Objective: To report the results of the PAN American MSA (PANMSA) database

Background: Multiple system atrophy (MSA) is a rare neurodegenerative disease and coordinated efforts are required to improve understanding, diagnosis, and treatment. Recently, Walsh RR et al. published some recommendations for Global MSA research including the creation of a unified dataset for MSA and implementation of a global international registry. In an attempt to reduce the knowledge gap in our region in 2014 we reported the preliminary data from PANMSA cohort.1 Two years later we implemented, a system with web domain database with a restricted access for site investigators to collect de-identified information to protect patient confidentiality.2

Methods: Demographic and clinical data from MSA patients were collected until March 2018 and included in the new encrypted database. Inclusion criteria required: >21 years old individuals fulfilling clinical diagnosis of MSA on the basis of the current consensus criteria for the disease (revised criteria for clinical diagnosis of MSA, 2008) and ancillary neuroimaging. Exclusion criteria required: patients with any other causes of Parkinsonism.

Results: 72 patients met criteria. The sample consisted of 61 Hispanic Latinos, 1 Amerindian and 10 non Hispanic white. 54% probable MSA-P, 16.6% probable MSA-C, 15.7% possible MSA-P 13.8% possible MSA-C. 55.5% were women. The mean age at start of symptoms is 58.4 years and. The mean years of diseases duration is 4.6. The mean UMSARS II score 48.6 points, H&Y between 2.5-4 involve more than 63 patients, 93% present with orthostatic hypotension. Premotor symptoms were identified as depression 69.4%, hyposmia 30.6%. Autonomic dysfunction occurred in 84%,(constipation 84%, orthostatism 93%, urogenital dysfunction 91.7%) Sleep disorders: RLS 15%, insomnia 50%, RBD 56.9%. Cognitive impairment 40%, and neuropsychiatric disorders like Hallucinations 9.7%. AS expected falls were frequent 91.7%, but were relatively infrequent Camptocormia 8.3%and severe anterocollis 31.9%. Benefit with L-dopa was reported in 30.6%, lasting 2.3 years. Urinary incontinence was present in 46.6%. MRI is available in 69 cases. The most frequent findings in MSA-P were Putaminal atrophy 13.8% and Putaminal rib 8.3%.

Conclusions: Despite the larger race mixture in PAN American region, our cohort data are in accordance with other study. On the other hand, this sample included few Amerindian representation, future studies should include a larger representation.

References: 1. Wenning GK, Geser F, Krismer F, Seppi K, Duerr S, Boesch S, K¨ollensperger M, Goebel G, Pfeiffer KP, Barone P, Pellecchia MT, Quinn NP, Koukouni V, Fowler CJ, Schrag A, Mathias CJ, Giladi N, Gurevich T, Dupont E, Ostergaard K, Nilsson CF,Widner H, Oertel W, Eggert KM, Albanese A, del Sorbo F, Tolosa E, Cardozo A,Deuschl G, Hellriegel H, Klockgether T, Dodel R, Sampaio C, Coelho M, Djaldetti R, Melamed E, Gasser T,KammC, Meco G, Colosimo C, Rascol O, Meissner WG,Tison F, PoeweW&European Multiple System Atrophy Study Group (2013) The natural history of multiple system atrophy: A prospective European cohort. Lancet Neurol, 12, 264-274. 2. Kuzdas-Wood D, Stefanova N, Jellinger KA, Seppi K 1 Schlossmacher MG, PoeweW, & Wenning GK (2014) Towards translational therapies for multiple system atrophy. Prog Neurobiol, 118C, 19-35 Yabe I, Soma H, Takei A, Fujiki N, Yanagihara T, & Sasaki H (2006) MSA-C is the predominant clinical phenotype of MSA in Japan: Analysis of 142 patients with probable MSA. J Neurol Sci, 249 115-121. 3. Wenning GK, & Stefanova N (2009) Recent developments in multiple system atrophy. J Neurol, 256, 1791-1808. 4. Jecmenica-Lukic M, Poewe W, Tolosa E, Wenning GK. Premotor signs and symptoms of multiple system atrophy. Lancet Neurol 2012; 11:361-8. 5. Gilman S, Wenning GK, Low PA, et al. Second consensus statement on the diagnosis of multiple system atrophy. Neurology 2008; 71: 670-6.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/msa-preliminary-panamerican-report/