Yasuo Terao1, Hideki Fukuda2, Shinnichi Tokushige3, Satomi Inomata-Terada3, Akihiro Yugeta3, Masashi Hamada3, Yaeko Ichikawa4, Ritsuko Hanajima5, Yoshikazu Ugawa6. 1. Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. Electronic address: yterao-tky@umin.ac.jp. 2. Neurological Clinic for Children, Japan. 3. Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. 4. Department of Neurology, Kyorin University, Japan. 5. Department of Neurology, School of Medicine, Kitasato University, Japan. 6. Department of Neurology, School of Medicine, Fukushima Medical University, Japan.
Abstract
OBJECTIVE: Patients with multiple system atrophy (MSA) are classified into those mainly manifesting cerebellar ataxia (MSA-C) and those mainly manifesting parkinsonism (MSA-P). Pathophysiological bases of these subtypes remain unclear. We hypothesized that MSA-C patients would resemble spinocerebellar degeneration patients and MSA-P patients would resemble Parkinson's disease (PD) patients in saccade abnormalities. METHODS: We recorded visually guided and memory guided saccades (MGS) in 27 MSA-C and 15 MSA-P patients, as well as 50 age-matched normal subjects, 14 spinocerebellar degeneration patients showing pure cerebellar symptoms (SCD) and 61 Parkinson's disease (PD) patients. RESULTS: Saccade parameters of both tasks showed similar changes with progressing disease in SCD and MSA-C patients, as did those of MSA-C and MSA-P patients, although hypometria was slightly more pronounced in MSA-P. In both subtypes of MSA, latency and success rate of MGS were stable throughout disease stages, whereas they deteriorated progressively with progressing disease in PD. CONCLUSIONS: Pathophysiology underlying MSA-C and MSA-P is similar as viewed from saccade performance. The MGS performance in MSA was preserved. However, MSA-P patients showed more marked hypometria, suggesting a mixture of basal ganglia pathophysiology. SIGNIFICANCE: The similarity of saccade performance between MSA-C and MSA-P may reflect common olivopontocerebellar pathology, while the direct pathway of the basal ganglia is relatively spared compared with PD, even in MSA-P.
OBJECTIVE:Patients with multiple system atrophy (MSA) are classified into those mainly manifesting cerebellar ataxia (MSA-C) and those mainly manifesting parkinsonism (MSA-P). Pathophysiological bases of these subtypes remain unclear. We hypothesized that MSA-C patients would resemble spinocerebellar degenerationpatients and MSA-Ppatients would resemble Parkinson's disease (PD) patients in saccade abnormalities. METHODS: We recorded visually guided and memory guided saccades (MGS) in 27 MSA-C and 15 MSA-Ppatients, as well as 50 age-matched normal subjects, 14 spinocerebellar degenerationpatients showing pure cerebellar symptoms (SCD) and 61 Parkinson's disease (PD) patients. RESULTS: Saccade parameters of both tasks showed similar changes with progressing disease in SCD and MSA-C patients, as did those of MSA-C and MSA-Ppatients, although hypometria was slightly more pronounced in MSA-P. In both subtypes of MSA, latency and success rate of MGS were stable throughout disease stages, whereas they deteriorated progressively with progressing disease in PD. CONCLUSIONS: Pathophysiology underlying MSA-C and MSA-P is similar as viewed from saccade performance. The MGS performance in MSA was preserved. However, MSA-Ppatients showed more marked hypometria, suggesting a mixture of basal ganglia pathophysiology. SIGNIFICANCE: The similarity of saccade performance between MSA-C and MSA-P may reflect common olivopontocerebellar pathology, while the direct pathway of the basal ganglia is relatively spared compared with PD, even in MSA-P.
Authors: Sarah H Brooks; Eliana M Klier; Stuart D Red; Neeti D Mehta; Saumil S Patel; Alice Z Chuang; Jessika Suescun; Mya C Schiess; Anne B Sereno Journal: Front Neurol Date: 2017-06-20 Impact factor: 4.003