Objective: Our objective was to describe the characteristics of vocal fold motion impairments (VFMI) in MSA and to determine whether they had a diagnostic and prognostic value.

Background: Multiple system atrophy (MSA) is a neurodegenerative disorder in which vocal fold mobility can be affected sometimes leading to life-threatening situations. However, the exact nature of these VFMI remains largely unknown.

Methods: Between 2004 to 2014, all consecutive patients diagnosed with probable MSA were included in this retrospective, monocentric study. Flexible laryngoscopy was obtained in 51 MSA patients and compared with 27 patients with Parkinson’s disease (PD). Laryngeal muscles EMG was available in 6 MSA patients.

Results: Vocal fold motion impairments (VFMI) was found in 35 (68.1%) MSA patients: 15 (29.4%) had uni- or bilateral vocal fold abnormal movement (VFAM), 13 (25.5%) had uni- or bilateral vocal fold abductor paresis (VFABP), 4 (7.8%) had uni- or bilateral vocal fold adductor paresis (VFADP), 10 (19.6%) had bilateral vocal fold paralysis (BVFP). VFMI was found in 13 PD patients (48.1%) all of whom had VFADP. Presence of BVFP was found associated with stridor (p<0.001) and dysphagia (p=0.002). In all muscles examined in 6 MSA patients, the EMG showed neuropathic patterns.

Conclusions: Our data support that VFMI may be encountered in two-thirds of MSA with a variable degree of gravity. Laryngologic examination is a supplementary tool for the diagnosis and prognosis of MSA. VFMI in particular VFAM, VFABD and BVFP should be discussed as an additional possible red flag even at an early stage of MSA.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-and-characterisation-of-vocal-fold-motion-impairment-vfmi-in-patients-with-multiple-system-atrophy/