Table VIs.
Sphincter EMG in parkinsonisms.
| Reference | Objective | No. of patients | Muscle | Technique | Results | Evidece |
|---|---|---|---|---|---|---|
| Kirby et al., 1986 | To assess the diagnostic value of sphincter EMG in MSA | 14 | EUS | Single MUP | ABR: 66% | Class 3 |
| Eardley et al., 1989 | To assess the diagnostic value of sphincter EMG in differentiating MSA from IPD | 41 MSA; 13 IPD | EUS | Single MUP | Se: 62%, Sp: 92% | Class 2 |
| Wenning et al., 1994 | To assess the diagnostic value of sphincter EMG in MSA | 49 | EAS; EUS | CNEMG | ABR: 86% | Class 3 |
| Beck et al., 1994 | To assess the diagnostic value of sphincter EMG in MSA | 62 | EAS; EUS | Single MUP | ABR: 100% | Class 3 |
| Pramstaller et al., 1995 | To assess the diagnostic value of sphincter EMG in MSA | 71 | EAS; EUS | Single MUP | ABR: 90% | Class 3 |
| Valldeoriola et al., 1995 | To assess the diagnostic value of sphincter EMG in the differential diagnosis of parkinsonisms | 6 MSA; 12 PSP; 6 IPD | EAS | Single MUP | ABR: 100% in MSA, 41.6% in PSP, 33.3% in IPD | Class 3 |
| Rodi et al., 1996 a | To assess the diagnostic value of sphincter EMG in differentiating MSA from IPD | 10 MSA; 14 IPD | EAS | CNEMG; SFEMG | Se: 80%, Sp: 93% in MSA; Se: 80%, Sp: 100% in IPD | Class 3 |
| Palace et al., 1997 | To assess the diagnostic value of sphincter EMG in differentiating MSA from IPD | 126 MSA; 12 IPD | EAS | Single MUP | ABR: 82% in MSA, 16% in IPD | Class 3 |
| Stocchi et al., 1997 | To assess the diagnostic value of sphincter EMG in differentiating MSA from IPD | 32 MSA; 30 IPD | EAS | CNEMG | ABR: 75% in MSA, 0% in IPD | Class 2 |
| Schwarz et al., 1997 | To assess the diagnostic value of sphincter EMG in differentiating MSA from IPD | 15 MSA; 10 IPD | EAS | Single MUP; Sp. activity | N.D. between groups; ABR: 66% in MSA, 0% in IPD | Class 3 |
| Libelius and Johansson, 2000 | To assess the diagnostic value of sphincter EMG in differentiating MSA from IPD | 13 MSA; 66 IPD | EAS | Single MUP | ABR: 100% in MSA, variable results in IPD | Class 2 |
| Tison et al., 2000 | To assess the diagnostic value of sphincter EMG in MSA and in differentiating MSA from IPD | 31 MSA; 21 IPD | EAS | Single MUP | Se: 81%, Sp: 67%, PPV: 80%, NPV: 70% in MSA; able to differentiate MSA-IPD | Class 3 |
| Giladi et al., 2000 | To assess the diagnostic value of sphincter EMG in differentiating MSA from IPD | 10 MSA; 13 IPD | EAS | QEMG; Sp. activity | N.D. between groups; N.D. between groups | Class 2 |
| Colosimo et al., 2000 | To assess the diagnostic value of sphincter EMG in IPD | 7 IPD | EAS | CNEMG | ABR: 100% | Class 3 |
| Gilad et al., 2001 | To assess the diagnostic value of sphincter EMG in MSA | 11 | EAS | Multi-MUP; Recruitment; | N.D. from normal values; reduced; reduced; | Class 2 |
| Sakakibara et al., 2001 | To assess the diagnostic value of sphincter EMG in differentiating MSA from IPD | 15 MSA; 21 IPD | EUS | MUP count at rest; SFEMG CNEMG | N.D. from normal values ABR: 93% in MSA, 5% in IPD | Class 3 |
| Lee et al., 2002 | To assess the diagnostic value of sphincter EMG in MSA and in differentiating MSA from IPD | 23 MSA-p; 22 MSA-c; 21 IPD | EAS | CNEMG | Se: 86–96%, Sp: 67%, PPV: 73–76%, NPV: 82–93% in MSA; Se: 33% in IPD | Class 3 |
| Pellegrinetti et al., 2003 | To assess the diagnostic value of sphincter EMG in MSA | 13 | EAS | CNEMG | ABR: 77% | Class 3 |
| Podnar and Fowler, 2004 | To compare the sensitivity of different quantitative EMG techniques in the EAS for diagnosis of MSA | 5 | EAS | Single MUP; Multi-MUP | Se: 100%; Se: 40% | Class 2 |
| Paviour et al., 2005 | To assess the diagnostic value of sphincter EMG in MSA | 37 | EAS; EUS | CNEMG | ABR: 80% | Class 3 |
| Yamamoto et al., 2005 | To assess the diagnostic value of sphincter EMG in the different stages of MSA | 84 | EAS | Single MUP | ABR: 52% in the I year, 83% in the V year | Class 3 |
| Winge et al., 2010 | To assess the diagnostic value of sphincter EMG in the differential diagnosis of parkinsonisms | 14 MSA; 8 PSP; 6 IPD | EAS | CNEMG | Mean duration of MUPs significantly longer in MSA-PSP than in IPD | Class 2 |
| Linder et al., 2012 | To assess the diagnostic value of sphincter EMG in the differential diagnosis of parkinsonisms in the early stage of the disease | 16 MSA; 11 PSP; 121 IPD | EAS | Single MUP | ABR: 62% in MSA, 82% in PSP, 52–54% in IPD | Class 2 |
| Aerts et al., 2015 | To assess the diagnostic value of sphincter EMG in the differential diagnosis of parkinsonisms | 62 IPD; 94 APs | EAS | CNEMG | Sphincter EMG does not improve diagnostic accuracy | Class 2 |
Abbreviations: MSA=multiple system atrophy; MSA-p=multiple system atrophy of parkinsonian type; MSA-c=multiple system atrophy of cerebellar type; IPD=idiopathic Parkinson’s disease; PSP=progressive supranuclear palsy; APs=atypical parkinsonisms; EAS=external anal sphincter muscle; EUS=external urethral sphincter muscle; MUP=motor unit potential; CNEMG=concentric needle EMG; SFEMG=single fiber EMG; Sp. activity=spontaneous activity; QEMG=quantitative EMG; ABR=abnormality rate; Se=sensitivity; Sp=specificity; PPV=positive predictive value; NPV=negative predictive value; N.D. =not significantly different.