ArticleJournal of neurology2020
Early presentation of urinary retention in multiple system atrophy: can the disease begin in the sacral spinal cord?
Article in Journal of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 42 citations in OpenAlex.
- Lower Urinary Tract Symptoms as Diagnostic Clues in Parkinsonism: A Practical Framework for Neurologists.Movement disorders clinical practice · 2026Review
- Lower Urinary Tract Symptoms as an Indicator of Occult Neurologic Disease: A System-first Framework for Urologic Practice.Current urology reports · 2026Review
- Multiple System Atrophy Combined Outcome Assessment (MuSyCA): process, format, and validation plan.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- Applications of pelvic neurophysiology testing in clinical practice.Clinical neurophysiology practice · 2026Review
- Autonomic dysfunction in multiple system atrophy: from pathophysiology to clinical manifestations.Annals of medicine · 2025Review
- Review
- Multiple system atrophy related neurogenic bladder: mechanism and treatment.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Can We Improve Our Routine Urological Assessment to Exclude Neurogenic Causes for Lower Urinary Tract Dysfunction? ICI-RS 2024.Neurourology and urodynamics · 2025Review
- Case Report: When multiple system atrophy masquerades as CASPR2 autoimmune encephalopathy: a diagnostic pitfall.Frontiers in human neuroscience · 2025Article
- The examination of detrusor underactivity in multiple system atrophy.Frontiers in neurology · 2024Article
- Article
- A Review on the Clinical Diagnosis of Multiple System Atrophy.Cerebellum (London, England) · 2023Review
- Urinary tract infections trigger synucleinopathy via the innate immune response.Acta neuropathologica · 2023Article
- Female Urinary Retention Progressing to Possible Multiple System Atrophy-cerebellar Form after 12 Years.Internal medicine (Tokyo, Japan) · 2022Article
- Optimized multi-echo gradient-echo magnetic resonance imaging for gray and white matter segmentation in the lumbosacral cord at 3 T.Scientific reports · 2022Article
- Diagnosing Premotor Multiple System Atrophy: Natural History and Autonomic Testing in an Autopsy-Confirmed Cohort.Neurology · 2022Article
- Diagnostic and Prognostic Value of External Anal Sphincter EMG Patterns in Multiple System Atrophy.Movement disorders : official journal of the Movement Disorder Society · 2022Article
- Editorial: Autonomic dysfunction in multiple system atrophy.Frontiers in neurology · 2022Article
- Lower urinary tract dysfunction in Parkinsonian syndromes.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Review
- Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study.Movement disorders clinical practice · 2021Article
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Lower urinary tract (LUT) dysfunction presents early in multiple system atrophy (MSA), usually initially as urinary urgency, frequency and incontinence, and voiding difficulties/urinary retention becomes apparent over time. We have observed a subset of patients who instead presented initially with urinary retention requiring catheterisation. At presentation, these patients had only subtle neurological signs that would not fulfil the diagnostic criteria of MSA; however, the anal sphincter electromyography (EMG) was abnormal and they reported bowel and sexual dysfunction, suggesting localisation at the level of the sacral spinal cord. They subsequently developed classical neurological signs, meeting the diagnostic criteria for probable MSA. One patient was confirmed to have MSA at autopsy. We postulate that in a subset of patients with MSA, the disease begins in the sacral spinal cord and then spreads to other regions resulting in the classical signs of MSA. The transmissibility of alpha-synuclein has been demonstrated in animal models and the spread of pathology from sacral cord to other regions of the central nervous system is therefore plausible. Patients presenting with urinary retention and mild neurological features would be an ideal group for experimental trials evaluating neuroprotection in MSA.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.