open access

Vol 53, No 1 (2019)
Research Paper
Submitted: 2018-12-06
Accepted: 2018-12-06
Published online: 2019-01-08
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Electrophysiological and clinical assessment of dysautonomia in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP): a comparative study

Monika Nojszewska1, Anna Potulska-Chromik1, Zygmunt Jamrozik1, Piotr Janik1, Beata Zakrzewska-Pniewska1
·
Pubmed: 30620042
·
Neurol Neurochir Pol 2019;53(1):26-33.
Affiliations
  1. Department of Neurology, Medical University of Warsaw, 8 Kondratowicza str, 03-242 Warsaw, Poland

open access

Vol 53, No 1 (2019)
Research papers
Submitted: 2018-12-06
Accepted: 2018-12-06
Published online: 2019-01-08

Abstract

Clinical rationale for the study. Autonomic nervous system (ANS) involvement in different parkinsonian syndromes has been frequently discussed. It is well established in multiple system atrophy (MSA), whereas it is less evident in progressive supranuclear palsy (PSP).

Aims of the study. The aims were to assess the presence and pattern of ANS involvement in MSA and PSP using noninvasive tests i.e. the sympathetic skin response (SSR) test and the R-R interval variation (RRIV) test; to analyse the relationship between clinical and electrophysiological abnormalities in both disorders; and to assess whether an autonomic profile might help to differentiate them.

Materials and methods. Clinical and electrophysiological assessments of dysautonomia were performed in 59 patients with MSA (24 cases of MSA-C and 35 cases of MSA-P), these 59 cases including 31 females, mean disease duration 4.2 ± 2.7 years, mean age 60.3 ± 8.4 years, and in 37 patients with PSP (12 females, mean disease duration 4.6 ± 3.6 years, mean age 67.5 ± 6.1 years) and the results were compared to the results obtained from 23 healthy controls matched for age and sex.

Results. Clinical dysautonomia assessed by an Autonomic Symptoms Questionnaire was observed in 97% of the MSA patients and in 84% of the PSP patients. SSR was abnormal in 64% and RRIV was abnormal in 73% of MSA cases. In PSP cases, these figures were 78% and 81% respectively. Dysautonomia was clinically more pronounced in MSA compared to PSP (p < 0.05), whereas electrophysiological testing revealed frequently subclinical ANS damage in PSP patients.

Conclusions and clinical implications. Our results point to the complementary role of electrophysiological tests in the diagnostic work-up of dysautonomia in parkinsonian syndromes.

Abstract

Clinical rationale for the study. Autonomic nervous system (ANS) involvement in different parkinsonian syndromes has been frequently discussed. It is well established in multiple system atrophy (MSA), whereas it is less evident in progressive supranuclear palsy (PSP).

Aims of the study. The aims were to assess the presence and pattern of ANS involvement in MSA and PSP using noninvasive tests i.e. the sympathetic skin response (SSR) test and the R-R interval variation (RRIV) test; to analyse the relationship between clinical and electrophysiological abnormalities in both disorders; and to assess whether an autonomic profile might help to differentiate them.

Materials and methods. Clinical and electrophysiological assessments of dysautonomia were performed in 59 patients with MSA (24 cases of MSA-C and 35 cases of MSA-P), these 59 cases including 31 females, mean disease duration 4.2 ± 2.7 years, mean age 60.3 ± 8.4 years, and in 37 patients with PSP (12 females, mean disease duration 4.6 ± 3.6 years, mean age 67.5 ± 6.1 years) and the results were compared to the results obtained from 23 healthy controls matched for age and sex.

Results. Clinical dysautonomia assessed by an Autonomic Symptoms Questionnaire was observed in 97% of the MSA patients and in 84% of the PSP patients. SSR was abnormal in 64% and RRIV was abnormal in 73% of MSA cases. In PSP cases, these figures were 78% and 81% respectively. Dysautonomia was clinically more pronounced in MSA compared to PSP (p < 0.05), whereas electrophysiological testing revealed frequently subclinical ANS damage in PSP patients.

Conclusions and clinical implications. Our results point to the complementary role of electrophysiological tests in the diagnostic work-up of dysautonomia in parkinsonian syndromes.

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Keywords

MSA, PSP, autonomic nervous system, dysautonomia, SSR, RRIV

About this article
Title

Electrophysiological and clinical assessment of dysautonomia in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP): a comparative study

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 53, No 1 (2019)

Article type

Research Paper

Pages

26-33

Published online

2019-01-08

Page views

1520

Article views/downloads

1367

DOI

10.5603/PJNNS.a2019.0005

Pubmed

30620042

Bibliographic record

Neurol Neurochir Pol 2019;53(1):26-33.

Keywords

MSA
PSP
autonomic nervous system
dysautonomia
SSR
RRIV

Authors

Monika Nojszewska
Anna Potulska-Chromik
Zygmunt Jamrozik
Piotr Janik
Beata Zakrzewska-Pniewska

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