Emilia Gatto1, Mayela Rodríguez-Violante2, Carlos Cosentino3, Pedro Chana-Cuevas4, Marcelo Miranda5, Ellin Gallin6, Jose L Etcheverry7, Yesenia Nuñez3, Virginia Parisi8, Gabriel Persi8, Celeste Vecchi7, Ana Sanguinetti7, Alejandro Alleva9, Juliana Aparcana3, Luis Torres3, Irene Litvan10. 1. Department of Movement Disorders, Instituto Neurociencias de Buenos Aires, INEBA, Buenos Aires, Argentina Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina. 2. Instituto Nacional de Neurología y Neurocirugía, México City, Mexico. 3. Instituto Nacional de Ciencias Neurológicas, Lima, Perú 4. CETRAM, Facultad de Ciencias Médicas, Universidad de Santiagode Chile, Santiago, Chile. 5. Clínica Las Condes, Santiago, Chile. 6. Clinical Research Services and Support (OCRSS) University of Louisville, Louisville, KY, USA. 7. Department of Movement Disorders, Instituto Neurociencias de Buenos Aires, INEBA, Buenos Aires, Argentina. 8. Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina. 9. Servicio Neurología, Hospital Tornú, Buenos Aires, Argentina. 10. UC San Diego Movement Disorder Center, La Jolla, CA, USA.
Abstract
BACKGROUND: Multiple system atrophy (MSA) is an adult-onset and rapidly progressive, neurodegenerative condition that presents with autonomic dysfunction, parkinsonism, cerebellar ataxia and corticospinal deficits. Clinical, demographic and epidemiological data from different regions have provided valuable information concerning the natural history of MSA. There are no published data of Multiple System Atrophy (MSA) in Latin American countries. OBJECTIVE: To describe clinical and epidemiological data of patients with "possible" MSA from seven referral movement disorders centers from Argentina, Chile, Mexico, Peru and United States. METHODS: We conducted a retrospective, observational, cross-sectional Pan-American multicentre cohort study of MSA. RESULTS: The sample was composed of 82 females and 77 men with the diagnosis of "possible" MSA with a mean age at onset of 65 ± 10 years. 67.29% of the individuals had a MSA-P variant with a mean age at onset of 61.47 ± 10.28 years, whereas the mean age at onset in the MSA-C patients was 57.44 ± 10.58 years. Interestingly, MSA-C-was more prevalent in Non-Caucasian (50-Mestizo and 2 Asian patients) than Caucasians (51.92% vs. 20.79%, p = 0.0001). Dysautonomic symptoms were present in 95.6% of the patients, parkinsonism in 85.5%, pyramidal signs in 25.8% and depression in 48.4% of the patients. CONCLUSIONS: Our epidemiological and clinical data appears to be similar to other Western international series, however, of note, the MSA-C phenotype was predominant in Non-Caucasians, more specifically the Mestizo population. This observation opens a new path to explore. Larger prospective epidemiologic studies in Latin America may provide valuable information concerning MSA in the region.
BACKGROUND:Multiple system atrophy (MSA) is an adult-onset and rapidly progressive, neurodegenerative condition that presents with autonomic dysfunction, parkinsonism, cerebellar ataxia and corticospinal deficits. Clinical, demographic and epidemiological data from different regions have provided valuable information concerning the natural history of MSA. There are no published data of Multiple System Atrophy (MSA) in Latin American countries. OBJECTIVE: To describe clinical and epidemiological data of patients with "possible" MSA from seven referral movement disorders centers from Argentina, Chile, Mexico, Peru and United States. METHODS: We conducted a retrospective, observational, cross-sectional Pan-American multicentre cohort study of MSA. RESULTS: The sample was composed of 82 females and 77 men with the diagnosis of "possible" MSA with a mean age at onset of 65 ± 10 years. 67.29% of the individuals had a MSA-P variant with a mean age at onset of 61.47 ± 10.28 years, whereas the mean age at onset in the MSA-Cpatients was 57.44 ± 10.58 years. Interestingly, MSA-C-was more prevalent in Non-Caucasian (50-Mestizo and 2 Asian patients) than Caucasians (51.92% vs. 20.79%, p = 0.0001). Dysautonomic symptoms were present in 95.6% of the patients, parkinsonism in 85.5%, pyramidal signs in 25.8% and depression in 48.4% of the patients. CONCLUSIONS: Our epidemiological and clinical data appears to be similar to other Western international series, however, of note, the MSA-C phenotype was predominant in Non-Caucasians, more specifically the Mestizo population. This observation opens a new path to explore. Larger prospective epidemiologic studies in Latin America may provide valuable information concerning MSA in the region.
Entities:
Keywords:
Latin America; MSA; Parkinsonism; multiple system atrophy; synucleinopathies
Authors: Laura Bannach Jardim; Ali Hasan; Sheng-Han Kuo; Jonathan Javier Magaña; Marcondes França; Wilson Marques; Claudia Camejo; Luiz Carlos Santana-da-Silva; Emília Embiruçu Leão; Gisele Espíndola; Francisca Canals; Marcelo Miranda; Igor Salvatierra; Mario Cornejo-Olivas; Juan Fernandez-Ruiz; Pedro Braga-Neto; David José Dávila-Ortiz de Montellano; Luis Leonardo Flores-Lagunes; Nicolas Dupré; Bernard Brais; Fernando Regla Vargas; Clécio Godeiro; Léo Coutinho; Helio G Teive; Marcelo Kaufmann; Paula Saffie; Gabriel Vasata Furtado; Maria Luiza Saraiva-Pereira; Orlando Barsottini; José Luiz Pedroso; Roberto Rodríguez-Labrada; Luis Velázquez-Pérez; Christopher Gomez Journal: Cerebellum Date: 2022-07-07 Impact factor: 3.847