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

• Autores: Pavy-Le Traon, A.; Piedvache, A.; Pérez Lloret, Santiago; Calandra-Buonaura, G.; Cochen De Cock, Valérie; Colosimo, C.; Cortelli, P.; Debs, R.; Duerr, S.; Fanciulli, A.; Foubert Samier, Alexandra; Gerdelat, A.; Gurevich, T.; Krismer, F.; Poewe, W.; Tison, F.; Tranchant, C.; Wenning, G.; Rascol, O.; Meissner, W. G.
• Año de publicación: 2016
• Idioma: inglés
• Tipo de recurso: artículo
• Fuente: Journal of Neurology, Neurosurgery and Psychiatry. 2016, 87(5)
• Materia: COMORBILIDAD; TRASTORNOS DEL MOVIMIENTO; ATROFIA MULTISISTÉMICA; HIPOTENSION ORTOSTATICA
• Institución: Pontificia Universidad Católica Argentina

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, Valérie. University Hospital of Toulouse. French Reference Center for MSA. Neurology Department; Francia
Fil: Cochen De Cock, Valérie. 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.