Symptomatic medication of 97 patients with multiple system atrophy parkinsonian subtype: An observational study

Sarunas Augustis , Wolfgang H. Jost
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引用次数: 1

Abstract

Background

Multiple system atrophy (MSA) is a sporadic, adult-onset and rapidly progressive neurodegenerative disorder. MSA clinically is characterized by prominent autonomic dysfunction with combinations of parkinsonism (MSA-P), cerebellar ataxia (MSA-C) and possible corticospinal signs. To date no disease-modifying treatment is available. Motor symptoms of certain patients with MSA-P, however, are somewhat responsive to dopaminergic medication.

Objective

To present the analysis of symptomatic treatment options on 97 patients suffering from probable MSA-P.

Methods

A retrospective survey was conducted on 97 patients from a specialized neurological acute care hospital, all meeting appropriate published criteria of probable MSA-P. We undertook a thorough analysis on patients’ records regarding the dopaminergic drugs and amantadine.

Results

Ten patients from our study cohort received no L-dopa, in the remaining 87 patients (89.69%) the mean L-dopa daily dose was 650.93 ± 289.21 mg. Fifteen study patients received ≥1000 mg of L-dopa per day. For 31 MSA-P patients (31.96%) dopamine agonists were added as a second treatment option with pramipexole and ropinirole being the most frequently used. Further, two study patients received amantadine as an alternative medication.

Conclusions

In the study the considerable proportion of MSA-P patients received high levels of dopaminergic medication chronically. Its efficacy on MSA is still uncertain and further studies with standardised clinical efficacy monitoring are highly welcome.

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97例多系统萎缩性帕金森亚型患者的对症用药观察研究
多系统萎缩(MSA)是一种散发的、成人发病的、快速进展的神经退行性疾病。MSA临床表现为明显的自主神经功能障碍,并伴有帕金森病(MSA- p)、小脑性共济失调(MSA- c)和可能的皮质脊髓征候。到目前为止,还没有改善疾病的治疗方法。然而,某些MSA-P患者的运动症状对多巴胺能药物有一定的反应。目的分析97例疑似MSA-P患者的对症治疗方案。方法对97例神经内科急症患者进行回顾性调查,所有患者均符合公布的可能MSA-P标准。我们对患者关于多巴胺能药物和金刚烷胺的记录进行了全面的分析。结果本研究队列中有10例患者未接受左旋多巴治疗,其余87例患者(89.69%)平均日左旋多巴剂量为650.93 ± 289.21 mg。15名研究患者每天接受≥1000 mg左旋多巴。对于31例MSA-P患者(31.96%),多巴胺激动剂作为第二种治疗选择,普拉克索和罗匹尼罗是最常用的。此外,两名研究患者接受金刚烷胺作为替代药物。结论相当比例的MSA-P患者长期接受高水平的多巴胺能药物治疗。其对MSA的疗效尚不确定,值得进一步研究并进行规范化的临床疗效监测。
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