Objective: To investigate epidemiological information of multiple system atrophy (MSA) patients in Hokkaido, Japan by using the registry data from the Hokkaido Rare-disease Consortium for MSA (HoRC-MSA).
Background: MSA is an intractable neurodegenerative disease whose main symptoms are autonomic dysfunction, cerebellar ataxia, and parkinsonism. There is a lack of long-term, large-scale epidemiological data on MSA, so data collection and analysis are important. On the other hand, since its development in the 1800s, Hokkaido has had many residents who were immigrants from all over Japan, making it a microcosm of Japan as a whole. Hokkaido also has a relatively low population turnover, making it well suited to conducting epidemiological studies of MSA.
Method: We started recruiting MSA patients in November 2014. Postal surveys were sent to medical facilities and MSA patients. Clinical information is collected from attending doctors and patients at the time of registration and annually.
Results: As of February 28, 2025, informed consent to this study was obtained from 277 MSA patients. Diagnostic criteria and their activity of daily living (ADL) were examined for 260 patients (female was 53％). The average time from onset to diagnosis was 2.8 years. The number of MSA-C cases was 161 (male 67% / female 57%), and UMSARS part 2 and part 4 score in female were higher than those in male. At the time of the initial evaluation, male was more likely than female to have urinary problems, and parkinsonism was more common in female. Regarding medication, levodopa use was more frequent in female than in male. Male was more likely to be taking drugs to treat urinary problems. Previous reports have also shown that men tend to have more residual urine and are more likely to require urinary catheter placement.
Conclusion: In this study, parkinsonism was more commonly observed in female MSA patients. Reflecting this, it was likely that ADL was more severe in female, with a higher frequency of levodopa use. Further detailed consideration of MSA natural history studies is required in the future.
To cite this abstract in AMA style:
M. Matsushima, K. Sakushima, Y. Kanatani, N. Nishimoto, J. Sawada, T. Matsuoka, H. Uesugi, N. Minami, K. Sako, A. Takei, S. Hisahara, A. Tamakoshi, N. Sato, I. Yabe. Natural history and epidemiological study of multiple system atrophy in Hokkaido: HoRC-MSA 2014-2025 [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/natural-history-and-epidemiological-study-of-multiple-system-atrophy-in-hokkaido-horc-msa-2014-2025/. Accessed November 20, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/natural-history-and-epidemiological-study-of-multiple-system-atrophy-in-hokkaido-horc-msa-2014-2025/