Decision-making trends in therapeutic interventions for multiple system atrophy: a 24-year retrospective study.

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY Movement Disorders Clinical Practice Pub Date : 2025-06-01 Epub Date: 2025-02-14 DOI:10.1002/mdc3.70000

Katsuya Nishida, Kento Sakashita, Naonobu Futamura

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Abstract

Background: Managing multiple system atrophy (MSA) is challenging. While invasive interventions for amyotrophic lateral sclerosis are well-studied, those for MSA remain less explored.

Objectives: To explore factors influencing treatment choices and trends in advanced-stage MSA.

Methods: A retrospective cohort study analyzed 128 MSA patients at Hyogo Chuo National Hospital, Japan, from 2000 to 2024, focusing on treatment period and age at onset.

Results: Tracheostomy invasive ventilation (TIV) decreased after 2014 (26.9% vs. 9.2%; P = 0.023). TIV-treated patients remained similarly young before and after 2014 (age at onset 52.7 vs. 54.5 years; P = 0.659) and tracheostomy was chosen by younger patients after 2014 (58.3 vs. 51.5 years; P < 0.001). Conversely, enteral nutrition increased in older patients (57.4 vs. 62.9 years; P = 0.011).

Conclusions: In Japanese MSA, preferences for invasive treatments shifted, with younger patients favoring TIV and tracheostomy, while older patients preferred less invasive options, emphasizing personalized care.

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多系统萎缩治疗干预的决策趋势：一项24年回顾性研究。

背景：多系统萎缩（MSA）的管理具有挑战性。虽然对肌萎缩性侧索硬化症的侵入性干预研究得很好，但对MSA的干预研究还很少。目的：探讨影响晚期MSA治疗选择的因素及趋势。方法：回顾性队列研究，分析2000年至2024年在日本兵库县中央国立医院就诊的128例MSA患者的治疗时间和发病年龄。结果：2014年后气管造口术有创通气（TIV）减少(26.9% vs. 9.2%；p = 0.023)。2014年前后，接受tivo治疗的患者保持年轻(发病年龄52.7岁vs. 54.5岁；P = 0.659)， 2014年以后年轻患者选择气管切开术(58.3 vs. 51.5；结论：在日本MSA中，对侵入性治疗的偏好发生了变化，年轻患者倾向于TIV和气管切开术，而老年患者倾向于侵入性较小的选择，强调个性化护理。

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来源期刊

Movement Disorders Clinical Practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

7.50%

发文量

218

期刊介绍： Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)