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Related Experiment Videos

Urethro-vesical dysfunction in progressive autonomic failure with multiple system atrophy.

R Kirby, C Fowler, J Gosling

    Journal of Neurology, Neurosurgery, and Psychiatry
    |May 1, 1986
    PubMed
    Summary
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    This study reveals three key urinary tract dysfunctions in multiple system atrophy: involuntary bladder contractions, inability to initiate urination, and severe urethral sphincter problems. These issues stem from neurological degeneration affecting specific brain and spinal cord areas.

    Area of Science:

    • Neurology
    • Urology
    • Neuroscience

    Background:

    • Multiple system atrophy (MSA) is a progressive neurodegenerative disorder.
    • Autonomic failure is a common and debilitating symptom in MSA patients.
    • Lower urinary tract dysfunction significantly impacts quality of life in MSA.

    Purpose of the Study:

    • To investigate the urodynamic, electromyographic, and neurohistochemical basis of lower urinary tract dysfunction in MSA.
    • To identify specific neurological deficits underlying urinary abnormalities in MSA.
    • To explore the neuroanatomical correlates of bladder and urethral dysfunction in MSA.

    Main Methods:

    • Urodynamic studies to assess bladder function.
    • Electromyography to evaluate urethral sphincter activity.

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  • Neurohistochemical analysis to examine nerve density and cell degeneration.

    • Main Results:

    • Identified involuntary detrusor contractions, potentially due to loss of striatal and nigral inhibitory influences.
    • Observed impaired voluntary micturition reflex initiation, linked to neuronal degeneration in the pons, medulla, and sacral cord.
    • Demonstrated profound urethral dysfunction, including bladder neck incompetence and impaired striated sphincter function, associated with Onuf's nucleus degeneration.

    Conclusions:

    • MSA involves complex lower urinary tract dysfunction resulting from selective neurodegeneration.
    • Degeneration of specific neuronal pathways, including those originating from the corpus striatum, substantia nigra, and Onuf's nucleus, underlies these urinary issues.
    • The selective vulnerability of certain neuronal populations in MSA raises fundamental questions about neurodegenerative disease mechanisms.