Original Communication

Journal of Neurology

, Volume 259, Issue 7, pp 1448-1452

Is there delayed gastric emptying in patients with multiple system atrophy? An analysis using the 13C-acetate breath test

  • Yuji TanakaAffiliated withDepartment of Neurology and Geriatrics, Graduate School of Medicine, Gifu UniversityFirst Department of Internal Medicine, Graduate School of Medicine, Gifu University Email author 
  • , Tomohiro KatoAffiliated withFirst Department of Internal Medicine, Graduate School of Medicine, Gifu University
  • , Hiroshi NishidaAffiliated withDepartment of Neurology and Geriatrics, Graduate School of Medicine, Gifu UniversityFirst Department of Internal Medicine, Graduate School of Medicine, Gifu University
  • , Megumi YamadaAffiliated withDepartment of Neurology and Geriatrics, Graduate School of Medicine, Gifu University
  • , Akihiro KoumuraAffiliated withDepartment of Neurology and Geriatrics, Graduate School of Medicine, Gifu University
  • , Takeo SakuraiAffiliated withDepartment of Neurology and Geriatrics, Graduate School of Medicine, Gifu University
  • , Yuichi HayashiAffiliated withDepartment of Neurology and Geriatrics, Graduate School of Medicine, Gifu University
  • , Akio KimuraAffiliated withDepartment of Neurology and Geriatrics, Graduate School of Medicine, Gifu University
  • , Isao HozumiAffiliated withDepartment of Neurology and Geriatrics, Graduate School of Medicine, Gifu University
    • , Hiroshi ArakiAffiliated withFirst Department of Internal Medicine, Graduate School of Medicine, Gifu University
    • , Masahiko MuraseAffiliated withFirst Department of Internal Medicine, Graduate School of Medicine, Gifu University
    • , Masahito NagakiAffiliated withFirst Department of Internal Medicine, Graduate School of Medicine, Gifu University
    • , Hisataka MoriwakiAffiliated withFirst Department of Internal Medicine, Graduate School of Medicine, Gifu University
    • , Takashi InuzukaAffiliated withDepartment of Neurology and Geriatrics, Graduate School of Medicine, Gifu University

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Abstract

Autonomic failure is one of the criteria according to the second consensus statement for the diagnosis of multiple system atrophy (MSA). Gastrointestinal symptoms are frequent complaints in patients with MSA and may be associated with reduced gastrointestinal motility due to autonomic nervous system dysfunction. However, there are few reports on gastric emptying in patients with MSA. We investigated gastric emptying in 25 patients with MSA, 20 patients with sporadic adult-onset ataxia of unknown etiology (SAOA), and 20 healthy volunteers using the 13C-acetate breath test. Gastric emptying function is estimated by this test as the half-emptying time (HET) and peak time of the 13C-%-dose-excess curve (T max), with expirations collected for 4 h after a test meal and determination of 13CO2 content using an infrared (IR) spectrophotometer. The HET and T max of gastric emptying were significantly delayed in patients with MSA as compared to those in SAOA and controls (p < 0.01). The HET and T max were not significantly different between SAOA and controls. No correlation existed between the HET or T max and the duration or severity of the disease in MSA patients. These results suggested that gastric emptying was significantly delayed in patients with MSA, and the delay already appeared in the early stage of the disease. Delayed gastric emptying is one of the autonomic failures and may be a clinical marker of MSA.

Keywords

Multiple system atrophy Sporadic adult-onset ataxia of unknown etiology Gastric emptying 13C-Acetate breath test Autonomic failure