Is there delayed gastric emptying in patients with multiple system atrophy? An analysis using the 13C-acetate breath test
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 (Tmax), with expirations collected for 4 h after a test meal and determination of 13CO2 content using an infrared (IR) spectrophotometer. The HET and Tmax of gastric emptying were significantly delayed in patients with MSA as compared to those in SAOA and controls (p < 0.01). The HET and Tmax were not significantly different between SAOA and controls. No correlation existed between the HET or Tmax 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.
KeywordsMultiple system atrophy Sporadic adult-onset ataxia of unknown etiology Gastric emptying 13C-Acetate breath test Autonomic failure
- 1.Gilman S, Wenning GK, Low PA, Brooks DJ, Mathias CJ, Trojanowski JQ, Wood NW, Colosimo C, Dürr A, Fowler CJ, Kaufmann H, Klockgether T, Lees A, Poewe W, Quinn N, Revesz T, Robertson D, Sandroni P, Seppi K, Vidailhet M (2008) Second consensus statement on the diagnosis of multiple system atrophy. Neurology 71:670–676PubMedCrossRefGoogle Scholar
- 8.Tanaka Y, Kato T, Nishida H, Araki H, Murase M, Nagaki M, Moriwaki H, Inuzuka T (2009) Is there a difference in gastric emptying between Parkinson’s disease patients under long-term l-dopa therapy with and without motor fluctuations? An analysis using the 13C-acetate breath test. J Neurol 256:1972–1976PubMedCrossRefGoogle Scholar
- 9.Tanaka Y, Kato T, Nishida H, Yamada M, Koumura A, Sakurai T, Hayashi Y, Kimura A, Hozumi I, Araki H, Murase M, Nagaki M, Moriwaki H, Inuzuka T (2011) Is there a delayed gastric emptying of patients with early-stage, untreated Parkinson’s disease? An analysis using the 13C-acetate breath test. J Neurol 258:421–426PubMedCrossRefGoogle Scholar
- 23.Bennett T (1983) Physiological investigation of diabetic autonomic failure. In: Bannister R (ed) Autonomic failure. Oxford University Press, Oxford, pp 407–436Google Scholar