6	5.3±1	7.30±0.78		12.8±4.83
Yamamoto T, 2012^[14]	MSA	263	3.2	9.33±2.38	516.14±824.58
	PD	129	3.2	7.43±1.77	462.28±234.29
胡新颖, 2020^[15]	MSA	21	3.4±1.6	12.64±2.36	626.52±55.35	49.14±12.15	42.9(9/21)
	PD	33	5.4±1.9	10.05±1.18	465.39±58.42	40.55±6.15	12.1(4/33)
吴少婷, 2015^[16]	MSA	28	2.86±2.37	12.1±1.4		56.2±13.8	64.3(18/28)	72.8±18.2
	PD	11	2.92±3.23	9.4±1.6		53.1±13.6	18.2(2/11)	38.8±25.5
曹振汤, 2018^[17]	MSA	171	2.5±2.0	11.6±1.7	567.0±183.0	54.9±17.5	10.0±10.0	70.0±25.0
	PD	477	5.0±4.0	10.6±1.6	542.0±165.5	45.0±30.0	5.0±10.0	55.0±30.0
戚晓昆, 2011^[18]	MSA	88	4.0±2.75	12.92±2.59	648.6±251.0	42.6±21.2	34/88
	PD	69	4.2±1.93	8.99±0.47	470.0±91.9	24.2±11.0	0
王含, 2011^[19]	MSA	68	2.19±0.97	15.4±3.0		63.9±15.8	26.5±15.9
	PD	60	3.88±3.25	12.0±1.6		46.2±19.2	9.5±8.3
张小瑾, 2009^[20]	MSA	42	3.0±2.4	8.1±2.5	319.7±185.8	41.9±19.6
	PD	51	5.7±4.7	6.9±1.2	339.6±256.6	40.6±20.8

纳入文献	组别	例数	病程 (年)	MUP时限 (ms)	平均波幅 (μV)	多相波 (%)	卫星电位 (%)	平均时限 >10 ms%
Linder J, 2012^[5]	MSA	16	2.12±0.81	9.0±1.02	575±181.17	45±8.33	30±11.67
	PD	100	1.21±2.45	8.4±1.35	549±185.17	40±15		30±13.33
Schwarz J, 1997^[7]	MSA	14	未提供	9.04±1.4		48.1±15.9		32.1±11.4
	PD	10	>5	8.1±1.45		0.5±16.7		23.5±16.2
Libelius R, 2000^[8]	MSA	13	5.5±0.83	14.2±1.9	512±135	57.7±13.6		75.4±10.5
	PD	66	7.8±4.67	9.5±2.3	550±246	33.8±18.9		35.8±25.0
Cao Z, 2020^[10]	MSA	16	3.06±1.73	11.90±1.37	590.63±158.21		10±2.5
	PD	26	2.64±1.19	10.92±1.10	570.78±108.22		5±1.67
Niu X, 2020^[11]	MSA	43	0.5~13	13.9±2.6	502±69.4	65.8±11.6	76.7(33/43)
	中晚期PD	60	>5	12.6±2.1	489±74.2	43.32±12.5	53.3(32/60)
	早期PD	60	<5	8.0±1.9	462±71.0	19.2±11.3	11.7(7/60)
Qiu F, 2019^[12]	MSA	99	2.4±0.42	12.2±0.43	465±39.83	37.1±5.47
	PD	100	3.0±0.65	9.8±0.1875	481±39.46	31.6±2.58
Winge K, 2010^[13]	MSA	14	4.3±1	16.31±2.88		22.15±11.5
	PD	6	5.3±1	7.30±0.78		12.8±4.83
Yamamoto T, 2012^[14]	MSA	263	3.2	9.33±2.38	516.14±824.58
	PD	129	3.2	7.43±1.77	462.28±234.29
胡新颖, 2020^[15]	MSA	21	3.4±1.6	12.64±2.36	626.52±55.35	49.14±12.15	42.9(9/21)
	PD	33	5.4±1.9	10.05±1.18	465.39±58.42	40.55±6.15	12.1(4/33)
吴少婷, 2015^[16]	MSA	28	2.86±2.37	12.1±1.4		56.2±13.8	64.3(18/28)	72.8±18.2
	PD	11	2.92±3.23	9.4±1.6		53.1±13.6	18.2(2/11)	38.8±25.5
曹振汤, 2018^[17]	MSA	171	2.5±2.0	11.6±1.7	567.0±183.0	54.9±17.5	10.0±10.0	70.0±25.0
	PD	477	5.0±4.0	10.6±1.6	542.0±165.5	45.0±30.0	5.0±10.0	55.0±30.0
戚晓昆, 2011^[18]	MSA	88	4.0±2.75	12.92±2.59	648.6±251.0	42.6±21.2	34/88
	PD	69	4.2±1.93	8.99±0.47	470.0±91.9	24.2±11.0	0
王含, 2011^[19]	MSA	68	2.19±0.97	15.4±3.0		63.9±15.8	26.5±15.9
	PD	60	3.88±3.25	12.0±1.6		46.2±19.2	9.5±8.3
张小瑾, 2009^[20]	MSA	42	3.0±2.4	8.1±2.5	319.7±185.8	41.9±19.6
	PD	51	5.7±4.7	6.9±1.2	339.6±256.6	40.6±20.8