Multiple System Atrophy: Prognostic Indicators of Survival
Identifieur interne : 000407 ( Pmc/Corpus ); précédent : 000406; suivant : 000408Multiple System Atrophy: Prognostic Indicators of Survival
Auteurs : Juan J. Figueroa ; Wolfgang Singer ; Ajay Parsaik ; Eduardo E. Benarroch ; J. Eric Ahlskog ; Robert D. Fealey ; Joseph E. Parisi ; Paola Sandroni ; Jay Mandrekar ; Valeria Iodice ; Phillip A. Low ; James H. BowerSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2014.
Abstract
Neurologic and autonomic presentation in multiple system atrophy (MSA) may predict early mortality. Quantification of early autonomic failure as mortality predictor is lacking.
Early neurologic and autonomic clinical features were retrospectively reviewed in 49 MSA cases (median age at onset, 56.1 years; 16 women) confirmed by autopsy at Mayo Clinic. When available, the 10-point composite autonomic severity score derived from the autonomic reflex screen provided quantification of the degree of autonomic failure and thermoregulatory sweat test quantitated body surface anhidrosis.
Symptoms at onset were autonomic in 50%, parkinsonian in 30%, and cerebellar in 20% of cases. Survival (median [95% confidence interval]) was 8.6 [6.7–10.2] years. Survival was shorter in patients with early laboratory evidence of generalized (composite autonomic severity score ≥ 6) autonomic failure (7.0 [3.9–9.8] vs. 9.8 [4.6–13.8] years;
Our data suggests that early development of severe generalized autonomic failure more than triples the risk of shorter survival in patients with MSA.
Url:
DOI: 10.1002/mds.25927
PubMed: 24909319
PubMed Central: 4139446
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