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Self-presentation is a fundamental aspect of social interaction, shaping both how others perceive individuals and how they view themselves. This dynamic process influences behaviors in various social settings, often leading people to adjust their appearance, speech, and demeanor to align with their desired identity. While self-presentation can be deliberate or unconscious, it plays a critical role in interpersonal relationships and self-perception.Forms of Self-PresentationSelf-presentation can...
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Processes of Self-Presentation01:29

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Bladder dysfunction as the initial presentation of multiple system atrophy: a prospective cohort study.

Ryuji Sakakibara1,2, Jalesh Panicker3,4, Sara Simeoni3,4

  • 1Neurology, Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura, 285-8741, Japan. sakakibara@sakura.med.toho-u.ac.jp.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|July 26, 2018
PubMed
Summary
This summary is machine-generated.

In Multiple System Atrophy (MSA), bladder dysfunction precedes motor symptoms in 18.2% of patients by an average of 2.8 years. Early recognition of autonomic dysfunction is crucial for accurate diagnosis and avoiding misdiagnosis, especially in urology. Keywords: Multiple System Atrophy, autonomic dysfunction, bladder dysfunction, motor symptoms, early diagnosis.

Keywords:
Autonomic dysfunctionMultiple system atrophyNonmotor signsProstatic hypertrophyUrinary dysfunction

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Area of Science:

  • Neurology
  • Autonomic Nervous System Disorders
  • Urology

Background:

  • Multiple System Atrophy (MSA) is a progressive neurodegenerative disorder characterized by a combination of autonomic and motor dysfunction.
  • Autonomic dysfunction, including bladder and orthostatic issues, can precede motor symptoms (parkinsonian or cerebellar), but the frequency and timing are not well-established.
  • A prospective study is needed to clarify the early presentation of autonomic dysfunction in MSA.

Purpose of the Study:

  • To prospectively determine the frequency and early onset of bladder autonomic dysfunction preceding motor symptoms in patients with Multiple System Atrophy (MSA).
  • To analyze the temporal relationship between autonomic and motor symptom onset in different MSA subtypes (MSA-C and MSA-P).

Main Methods:

  • A prospective cohort study involving 121 patients diagnosed with MSA (73 MSA-C, 48 MSA-P).
  • Detailed history-taking and questionnaire administration were used to collect data on symptom onset and progression.
  • Follow-up data were collected over a mean period of 6.5 years.

Main Results:

  • 18.2% of all MSA patients presented with bladder dysfunction as the sole initial manifestation.
  • The mean interval between the onset of urinary symptoms and motor symptoms was 2.8 years (range 1-7 years).
  • In MSA-C, 30% experienced autonomic dysfunction first; in MSA-P, 46% experienced autonomic dysfunction first. Urinary dysfunction was a common early autonomic symptom.

Conclusions:

  • Bladder dysfunction can be the initial presenting symptom in a significant proportion of MSA patients, preceding motor symptoms by several years.
  • Early identification of autonomic dysfunction, particularly urinary symptoms, is critical for timely MSA diagnosis.
  • Clinicians, especially urologists, should consider MSA in patients presenting with isolated bladder issues to avoid misdiagnosis and inappropriate treatments like unnecessary prostate surgery.