Multiple System Atrophy: Prognostic Indicators of Survival
Identifieur interne : 000407 ( Pmc/Curation ); précédent : 000406; suivant : 000408Multiple System Atrophy: Prognostic Indicators of Survival
Auteurs : Juan J. Figueroa [États-Unis] ; Wolfgang Singer [États-Unis] ; Ajay Parsaik [États-Unis] ; Eduardo E. Benarroch [États-Unis] ; J. Eric Ahlskog [États-Unis] ; Robert D. Fealey [États-Unis] ; Joseph E. Parisi [États-Unis] ; Paola Sandroni [États-Unis] ; Jay Mandrekar [États-Unis] ; Valeria Iodice [Royaume-Uni] ; Phillip A. Low [États-Unis] ; James H. Bower [États-Unis]Source :
- 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
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: Pour aller vers cette notice dans l'étape Curation :000407
Links to Exploration step
PMC:4139446Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Multiple System Atrophy: Prognostic Indicators of Survival</title>
<author><name sortKey="Figueroa, Juan J" sort="Figueroa, Juan J" uniqKey="Figueroa J" first="Juan J." last="Figueroa">Juan J. Figueroa</name>
<affiliation wicri:level="2"><nlm:aff id="A1">Department of Neurology, Medical College of Wisconsin, Milwaukee, WI</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Wisconsin</region>
</placeName>
<wicri:cityArea>Department of Neurology, Medical College of Wisconsin, Milwaukee</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Singer, Wolfgang" sort="Singer, Wolfgang" uniqKey="Singer W" first="Wolfgang" last="Singer">Wolfgang Singer</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Parsaik, Ajay" sort="Parsaik, Ajay" uniqKey="Parsaik A" first="Ajay" last="Parsaik">Ajay Parsaik</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A3">Department of Psychiatry and Behavior Sciences, University of Texas Health Science Center, Houston, TX</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Texas</region>
</placeName>
<wicri:cityArea>Department of Psychiatry and Behavior Sciences, University of Texas Health Science Center, Houston</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Benarroch, Eduardo E" sort="Benarroch, Eduardo E" uniqKey="Benarroch E" first="Eduardo E." last="Benarroch">Eduardo E. Benarroch</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Ahlskog, J Eric" sort="Ahlskog, J Eric" uniqKey="Ahlskog J" first="J. Eric" last="Ahlskog">J. Eric Ahlskog</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Fealey, Robert D" sort="Fealey, Robert D" uniqKey="Fealey R" first="Robert D." last="Fealey">Robert D. Fealey</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Parisi, Joseph E" sort="Parisi, Joseph E" uniqKey="Parisi J" first="Joseph E." last="Parisi">Joseph E. Parisi</name>
<affiliation wicri:level="2"><nlm:aff id="A4">Department of Pathology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Pathology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Sandroni, Paola" sort="Sandroni, Paola" uniqKey="Sandroni P" first="Paola" last="Sandroni">Paola Sandroni</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Mandrekar, Jay" sort="Mandrekar, Jay" uniqKey="Mandrekar J" first="Jay" last="Mandrekar">Jay Mandrekar</name>
<affiliation wicri:level="2"><nlm:aff id="A5">Department of Health Sciences Research, Mayo Clinic Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Health Sciences Research, Mayo Clinic Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Iodice, Valeria" sort="Iodice, Valeria" uniqKey="Iodice V" first="Valeria" last="Iodice">Valeria Iodice</name>
<affiliation wicri:level="1"><nlm:aff id="A6">Neurovascular and Autonomic Medicine Unit, Imperial College, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Neurovascular and Autonomic Medicine Unit, Imperial College, London</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Low, Phillip A" sort="Low, Phillip A" uniqKey="Low P" first="Phillip A." last="Low">Phillip A. Low</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Bower, James H" sort="Bower, James H" uniqKey="Bower J" first="James H." last="Bower">James H. Bower</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">24909319</idno>
<idno type="pmc">4139446</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4139446</idno>
<idno type="RBID">PMC:4139446</idno>
<idno type="doi">10.1002/mds.25927</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">000407</idno>
<idno type="wicri:Area/Pmc/Curation">000407</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Multiple System Atrophy: Prognostic Indicators of Survival</title>
<author><name sortKey="Figueroa, Juan J" sort="Figueroa, Juan J" uniqKey="Figueroa J" first="Juan J." last="Figueroa">Juan J. Figueroa</name>
<affiliation wicri:level="2"><nlm:aff id="A1">Department of Neurology, Medical College of Wisconsin, Milwaukee, WI</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Wisconsin</region>
</placeName>
<wicri:cityArea>Department of Neurology, Medical College of Wisconsin, Milwaukee</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Singer, Wolfgang" sort="Singer, Wolfgang" uniqKey="Singer W" first="Wolfgang" last="Singer">Wolfgang Singer</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Parsaik, Ajay" sort="Parsaik, Ajay" uniqKey="Parsaik A" first="Ajay" last="Parsaik">Ajay Parsaik</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A3">Department of Psychiatry and Behavior Sciences, University of Texas Health Science Center, Houston, TX</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Texas</region>
</placeName>
<wicri:cityArea>Department of Psychiatry and Behavior Sciences, University of Texas Health Science Center, Houston</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Benarroch, Eduardo E" sort="Benarroch, Eduardo E" uniqKey="Benarroch E" first="Eduardo E." last="Benarroch">Eduardo E. Benarroch</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Ahlskog, J Eric" sort="Ahlskog, J Eric" uniqKey="Ahlskog J" first="J. Eric" last="Ahlskog">J. Eric Ahlskog</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Fealey, Robert D" sort="Fealey, Robert D" uniqKey="Fealey R" first="Robert D." last="Fealey">Robert D. Fealey</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Parisi, Joseph E" sort="Parisi, Joseph E" uniqKey="Parisi J" first="Joseph E." last="Parisi">Joseph E. Parisi</name>
<affiliation wicri:level="2"><nlm:aff id="A4">Department of Pathology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Pathology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Sandroni, Paola" sort="Sandroni, Paola" uniqKey="Sandroni P" first="Paola" last="Sandroni">Paola Sandroni</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Mandrekar, Jay" sort="Mandrekar, Jay" uniqKey="Mandrekar J" first="Jay" last="Mandrekar">Jay Mandrekar</name>
<affiliation wicri:level="2"><nlm:aff id="A5">Department of Health Sciences Research, Mayo Clinic Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Health Sciences Research, Mayo Clinic Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Iodice, Valeria" sort="Iodice, Valeria" uniqKey="Iodice V" first="Valeria" last="Iodice">Valeria Iodice</name>
<affiliation wicri:level="1"><nlm:aff id="A6">Neurovascular and Autonomic Medicine Unit, Imperial College, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Neurovascular and Autonomic Medicine Unit, Imperial College, London</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Low, Phillip A" sort="Low, Phillip A" uniqKey="Low P" first="Phillip A." last="Low">Phillip A. Low</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Bower, James H" sort="Bower, James H" uniqKey="Bower J" first="James H." last="Bower">James H. Bower</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Department of Neurology, Mayo Clinic, Rochester, MN</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Neurology, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
<idno type="ISSN">0885-3185</idno>
<idno type="eISSN">1531-8257</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Neurologic and autonomic presentation in multiple system atrophy (MSA) may predict early mortality. Quantification of early autonomic failure as mortality predictor is lacking.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">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.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">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; <italic>P</italic>
=0.036), and early requirement of bladder catheterization (7.3 [3.1–10.2] vs. 13.7 [8.5–14.9] years; <italic>P</italic>
=0.003) compared to those without these clinical features. On Cox proportional analysis, prognostic indicators of shorter survival were older age at onset (hazard ratio [95% confidence interval], 1.04 [1.01–1.08]; <italic>P</italic>
=0.03), early requirement of bladder catheterization (7.9 [1.88–38.63]; <italic>P</italic>
=0.004) and early generalized (composite autonomic severity score ≥ 6) autonomic failure (2.8 [1.01–9.26]; <italic>P</italic>
=0.047). Gender, phenotype, and early development of gait instability, aid-requiring ambulation, orthostatic symptoms, neurogenic bladder or significant anhidrosis (thermoregulatory sweat test ≥ 40%) were not indicators of shorter survival.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Our data suggests that early development of severe generalized autonomic failure more than triples the risk of shorter survival in patients with MSA.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8610688</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5937</journal-id>
<journal-id journal-id-type="nlm-ta">Mov Disord</journal-id>
<journal-id journal-id-type="iso-abbrev">Mov. Disord.</journal-id>
<journal-title-group><journal-title>Movement disorders : official journal of the Movement Disorder Society</journal-title>
</journal-title-group>
<issn pub-type="ppub">0885-3185</issn>
<issn pub-type="epub">1531-8257</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24909319</article-id>
<article-id pub-id-type="pmc">4139446</article-id>
<article-id pub-id-type="doi">10.1002/mds.25927</article-id>
<article-id pub-id-type="manuscript">NIHMS597796</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Multiple System Atrophy: Prognostic Indicators of Survival</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Figueroa</surname>
<given-names>Juan J.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Singer</surname>
<given-names>Wolfgang</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Parsaik</surname>
<given-names>Ajay</given-names>
</name>
<degrees>MD, MS</degrees>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Benarroch</surname>
<given-names>Eduardo E.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ahlskog</surname>
<given-names>J. Eric</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fealey</surname>
<given-names>Robert D.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Parisi</surname>
<given-names>Joseph E.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sandroni</surname>
<given-names>Paola</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mandrekar</surname>
<given-names>Jay</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Iodice</surname>
<given-names>Valeria</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Low</surname>
<given-names>Phillip A.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bower</surname>
<given-names>James H.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
<xref rid="FN1" ref-type="author-notes">*</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Neurology, Medical College of Wisconsin, Milwaukee, WI</aff>
<aff id="A2"><label>2</label>
Department of Neurology, Mayo Clinic, Rochester, MN</aff>
<aff id="A3"><label>3</label>
Department of Psychiatry and Behavior Sciences, University of Texas Health Science Center, Houston, TX</aff>
<aff id="A4"><label>4</label>
Department of Pathology, Mayo Clinic, Rochester, MN</aff>
<aff id="A5"><label>5</label>
Department of Health Sciences Research, Mayo Clinic Rochester, MN</aff>
<aff id="A6"><label>6</label>
Neurovascular and Autonomic Medicine Unit, Imperial College, London, UK</aff>
<author-notes><corresp id="FN1"><label>*</label>
Corresponding Author: James H. Bower, M.D. Mayo Clinic, 200 First Street SW, Rochester, MN, USA, 55905, Phone: 507-538-1038, Fax: 507-538-6012, <email>bower.james@mayo.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>18</day>
<month>6</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>07</day>
<month>6</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>8</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>8</month>
<year>2015</year>
</pub-date>
<volume>29</volume>
<issue>9</issue>
<fpage>1151</fpage>
<lpage>1157</lpage>
<pmc-comment>elocation-id from pubmed: 10.1002/mds.25927</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Neurologic and autonomic presentation in multiple system atrophy (MSA) may predict early mortality. Quantification of early autonomic failure as mortality predictor is lacking.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">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.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">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; <italic>P</italic>
=0.036), and early requirement of bladder catheterization (7.3 [3.1–10.2] vs. 13.7 [8.5–14.9] years; <italic>P</italic>
=0.003) compared to those without these clinical features. On Cox proportional analysis, prognostic indicators of shorter survival were older age at onset (hazard ratio [95% confidence interval], 1.04 [1.01–1.08]; <italic>P</italic>
=0.03), early requirement of bladder catheterization (7.9 [1.88–38.63]; <italic>P</italic>
=0.004) and early generalized (composite autonomic severity score ≥ 6) autonomic failure (2.8 [1.01–9.26]; <italic>P</italic>
=0.047). Gender, phenotype, and early development of gait instability, aid-requiring ambulation, orthostatic symptoms, neurogenic bladder or significant anhidrosis (thermoregulatory sweat test ≥ 40%) were not indicators of shorter survival.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Our data suggests that early development of severe generalized autonomic failure more than triples the risk of shorter survival in patients with MSA.</p>
</sec>
</abstract>
<kwd-group><kwd>Autonomic failure</kwd>
<kwd>multiple system atrophy</kwd>
<kwd>prognosis</kwd>
<kwd>parkinsonism</kwd>
<kwd>neurogenic bladder</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/MovDisordV3/Data/Pmc/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000407 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd -nk 000407 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Santé |area= MovDisordV3 |flux= Pmc |étape= Curation |type= RBID |clé= PMC:4139446 |texte= Multiple System Atrophy: Prognostic Indicators of Survival }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Curation/RBID.i -Sk "pubmed:24909319" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd \ | NlmPubMed2Wicri -a MovDisordV3
This area was generated with Dilib version V0.6.23. |