Multiple system atrophy

Wenning, Gregor K.; Colosimo, Carlo; Geser, Felix; Poewe, Werner

doi:10.1016/s1474-4422(03)00662-8

Cited by 421 publications

(284 citation statements)

References 125 publications

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“…Consequently, the marked reduction in [ 123 I]β-CIT uptake detected in the dorsal and ventral midbrain of the MSA-P patients compared to the PD patients at both time points suggests neurodegeneration of serotonergic neurons relatively early in the disease course of MSA-P, although additional effects of dopaminergic or adrenergic denervation cannot be excluded. Indeed, neuropathological studies in MSA-P patients have shown neuronal loss in brainstem areas containing neurons bearing DAT, SERT or noradrenergic transporters such as the substantia nigra, the locus coeruleus and the raphe nuclei [2,[40][41][42]. Although group analysis revealed highly significant signal reductions in the midbrain of MSA-P patients when compared to the PD patients and the control subjects, the exact signal changes were likely to have been slightly underestimated, due to partial volume effects affecting particularly the quantification of signals in structures smaller than twice the FWHM resolution of the scanner.…”

Section: Discussionmentioning

confidence: 99%

Progression of dopamine transporter decline in patients with the Parkinson variant of multiple system atrophy: a voxel-based analysis of [123I]β-CIT SPECT

Nocker

Seppi

Donnemiller

et al. 2012

Eur J Nucl Med Mol Imaging

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In contrast to PD, the relatively higher rate of signal reduction in the caudate and anterior putamen is consistent with the faster disease progression reported in MSA-P. At baseline, the tracer uptake in the brainstem was already at very low levels in the MSA-P patients compared to that in healthy control subjects and did not progress any further, suggesting that the degeneration of monoaminergic neurons is almost complete early in the disease course.

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Section: Discussionmentioning

confidence: 99%

Progression of dopamine transporter decline in patients with the Parkinson variant of multiple system atrophy: a voxel-based analysis of [123I]β-CIT SPECT

Nocker

Seppi

Donnemiller

et al. 2012

Eur J Nucl Med Mol Imaging

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“…Both MSA and PD are currently classified as alpha-synucleinopathies and both share some parkinsonian signs, but with different intensity, location and outcome, as well as different is the distribution of brain lesions in each disorder (Wenning et al, 2003). Despite some common elements, there are several differences between the two entities: MSA is a rare disease; MSA age of onset is earlier; outcome progresses faster in MSA; parkinsonism is less asymmetrical in MSA; tremor at rest is rare in MSA and frequent in PD; postural stability is compromised early in MSA unlike PD; hallucinations are practically inexistent in MSA, but occur with relative frequency in PD dementia; pyramidal and cerebellar signs occur in MSA, but not in the PD dementia; neuropsychological changes are milder (or even absent in the early stages) and the presence of dementia speaks against the possibility of MSA; symptoms such as orofacial dystonia, stridor and REM sleep behavior disorder are more common in MSA; poor response to levodopa in MSA; presence of oligodendroglial inclusions in neuropathology of MSA, but not in PD dementia (Wenning et al, 2004).…”

Section: Pd Dementia X Multiple System Atrophy (Msa)mentioning

confidence: 99%

Dementia in Parkinson's Disease: A Clinical Review

Vieira¹,

Caixeta²,

Machado³

et al. 2011

American Journal of Neuroscience

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Problem statement: Idiopathic Parkinson's Disease (PD) has being increasingly seen as a neuropsychiatric entity and no longer purely neurological, given the frequency and exuberance with which the psychiatric manifestations occurs. Approach: This review will focus on the epidemiology, clinical aspects, differential diagnosis with Alzheimer's Disease (AD) associated with parkinsonism, Dementia with Lewy Bodies (LBD), Progressive Supranuclear Palsy (PSP), Corticobasal Degeneration (CBD), Multiple System Atrophy (MSA), Vascular Parkinsonism and normal pressure hydrocephalus (NPN), underlying mechanisms and treatment of dementia in PD. A literature review of the studies that investigated the dementia in PD was performed. Results: The dementia in PD has being increasingly recognized as a distinct nosological entity. Although specific etiologies for cognitive impairment remain unknown, a symptomatic treatment has been approved and strategies for early intervention are envisioned. Conclusion: Larger scale, placebo controlled clinical trials are needed to be explored in future studies to provide an evidence base to guide the management in dementia associated with PD.

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“…Die Multisystematrophie (MSA) zählt wie der MP und die Lewy-Körper-Demenz zu den Synukleinopathien mit pathologischer Ablagerung von α-Synuclein in Nervenzellen verschiedener Regionen des ZNS [70]. Die damit einhergehende Degeneration von Nervenzellen führt zu einem progredientem Ausfall verschiedener Körperfunktionen.…”

Section: Multisystematrophieunclassified

“…Die Erkrankung beginnt meist im 6. Lebensjahrzehnt und führt im Mittel innerhalb von 6-9 Jahren zum Tod [70]. MSA tritt meist sporadisch auf, was den Einfluss eines Umweltfaktors wahrscheinlich macht.…”

Section: Multisystematrophieunclassified

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Neurourologische Funktionsstörungen des unteren Harntraktes bei Erkrankungen des ZNS

Mehnert

Nehiba

2012

Urologe

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The lower urinary tract (LUT) is regulated by a complex neural network that is subject to supraspinal control. Neurological disorders, especially of the central nervous system (CNS), can rapidly lead to disruption of this control. Multiple sclerosis, Parkinson's disease, multiple system atrophy, and stroke are neurological disorders which quite frequently cause dysfunction of the LUT. With respect to the pathophysiology of bladder dysfunction in CNS diseases there are various hypotheses regarding the individual disorders: disturbances of neural communication between the frontal cortex and pontine micturition center, between the pontine micturition center and the lumbosacral parts of the spinal cord, and between the basal ganglia, thalamus, and anterior cingulate gyrus appear to play a pivotal role in the development of bladder dysfunction. The symptoms and urodynamic presentation of LUT dysfunction can vary considerably depending on the disease and disease progression and can change in the course of the disease. The incidence and prevalence of LUT dysfunctions rise with increasing progression of the underlying neurological disease.Various conservative, minimally invasive, and open surgical procedures are available to prevent harmful sequelae and to improve the quality of life of these patients. As yet, however, few data exist on most of the treatment options in cases of the above-mentioned CNS diseases. Intermittent self-catheterization and antimuscarinic medications are among the most important conservative treatment options. Injection of botulinum neurotoxin type A into the detrusor muscle and increasingly sacral or pudendal neuromodulation are among the most important minimally invasive treatment options. Surgical methods include reconstructive continent or incontinent urinary diversion.When planning therapy the patient's current needs and neurological limitations as well as possible disease progression must be taken into consideration. It is often advisable to consult with and enlist the cooperation of the attending neurologist when planning treatment.

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Multiple system atrophy

Cited by 421 publications

References 125 publications

Progression of dopamine transporter decline in patients with the Parkinson variant of multiple system atrophy: a voxel-based analysis of [123I]β-CIT SPECT

Progression of dopamine transporter decline in patients with the Parkinson variant of multiple system atrophy: a voxel-based analysis of [123I]β-CIT SPECT

Dementia in Parkinson's Disease: A Clinical Review

Neurourologische Funktionsstörungen des unteren Harntraktes bei Erkrankungen des ZNS

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