**7. Conclusions**

Computational Intelligence in Electromyography Analysis – 300 A Perspective on Current Applications and Future Challenges

**6.3. Other parkinsonian disorders** 

*6.3.1. Progressive supranuclear palsy (PSP)* 

abnormalities in 2 of 3 patients with PSP.30

*6.3.2. Corticobasal degeneration (CBD)* 

*6.4.1. Spinocerebellar ataxia 3 (SCA3)/Machado-Joseph disease* 

*6.4.2. Late cortical cerebellar atrophy (LCCA):* 

exhibited neurogenic changes in the MUPs.

*6.4.3. Spinocerebellar ataxia 6 (SCA6)* 

**6.5. Other diseases** 

disorders.

**6.4. Cerebellar ataxia** 

We performed urodynamic studies in 9 patients with PSP and performed EAS-EMG in 4. Two of these 4 patients exhibited neurogenic changes in MUPs.50 Abnormal sphincter EMG was also reported in 5 of 12 patients by Valldeoriola et al. (1995)71, and in 2 of 8 patients by Palace et al. (1997)38. Libelius and Johansson (2000) also described anal sphincter EMG

We performed urodynamic studies in 6 patients with CBD and EAS-EMG in 5 of them. However, none of the 5 patients showed neurogenic changes in the MUPs.60 There is a considerable overlap in the clinical presentation of the parkinsonian form of MSA (MSA-P) and that of PSP. Therefore, we should be cautious in interpreting sphincter EMG in these

We performed urodynamic studies in 11 patients with spinocerebellar ataxia 3 (SCA3) and performed EAS-EMG in 9. Six of the 9 patients showed neurogenic changes in MUPs.59

We performed urodynamic studies in 7 patients with LCCA, which is a pure cerebellar ataxia without heredity, and EAS-EMG in 3 of them. However, none of the 3 patients

We performed urodynamic studies in 9 patients with spinocerebellar ataxia 6 (SCA6) and performed EAS-EMG in 8. Five of the 8 patients showed neurogenic changes in MUPs.

Sakuta et al. performed EAS-EMG in 30 patients with amyotrophic lateral sclerosis (ALS).62 None of them exhibited neurogenic changes in the MUPs, which contrasted with common neurogenic changes in the limb muscles in this disorder. These EMG findings correspond to the postmortem selective sparing of sacral Onuf's nucleus, which contrasts with severe loss of anterior horn cells innervating the limbs, tongue, and bulbar muscles2. Neurons in Onuf's nucleus demonstrate some morphological differences from the anterior horn cells innervating limb muscle 33. However, more recent studies have shown abnormalities in the We have reviewed the normal physiology and pathophysiology of the lower urinary tract and the lower gastrointestinal tract, the current methods and interpretations of sphincter EMG, and the application of this technique to various autonomic disorders. Sphincter EMG makes it easier to distinguish MSA from idiopathic Parkinson's disease in the first 5 years after disease onset, reflecting the significant involvement of the sacral spinal cord in MSA. However, abnormal sphincter EMG is also seen in some, though not many, patients with DLB or PSP. It is noteworthy that sphincter denervation leads to severe urinary and fecal incontinence in some female patients with MSA, which severely affects their quality of life. Sphincter EMG and relevant sacral autonomic tests are good diagnostic tools in autonomic disorders.
