Sequential constriction of upper airway and vocal cords in sleep apnoea of multiple system atrophy: Low field magnetic resonance fluoroscopic study

Low field magnetic resonance fluoroscopy was used to clarify temporal and spatial features of airway obstruction in sleep apnoea syndrome (SAS) in multiple system atrophy (MSA), as well as in obstructive SAS (OSAS). 20 patients with OSAS with severe obesity (mean (SD) age 66 (10) years; 16 men, 4 women) and 6 patients with SAS related to probable MSA (60 (9) years; 4 men, 2 women) were studied. In the OSAS group, body mass index, apnoea index, and desaturation index were significantly higher than in the MSA group. In OSAS, simultaneous obstruction extended from the retropalatal pharynx to the retroglossal during sleep on low field magnetic resonance fluoroscopy. In MSA, obstruction of upper airway followed a similar distribution, but obstruction of vocal cords followed upper airway obstruction. In contrast to OSAS, sequentially acting neural mechanisms are suspected in SAS with MSA.