Orthostatic Hypotension Is Differentially Associated with the Cerebellar Versus the Parkinsonian Variant of Multiple System Atrophy: a Comparative Study
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Orthostatic hypotension (OH) is a cardinal feature of autonomic failure in multiple system atrophy (MSA); however, there are few comparative data on OH in the motor subtypes of MSA. In the present retrospective study, postural blood pressure drop after 3 min of standing was determined in 16 patients with the cerebellar variant of MSA (MSA-C) and in 17 patients with the Parkinson variant (MSA-P). Twenty idiopathic Parkinson’s disease (IPD) patients matched for age, sex, disease duration and dopaminergic therapy served as control group. OH frequency and severity were more pronounced in MSA-C followed by MSA-P and IPD. Differences in brainstem pathology are likely to account for the tight association of MSA-C and OH. A simple standing test should be obligatory in the work-up of patients with sporadic late-onset ataxias.
KeywordsOrthostatic hypotension Multiple system atrophy Parkinson’s disease Postural blood pressure test Autonomic failure
We thank the referring consultant neurologists at the National Hospital for Neurology and Neurosurgery, Queen Square, London.
Conflicts of Interest
Financial disclosure related to this manuscript: All authors have nothing to disclose.
Financial disclosure: Gregor K. Wenning has received research grants from the Austrian science fund (FWF), Innsbruck Medical University (MUI) and the Österreichische Nationalbank (OeNB). He also received honoraria for consultancies from AstraZeneca and TEVA. Klaus Seppi has received honoraria for speaking and consulting from Novartis, Boehringer Ingelheim, Lundbeck, Schwarz Pharma, UCB Pharma and GlaxoSmithKline. Florian Krismer was supported by a research grant from österreichische Nationalbank (OeNB). Werner Poewe has received consultancy and lecture fees from AstraZeneca, Teva, Novartis, GSK, Boehringer Ingelheim, UCB, Orion Pharma and Merck Serono in relation to clinical drug development programmes for PD. Roberta Granata, Susanne Dürr, Katharine Bleasdale-Barr and Christopher J. Mathias have nothing to disclose.
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