Session Information
Date: Sunday, October 7, 2018
Session Title: Parkinsonism, MSA, PSP (Secondary and Parkinsonism-Plus)
Session Time: 1:45pm-3:15pm
Location: Hall 3FG
Objective: To assess non-motor symptoms (NMS) and their demographic and clinical correlates in MSA patients included in the CMSAR.
Background: NMS are an important and disabling feature in MSA. Some studies report that MSA with parkinsonian subtype (MSA-P) present more NMS than cerebellar subtype (MSA-C), especially in domains like mood/apathy, autonomic function and sleep/fatigue1, but not much is mentioned regarding gender differences or if certain symptoms are more prevalent in more disabled patients.
Methods: We analyzed baseline demographic and clinical data for 69 MSA patients included in the CMSAR (funded by F Marato-TV3), and correlated it with non-motor scales. NMS, including cognition, depression and sleep were assessed using: non-motor scale in Parkinson´s disease (NMS-PD), the Beck Depression Inventory (BDI-II) frontal assessment battery (FAB), Mini Mental State Examination (MMSE), Mattis Dementia-Rating Scale (MDRS-2), REM Sleep Behavior Disorder Screening Questionnaire (RBD-SQ), and Epworth Sleepiness Scale (ESS).
Results: The cohort includes 69 patients of which 37 are males, 36 have MSA-P, and, 49% of the cases scored >4 in Hoehn and Yahr (H&Y). MSA-P scored higher in total NMS-PD scale (p=0,005), presenting significantly more dysphagia, pain, and weight loss than MSA-C. Additionally, MSA-P scored higher for diurnal somnolence (p=0,011) in the ESS. There were no significant differences in cognitive tests, BDI or RBD-SQ (positive in 71% of all cases). Females scored higher on BDI (p=0,035) and were more depressed in NMS-PD (P=0,04). Males had more diurnal somnolence (p=0,027). Advanced cases had more dysphagia (p=0.03), and higher UMSARS score correlated with lower score on FAB (P=0,010) and Stroop (p=0,040). In contrast RALVT recognition score was higher (p=0,014). There were no significant differences between gender and MSA phenotype for disease duration, age at basal visit or age at disease onset.
Conclusions: MSA-P variants have more NMS, but the typical dysautonomic features of the disease are equally prevalent in both variants and all stages of the disease. Gender differences were only found for depression in females and somnolence in males. There are no significant cognitive differences between variants, although FAB scores were worse in advanced cases, and memory remains relatively well preserved even in advanced and late stages.
References: 1. S. Gilman, G.K. Wenning, P.A. Low, D.J. Brooks, C.J. Mathias, J.Q. Trojanowski, et al., Second consensus statement on the diagnosis of multiple system atrophy. Neurology 71 (2008) 670e6760. 2. Zhang L, et al. Non-motor symptoms and the quality of life in multiple system atrophy with different subtypes. Parkinsonism Relat Disord. 2017 Feb;35:63-68. doi: 10.1016/j.parkreldis.2016.12.007. Epub 2016 Dec 13.
To cite this abstract in AMA style:
D.M. Giraldo, A. Pérez Soriano, J. Rios Guillermo, E. Muñoz, Y. Compta, J. Pagonabarraga, F. Valldeoriola, J. Hernández-Vara, S. Jauma Classen, V. Puente, C. Pont, N. Caballol, E. Tolosa, A. Bayes, J. Campdelacreu, O. Fabregues, A. Avila, M. Calopa, C. Gaig, N. Fabregat, P. Pastor, M. Aguilar, M. Pujol, L. Planellas, A. Camara, M.J. Marti. Non-motor symptoms in patients from the Catalonian Multiple System Atrophy Registry (CMSAR) [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/non-motor-symptoms-in-patients-from-the-catalonian-multiple-system-atrophy-registry-cmsar/. Accessed June 15, 2025.« Back to 2018 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/non-motor-symptoms-in-patients-from-the-catalonian-multiple-system-atrophy-registry-cmsar/