Fatigue in Patients With Multiple System Atrophy: A Prospective Cohort Study

Area of Science:

• Neurology
• Clinical Neuroscience

Background:

• Nonmotor symptoms, particularly fatigue, are prevalent in multiple system atrophy (MSA).
• Limited understanding exists regarding the frequency, evolution, and contributing factors of fatigue in early-stage MSA.

Purpose of the Study:

• To investigate the prevalence and progression of fatigue in early-stage MSA.
• To identify factors associated with fatigue and its progression in MSA patients.

Main Methods:

• 146 patients with probable MSA were assessed at baseline and 1-year follow-up.
• Fatigue (Fatigue Severity Scale - FSS) and anxiety (Hamilton Anxiety Rating Scale - HARS) were evaluated.
• Orthostatic hypotension (OH) was defined by blood pressure changes; logistic and linear regression models analyzed fatigue factors and progression.

Main Results:

• Fatigue was present in 60.3% of MSA patients, increasing over the 1-year follow-up.
• Younger age, OH, and higher HARS scores were associated with fatigue in MSA.
• OH correlated with fatigue in MSA with parkinsonism (MSA-P), while high HARS scores correlated with fatigue in MSA with cerebellar ataxia (MSA-C).

Conclusions:

• Fatigue is a common and persistent nonmotor symptom in early MSA.
• Orthostatic hypotension and anxiety are significant factors associated with fatigue in MSA.