Involuntary inspiratory sigh in multiple system atrophy: A clinical and cerebral blood flow study
Abstract
BACKGROUND: Involuntary inspiratory sigh (IIS) is a characteristic symptom of multiple system atrophy (MSA) and a supportive non-motor feature in the current diagnostic criteria. However, IIS during wakefulness has not been systematically investigated.
OBJECTIVES: This study explored the clinical significance and neural correlates of IIS by comparing clinical characteristics and cerebral blood flow (CBF) single-photon emission computed tomography findings between patients with and without IIS, and evaluated a practical method for IIS assessment.
METHODS: We retrospectively investigated 90 patients with clinically established or probable MSA. IIS was assessed via structured interview and direct examination. Patients were classified as IIS-positive if either method yielded positive results. Clinical characteristics were compared between IIS-positive and IIS-negative patients. Agreement between the two detection methods was examined. CBF was also compared between groups.
RESULTS: IIS was identified in 21 (23.3%) of 90 patients. The IIS-positive patients showed higher Unified Multiple System Atrophy Rating Scale Part I scores and REM Sleep Behavior Disorder Screening Questionnaire scores, and more frequent severe orthostatic hypotension in exploratory comparisons. Interview- and examination-based IIS assessments showed moderate agreement, and IIS was significantly more likely to be detected during interviews than during examinations. The IIS-positive patients exhibited reduced…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 90 participants or records.
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