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Is There a Difference in Autonomic Dysfunction Between Multiple System Atrophy Subtypes?

Divyani Garg1, Achal Kumar Srivastava1, Ashok Kumar Jaryal2

  • 1Department of Neurology All India Institute of Medical Sciences New Delhi India.

Movement Disorders Clinical Practice
|May 7, 2020
PubMed
Summary
This summary is machine-generated.

Autonomic dysfunction is similar in Multiple System Atrophy subtypes (MSA-C and MSA-P) but more prominent in MSA than Parkinson's disease (PD). Focusing on autonomic symptoms aids early MSA diagnosis.

Keywords:
Parkinson's diseaseautonomic nervous systemdysautonomiamultiple system atrophy

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Area of Science:

  • Neurology
  • Autonomic Neuroscience

Background:

  • Autonomic dysfunction is key in diagnosing Multiple System Atrophy (MSA).
  • Limited data exist on autonomic dysfunction differences between MSA subtypes: MSA-C (cerebellar) and MSA-P (parkinsonian).

Purpose of the Study:

  • To compare autonomic dysfunction in MSA subtypes, Parkinson's disease (PD), and healthy controls.
  • To identify potential diagnostic markers for MSA.

Main Methods:

  • Cross-sectional study utilizing the SCOPA-AUT questionnaire for symptom screening.
  • Cardiovascular autonomic function tests including heart rate changes (deep breathing, tilt) and blood pressure response (Valsalva, hand grip, cold pressor).
  • Disease severity assessed using UMSARS, H & Y stage, and UPDRS Part III.

Main Results:

  • MSA patients exhibited higher autonomic dysfunction scores (SCOPA-AUT) than controls and PD patients across multiple domains.
  • No significant differences in autonomic dysfunction were found between MSA-C and MSA-P subtypes.
  • Specific cardiovascular autonomic tests (heart rate change on tilt/deep breathing, BP rise on cold pressor) showed significant differences between MSA and PD.

Conclusions:

  • Autonomic dysfunction is comparable between MSA-P and MSA-C.
  • Autonomic symptoms are more pronounced in MSA compared to PD.
  • Highlighting autonomic domains may enhance early clinical diagnosis of MSA.