External Anal Sphincter Electromyography And Autonomic Dysfunction In Patients With Parkinson's Disease

Objective The electromyogram changes of external anal sphincter and autonomic nerve dysfunction in patients with Parkinson's disease were analyzed.To explore the relationship between the degree of disease and the two kinds of examination methods,and the consistency of the two examination methods.Methods From June 2018 to August 2019,98 cases of confirmed Parkinson's disease patients were selected from Zhejiang provincial people's hospital,and 45 healthy controls(Patients with mononeurosis without systemic autonomic dysfunction,such as carpal tunnel,cubital tunnel syndrome,or peroneal nerve damage)were included.EAS-EMG examination and PD autonomic nerve symptom scale(SCOPA-AUT)score were performed in both groups.The observation group was divided into light,medium and heavy groups according to the grade of H&Y,to explore the correlation between the changes of the patients' condition and the EAS-EMG examination and the SCOPA-AUT score,the correlation between EAS-EMG and SCOPA-AUT was analyzed.Results The scores of EAS-EMG and SCOPA-AUT in the observation group were higher than those in the control group(P<0.05).Compared with the control group,the results of EAS-EMG examination in PD patients with different disease degrees showed statistically significant differences in the mean time duration and mean amplitude in the groups with different disease degrees compared with the control group(P<0.05).The percentage of multiphase waves showed no statistically significant difference between the mild group and the control group,while the difference was statistically significant in the moderate and severe groups(P<0.05).Pairwise comparison between different degrees of illness showed that the mean time was different between the moderate group and the severe group,and between the mild group and the severe group(P<0.05).There was no significant difference in the percentage and average amplitude of multiphase waves between the three groups.Compared with the control group,the SCOPA-AUT scores of PD patients with different degrees of disease showed statistically significant differences between the moderate and severe groups(P<0.05),and the mild group showed no statistically significant differences from the control group.Comparison of SCOPA-AUT scores in the observation group showed differences between the two groups(P<0.05).ROC curve showed that EAS-EMG was slightly more sensitive and specific in the diagnosis of PD autonomic nerve dysfunction than the SCOPA-AUT scale.Conclusion The EAS-EMG is abnormal in PD patients and autonomic nerve dysfunction is common.The more severe the PD patients were,the higher the degree of EAS-EMG abnormality was,and the more and more frequent the symptoms of autonomic nerve dysfunction were.Both SCOPA-AUT and EAS-EMG can be used to detect autonomic nerve dysfunction in Parkinson's disease patients,and the clinical evaluation of autonomic nerve dysfunction in patients could be conducted from the subjective and objective aspects,so as to improve the rate of early clinical diagnosis and treatment.