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Louise Wiblin 1 Article
Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort Study
Louise Wiblin, Rory Durcan, Brook Galna, Mark Lee, David Burn
J Mov Disord. 2019;12(3):177-183.   Published online August 9, 2019
DOI: https://doi.org/10.14802/jmd.19015
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  • 5 Citations
AbstractAbstract PDF
Objective
Multiple System Atrophy (MSA) and progressive supranuclear palsy (PSP) are rapidly progressive forms of degenerative Parkinsonism. The difficulties of diagnosing MSA and PSP in their early stages may lead to delayed referral to appropriate specialists and distress to patients, as well as delaying symptomatic treatment and participation in clinical trials. This work aimed to describe the symptoms that patients with MSA and PSP developed and plot their emergence relative to final diagnosis using a median onset in months.
Methods
Forty-seven patients from the United Kingdom with MSA or PSP diagnosed by a movement disorder specialist were interviewed with carers or relatives to establish milestone onset. This was corroborated using clinical notes and letters.
Results
In the MSA cohort (n = 23), autonomic symptoms (median 5.5 months before diagnosis) and falls (median 1 month before diagnosis) were the two clinical milestones which occurred before diagnosis. In the PSP cohort (n = 24), falling was the only milestone which occurred before diagnosis (median of 18.5 months).
Conclusion
This Study Shows That Psp Patients Experience Falling More Than A Year And A Half An Average Before Receiving A Diagnosis And Although Msa Patients Also Tended To Fall, This Was Much Closer To The Time Of Diagnosis. Further Work With Larger Cohorts May Illustrate Whether These Preliminary Findings Can Be Generalised To Guide Diagnosis And Management.

Citations

Citations to this article as recorded by  
  • Clinical milestones as triggers for palliative care intervention in progressive Supranuclear palsy and multiple system atrophy
    Robin Bessemer, Alla Iansavichene, Mary E. Jenkins, Elizabeth Finger, Teneille E. Gofton
    Journal of the Neurological Sciences.2023; 448: 120614.     CrossRef
  • Toward More Accessible Fully Automated 3D Volumetric MRI Decision Trees for the Differential Diagnosis of Multiple System Atrophy, Related Disorders, and Age-Matched Healthy Subjects
    Jisoo Kim, Geoffrey S. Young, Andrew S. Willett, Ariana T. Pitaro, Grace F. Crotty, Merlyne Mesidor, Kristie A. Jones, Camden Bay, Min Zhang, Mel B. Feany, Xiaoyin Xu, Lei Qin, Vikram Khurana
    The Cerebellum.2022; 22(6): 1098.     CrossRef
  • Disease course and treatment patterns in progressive supranuclear palsy: A real-world study
    John C. Morgan, Xiaolan Ye, Jennifer A. Mellor, Keisha J. Golden, Jorge Zamudio, Louis A. Chiodo, Yanjun Bao, Tao Xie
    Journal of the Neurological Sciences.2021; 421: 117293.     CrossRef
  • Patient and care partner views on exercise and structured physical activity for people with Progressive Supranuclear Palsy
    Susan C. Slade, Christopher Bruce, Jennifer L. McGinley, Bastiaan R. Bloem, Meg E. Morris, John Duda
    PLOS ONE.2020; 15(6): e0234265.     CrossRef
  • Effect of cold oral stimulation on orthostatic hypotension in multiple system atrophy: a case study
    Hironobu Uzawa, Shinta Takeuchi, Yusuke Nishida
    Journal of Physical Therapy Science.2020; 32(7): 473.     CrossRef

JMD : Journal of Movement Disorders