New insights into orthostatic hypotension in multiple system atrophy: a European multicentre cohort study

Autor: O. Rascol, Werner Poewe, Susanne Duerr, Wassilios G. Meissner, Rachel Debs, A Piedvache, V Cochen-De Cock, Tanya Gurevich, Alexandra Foubert-Samier, Florian Krismer, Alessandra Fanciulli, A. Pavy-Le Traon, Christine Tranchant, Gregor K. Wenning, Santiago Perez-Lloret, Giovanna Calandra-Buonaura, Cesare Colosimo, Angélique Gerdelat, François Tison, Pietro Cortelli
Přispěvatelé: Pavy-Le Traon, A, Piedvache, A, Perez-Lloret, S, Calandra-Buonaura, G, Cochen-De Cock, V, Colosimo, C, Cortelli, P, Debs, R, Duerr, S, Fanciulli, A, Foubert-Samier, A, Gerdelat, A, Gurevich, T, Krismer, F, Poewe, W, Tison, F, Tranchant, C, Wenning, G, Rascol, O, Meissner, W G., European MSA Study Group.
Rok vydání: 2014
Předmět:
Male
medicine.medical_specialty
Ataxia
Supine hypertension
TRASTORNOS DEL MOVIMIENTO
Comorbidity
030204 cardiovascular system & hematology
Gastroenterology
MULTISYSTEM ATROPHY
Cohort Studies
03 medical and health sciences
Orthostatic vital signs
Hypotension
Orthostatic
0302 clinical medicine
Atrophy
stomatognathic system
Internal medicine
parasitic diseases
mental disorders
medicine
ATROFIA MULTISISTÉMICA
Humans
Pure autonomic failure
COMORBILIDAD
Cerebellar ataxia
business.industry
Parkinsonism
Blood Pressure Determination
Middle Aged
Multiple System Atrophy
AUTONOMIC
medicine.disease
MOVEMENT DISORDERS
nervous system diseases
Europe
Psychiatry and Mental health
Blood pressure
nervous system
Physical therapy
Surgery
Female
HIPOTENSION ORTOSTATICA
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Zdroj: Journal of Neurology, Neurosurgery and Psychiatry. 2016, 87(5)
Repositorio Institucional (UCA)
Pontificia Universidad Católica Argentina
instacron:UCA
ISSN: 1468-330X
Popis: Fil: Pavy-Le Traon, A. University Hospital of Toulouse. French Reference Center for MSA. Neurology Department; Francia Fil: Pavy-Le Traon, A. Unité Institut national de la santé et de la recherche médicale U; Francia Fil: Piedvache, A. Paul Sabatier University. Faculty of Mathematics; Francia Fil: Pérez Lloret, Santiago. University of Toulouse. University Hospital of Toulouse. Clinical Investigation Center CIC. Department of Clinical Pharmacology; Francia Fil: Pérez Lloret, Santiago. Institut national de la santé et de la recherche médicale; Francia Fil: Pérez Lloret, Santiago. Pontificia Universidad Católica Argentina. Facultad de Ciencias Médicas. Instituto de Investigaciones Biomédicas; Argentina Fil: Pérez Lloret, Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Calandra-Buonaura, G. Università di Bologna; Italia Fil: Calandra-Buonaura, G. Istituto delle Scienze Neurologiche di Bologna; Italia Fil: Cochen-De Cock, V. University Hospital of Toulouse. French Reference Center for MSA. Neurology Department; Francia Fil: Cochen-De Cock, V. University of Montpellier; Francia Fil: Colosimo, C. Sapienza Università di Roma. Dipartimento di Neurologia e Psichiatria; Italia Fil: Cortelli, P. Università di Bologna; Italia Fil: Cortelli, P. Istituto delle Scienze Neurologiche di Bologna; Italia Fil: Debs, R. University Hospital of Toulouse. French Reference Center for MSA. Neurology Department; Francia Fil: Debs, R. Medical University. Department of Neurology; Austria Fil: Fanciulli, A. Medical University. Department of Neurology; Austria Fil: Foubert-Samier, A. CHU de Bordeaux. Centre de référence atrophie multisystématisée; Francia Fil: Foubert-Samier, A. CHU de Bordeaux. Service de Neurologie; Francia Fil: Foubert-Samier, A. Université de Bordeaux. Institut des Maladies Neurodégénératives; Francia Fil: Gerdelat, A. University Hospital of Toulouse. French Reference Center for MSA. Neurology Department; Francia Fil: Gurevich, T. Tel-Aviv University. Sourasky Medical Center. Department of Neurology. Movement Disorders Unit; Israel Fil: Krismer, F. Medical University. Department of Neurology; Austria Fil: Poewe, W. Medical University. Division of Neurobiology; Austria Fil: Tison, F. CHU de Bordeaux. Centre de référence atrophie multisystématisée; Francia Fil: Tison, F. CHU de Bordeaux. Service de Neurologie; Francia Fil: Tison, F. Université de Bordeaux. Institut des Maladies Neurodégénératives; Francia Fil: Tranchant, C. University Hospital Hautepierre. Neurology Department; Francia Fil: Wenning, G. Medical University. Department of Neurology; Austria Fil: Wenning, G. Medical University. Division of Neurobiology; Austria Fil: Rascol, O. University Hospital of Toulouse. French Reference Center for MSA. Neurology Department; Francia Fil: Rascol, O. University of Toulouse. University Hospital of Toulouse. Clinical Investigation Center CIC. Department of Clinical Pharmacology; Francia Fil: Rascol, O. Institut national de la santé et de la recherche médicale; Francia Fil: Meissner, W. G. CHU de Bordeaux. Centre de référence atrophie multisystématisée; Francia Fil: Meissner, W. G. CHU de Bordeaux. Service de Neurologie; Francia Fil: Meissner, W. G. Université de Bordeaux. Institut des Maladies Neurodégénératives; Francia Abstract: Objectives Orthostatic hypotension (OH) is a key feature of multiple system atrophy (MSA), a fatal progressive neurodegenerative disorder associated with autonomic failure, parkinsonism and ataxia. This study aims (1) to determine the clinical spectrum of OH in a large European cohort of patients with MSA and (2) to investigate whether a prolonged postural challenge increases the sensitivity to detect OH in MSA. Methods: Assessment of OH during a 10 min orthostatic test in 349 patients with MSA from seven centres of the European MSA-Study Group (age: 63.6±8.8 years; disease duration: 4.2±2.6 years). Assessment of a possible relationship between OH and MSA subtype (P with predominant parkinsonism or C with predominant cerebellar ataxia), Unified MSA Rating Scale (UMSARS) scores and drug intake. Results: 187 patients (54%) had moderate (>20 mm Hg (systolic blood pressure (SBP)) and/or >10 mm Hg (diastolic blood pressure (DBP)) or severe OH (>30 mm Hg (SBP) and/or >15 mm Hg (DBP)) within 3 min and 250 patients (72%) within 10 min. OH magnitude was significantly associated with disease severity (UMSARS I, II and IV), orthostatic symptoms (UMSARS I) and supine hypertension. OH severity was not associated with MSA subtype. Drug intake did not differ according to OH magnitude except for antihypertensive drugs being less frequently, and antihypotensive drugs more frequently, prescribed in severe OH. Conclusions: This is the largest study of OH in patients with MSA. Our data suggest that the sensitivity to pick up OH increases substantially by a prolonged 10 min orthostatic challenge. These results will help to improve OH management and the design of future clinical trials.
Databáze: OpenAIRE
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