Therapeutic strategies in multiple system atrophy
Identifieur interne : 003706 ( Main/Curation ); précédent : 003705; suivant : 003707Therapeutic strategies in multiple system atrophy
Auteurs : Gregor K. Wenning [Autriche] ; Felix Geser [Autriche] ; Werner Poewe [Autriche]Source :
- Movement Disorders [ 0885-3185 ] ; 2005-08.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adrenergic alpha-Antagonists (therapeutic use), Anti-Inflammatory Agents (therapeutic use), Anticonvulsants (therapeutic use), Autonomic Nervous System Diseases (therapy), Cholinergic Agents (therapeutic use), Dopamine Agonists (pharmacology), Dopamine Agonists (therapeutic use), Humans, Multiple System Atrophy (therapy), Multiple system atrophy, N-Methylaspartate (antagonists & inhibitors), Nervous system diseases, Palliative Care, Parkinsonian Disorders (therapy), Parkinsonism, Strategy, Treatment, dysautonomia, multiple system atrophy, therapy.
- MESH :
- chemical , antagonists & inhibitors : N-Methylaspartate.
- chemical , pharmacology : Dopamine Agonists.
- chemical , therapeutic use : Adrenergic alpha-Antagonists, Anti-Inflammatory Agents, Anticonvulsants, Cholinergic Agents, Dopamine Agonists.
- therapy : Autonomic Nervous System Diseases, Multiple System Atrophy, Parkinsonian Disorders.
- Humans, Palliative Care.
Abstract
This review provides an update on therapeutic principles and their implications for practical management in multiple system atrophy (MSA), a sporadic neurodegenerative disorder characterized clinically by various combinations of dysautonomia, Parkinsonism, or cerebellar ataxia, often associated with other warning features (red flags), and pathologically by cell loss, gliosis, and glial cytoplasmic inclusions in selected multiple regions of the brain and spinal cord. Because of the small number of randomized controlled trials, the management of MSA is largely based on empirical or open‐label evidence. Parkinsonism often shows a poor or unsustained response to chronic levodopa therapy, although more patients than previously recognized may experience an initial moderate‐to‐good dopaminergic response. There is no effective drug treatment for cerebellar ataxia. However, features of dysautonomia such as orthostatic hypotension, urinary retention or incontinence, constipation, and impotence, may often be relieved if recognized by the treating physician. Because no drug treatment consistently benefits patients with this disease in the long‐term, palliative therapies are all the more important. Novel symptomatic and neuroprotective therapies are urgently required. © 2005 Movement Disorder Society
Url:
DOI: 10.1002/mds.20543
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<front><div type="abstract" xml:lang="en">This review provides an update on therapeutic principles and their implications for practical management in multiple system atrophy (MSA), a sporadic neurodegenerative disorder characterized clinically by various combinations of dysautonomia, Parkinsonism, or cerebellar ataxia, often associated with other warning features (red flags), and pathologically by cell loss, gliosis, and glial cytoplasmic inclusions in selected multiple regions of the brain and spinal cord. Because of the small number of randomized controlled trials, the management of MSA is largely based on empirical or open-label evidence. Parkinsonism often shows a poor or unsustained response to chronic levodopa therapy, although more patients than previously recognized may experience an initial moderate-to-good dopaminergic response. There is no effective drug treatment for cerebellar ataxia. However, features of dysautonomia such as orthostatic hypotension, urinary retention or incontinence, constipation, and impotence, may often be relieved if recognized by the treating physician. Because no drug treatment consistently benefits patients with this disease in the long-term, palliative therapies are all the more important. Novel symptomatic and neuroprotective therapies are urgently required.</div>
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<seriesStmt><idno type="ISSN">0885-3185</idno>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adrenergic alpha-Antagonists (therapeutic use)</term>
<term>Anti-Inflammatory Agents (therapeutic use)</term>
<term>Anticonvulsants (therapeutic use)</term>
<term>Autonomic Nervous System Diseases (therapy)</term>
<term>Cholinergic Agents (therapeutic use)</term>
<term>Dopamine Agonists (pharmacology)</term>
<term>Dopamine Agonists (therapeutic use)</term>
<term>Humans</term>
<term>Multiple System Atrophy (therapy)</term>
<term>N-Methylaspartate (antagonists & inhibitors)</term>
<term>Palliative Care</term>
<term>Parkinsonian Disorders (therapy)</term>
<term>Parkinsonism</term>
<term>dysautonomia</term>
<term>multiple system atrophy</term>
<term>therapy</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="antagonists & inhibitors" xml:lang="en"><term>N-Methylaspartate</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Dopamine Agonists</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Adrenergic alpha-Antagonists</term>
<term>Anti-Inflammatory Agents</term>
<term>Anticonvulsants</term>
<term>Cholinergic Agents</term>
<term>Dopamine Agonists</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Autonomic Nervous System Diseases</term>
<term>Multiple System Atrophy</term>
<term>Parkinsonian Disorders</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Humans</term>
<term>Palliative Care</term>
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<front><div type="abstract" xml:lang="en">This review provides an update on therapeutic principles and their implications for practical management in multiple system atrophy (MSA), a sporadic neurodegenerative disorder characterized clinically by various combinations of dysautonomia, Parkinsonism, or cerebellar ataxia, often associated with other warning features (red flags), and pathologically by cell loss, gliosis, and glial cytoplasmic inclusions in selected multiple regions of the brain and spinal cord. Because of the small number of randomized controlled trials, the management of MSA is largely based on empirical or open‐label evidence. Parkinsonism often shows a poor or unsustained response to chronic levodopa therapy, although more patients than previously recognized may experience an initial moderate‐to‐good dopaminergic response. There is no effective drug treatment for cerebellar ataxia. However, features of dysautonomia such as orthostatic hypotension, urinary retention or incontinence, constipation, and impotence, may often be relieved if recognized by the treating physician. Because no drug treatment consistently benefits patients with this disease in the long‐term, palliative therapies are all the more important. Novel symptomatic and neuroprotective therapies are urgently required. © 2005 Movement Disorder Society</div>
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