Progression of parkinsonism in multiple system atrophy
Identifieur interne : 002D50 ( Main/Exploration ); précédent : 002D49; suivant : 002D51Progression of parkinsonism in multiple system atrophy
Auteurs : Klaus Seppi [Autriche] ; Farid Yekhlef [France] ; Anja Diem [Autriche] ; Elisabeth Luginger Wolf [Autriche] ; Joerg Mueller [Autriche] ; Francois Tison [France] ; Niall P. Quinn [Royaume-Uni] ; Werner Poewe [Autriche] ; Gregor K. Wenning [Autriche]Source :
- Journal of neurology [ 0340-5354 ] ; 2005.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Background Progression of parkinsonian motor impairment is usually rapid and relentless in multiple system atrophy (MSA). However, it may also be subject to considerable variation. Prospective natural history studies using validated rating scales are required to accurately determine the progression of parkinsonism in MSA. Objective To assess the progression of parkinsonism in patients with the Parkinson variant of MSA. Methods Parkinsonian motor impairment was assessed on regular therapy at two time points (mean follow-up 11.8 months, SD 1.4) using the Hoehn and Yahr scale (H&Y), the Schwab and England ADL scale (SES) and the motor examination section of the UPDRS (UPDRS-III) in 38 patients with clinically probable MSA-P. Results We examined 38 patients with probable MSA-P (mean age 63.2 years, SD 7.4; mean disease duration 4.1 years, SD 3.0). The mean difference of UPDRS-III between baseline and follow-up was 10.8 (95% CI 8.6-12.9), consistent with an average annual 28.3% increase of UPDRS-III baseline scores. Several variables were associated with faster progression of parkinsonism including low baseline global motor disability as assessed by H&Y and SES, low baseline UPDRS III score, and short disease duration. UPDRS-III progression was unrelated to gender, age at symptom onset, and age at baseline visit. Conclusion This is the first observational study on UPDRS rates of decline in MSA. The observed 28.6% annual increase of UPDRS-III scores illustrates the rapid progression of motor impairment in MSA. Furthermore, motor progression appeared to be accelerated during the early disease stages. Our data allow sample size calculations that may be helpful for the planning of future therapeutic trials.
Affiliations:
- Autriche, France, Royaume-Uni
- Angleterre, Aquitaine, Grand Londres, Nouvelle-Aquitaine, Tyrol (Land)
- Bordeaux, Innsbruck, Londres
- Université de médecine d'Innsbruck
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Quinn</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square</s1><s2>London</s2><s3>GBR</s3><sZ>7 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion><placeName><settlement type="city">Innsbruck</settlement><region nuts="2" type="region">Tyrol (Land)</region></placeName><orgName type="university">Université de médecine d'Innsbruck</orgName></affiliation></author><author><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">05-0094893</idno><date when="2005">2005</date><idno type="stanalyst">PASCAL 05-0094893 INIST</idno><idno type="RBID">Pascal:05-0094893</idno><idno type="wicri:Area/PascalFrancis/Corpus">000D20</idno><idno type="wicri:Area/PascalFrancis/Curation">000714</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000B02</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000B02</idno><idno type="wicri:doubleKey">0340-5354:2005:Seppi K:progression:of:parkinsonism</idno><idno type="wicri:Area/Main/Merge">003125</idno><idno type="wicri:Area/Main/Curation">002D50</idno><idno type="wicri:Area/Main/Exploration">002D50</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Progression of parkinsonism in multiple system atrophy</title><author><name sortKey="Seppi, Klaus" sort="Seppi, Klaus" uniqKey="Seppi K" first="Klaus" last="Seppi">Klaus Seppi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Yekhlef, Farid" sort="Yekhlef, Farid" uniqKey="Yekhlef F" first="Farid" last="Yekhlef">Farid Yekhlef</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Fédération de Neurologie Epidémiologie et Biostatistiques Centre, Hospitalo-Universitaire de Bordeaux</s1><s2>Bordeaux</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Diem, Anja" sort="Diem, Anja" uniqKey="Diem A" first="Anja" last="Diem">Anja Diem</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Wolf, Elisabeth Luginger" sort="Wolf, Elisabeth Luginger" uniqKey="Wolf E" first="Elisabeth Luginger" last="Wolf">Elisabeth Luginger Wolf</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Mueller, Joerg" sort="Mueller, Joerg" uniqKey="Mueller J" first="Joerg" last="Mueller">Joerg Mueller</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Tison, Francois" sort="Tison, Francois" uniqKey="Tison F" first="Francois" last="Tison">Francois Tison</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Institut National de la Santé et de la Recherche Médicale U-330, Epidémiologie et Biostatistiques Centre, Hospitalo-Universitaire de Bordeaux</s1><s2>Bordeaux</s2><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Quinn, Niall P" sort="Quinn, Niall P" uniqKey="Quinn N" first="Niall P." last="Quinn">Niall P. Quinn</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square</s1><s2>London</s2><s3>GBR</s3><sZ>7 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion><placeName><settlement type="city">Innsbruck</settlement><region nuts="2" type="region">Tyrol (Land)</region></placeName><orgName type="university">Université de médecine d'Innsbruck</orgName></affiliation></author><author><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Journal of neurology</title><title level="j" type="abbreviated">J. neurol.</title><idno type="ISSN">0340-5354</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of neurology</title><title level="j" type="abbreviated">J. neurol.</title><idno type="ISSN">0340-5354</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Multiple system atrophy</term><term>Nervous system diseases</term><term>Parkinsonism</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Parkinsonisme</term><term>Atrophie multisystématisée</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background Progression of parkinsonian motor impairment is usually rapid and relentless in multiple system atrophy (MSA). However, it may also be subject to considerable variation. Prospective natural history studies using validated rating scales are required to accurately determine the progression of parkinsonism in MSA. Objective To assess the progression of parkinsonism in patients with the Parkinson variant of MSA. Methods Parkinsonian motor impairment was assessed on regular therapy at two time points (mean follow-up 11.8 months, SD 1.4) using the Hoehn and Yahr scale (H&Y), the Schwab and England ADL scale (SES) and the motor examination section of the UPDRS (UPDRS-III) in 38 patients with clinically probable MSA-P. Results We examined 38 patients with probable MSA-P (mean age 63.2 years, SD 7.4; mean disease duration 4.1 years, SD 3.0). The mean difference of UPDRS-III between baseline and follow-up was 10.8 (95% CI 8.6-12.9), consistent with an average annual 28.3% increase of UPDRS-III baseline scores. Several variables were associated with faster progression of parkinsonism including low baseline global motor disability as assessed by H&Y and SES, low baseline UPDRS III score, and short disease duration. UPDRS-III progression was unrelated to gender, age at symptom onset, and age at baseline visit. Conclusion This is the first observational study on UPDRS rates of decline in MSA. The observed 28.6% annual increase of UPDRS-III scores illustrates the rapid progression of motor impairment in MSA. Furthermore, motor progression appeared to be accelerated during the early disease stages. Our data allow sample size calculations that may be helpful for the planning of future therapeutic trials.</div></front></TEI><affiliations><list><country><li>Autriche</li><li>France</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Aquitaine</li><li>Grand Londres</li><li>Nouvelle-Aquitaine</li><li>Tyrol (Land)</li></region><settlement><li>Bordeaux</li><li>Innsbruck</li><li>Londres</li></settlement><orgName><li>Université de médecine d'Innsbruck</li></orgName></list><tree><country name="Autriche"><noRegion><name sortKey="Seppi, Klaus" sort="Seppi, Klaus" uniqKey="Seppi K" first="Klaus" last="Seppi">Klaus Seppi</name></noRegion><name sortKey="Diem, Anja" sort="Diem, Anja" uniqKey="Diem A" first="Anja" last="Diem">Anja Diem</name><name sortKey="Mueller, Joerg" sort="Mueller, Joerg" uniqKey="Mueller J" first="Joerg" last="Mueller">Joerg Mueller</name><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name><name sortKey="Wolf, Elisabeth Luginger" sort="Wolf, Elisabeth Luginger" uniqKey="Wolf E" first="Elisabeth Luginger" last="Wolf">Elisabeth Luginger Wolf</name></country><country name="France"><region name="Nouvelle-Aquitaine"><name sortKey="Yekhlef, Farid" sort="Yekhlef, Farid" uniqKey="Yekhlef F" first="Farid" last="Yekhlef">Farid Yekhlef</name></region><name sortKey="Tison, Francois" sort="Tison, Francois" uniqKey="Tison F" first="Francois" last="Tison">Francois Tison</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Quinn, Niall P" sort="Quinn, Niall P" uniqKey="Quinn N" first="Niall P." last="Quinn">Niall P. Quinn</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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