ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2018
First symptoms in multiple system atrophy.
Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- A strategic approach of the management of sleep-disordered breathing in multiple system atrophy.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Pooled it
- A Systematic Review of the Spectrum and Prevalence of Non-motor Symptoms in Multiple System Atrophy.Cerebellum (London, England) · 2024Pooled it
- Gut microbiome dysbiosis, short-chain fatty acid depletion and implications for neuroinflammation in atypical parkinsonian syndromes - a systematic review of patient cohorts.Journal of Parkinson's disease · 2026Review
- Natural history and 12-month progression of multiple system atrophy in a Chinese cohort.BMC neurology · 2026Observational
- Diagnostic symptoms, treatment patterns, and healthcare resource utilization in multiple system atrophy in the United States.Neurodegenerative disease management · 2026Article
- Smoking and the risk of neurodegenerative diseases in a Chinese case-control study.BMJ neurology open · 2026Article
- Video Urodynamic Study in Patients with Parkinson's Disease and Multiple System Atrophy.Movement disorders clinical practice · 2026Article
- Self-testing for symptoms and signs of prodromal alpha-synucleinopathies: results from the Tasmanian ISLAND Sleep Study.GeroScience · 2025Article
- Neurodegeneration as Ecosystem Failure: A New Paradigm for Prevention and Treatment.International journal of molecular sciences · 2025Review
- Research progress of chronic fatigue in neurodegenerative diseases.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Validation of Monocular Pupillometry in Healthy Controls and Patients With Autonomic Dysfunction: Pupillary Biomarkers for Autonomic Failure.European journal of neurology · 2025Article
- The Inferior Cerebellar Peduncle Sign: A Novel Imaging Marker for Differentiating Multiple System Atrophy Cerebellar Type from Spinocerebellar Ataxia.AJNR. American journal of neuroradiology · 2025Article
- Multiple system atrophy related neurogenic bladder: mechanism and treatment.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Parkinson's Spectrum Mechanisms in Pregnancy: Exploring Hypothetical Scenarios for MSA in the Era of ART.International journal of molecular sciences · 2025Review
- Neurofilament Light Chain in Cerebrospinal Fluid and Blood in Multiple System Atrophy: A Systematic Review and Meta-Analysis.Brain sciences · 2025Review
- A simple and effective screening strategy for early multiple system atrophy diagnosis and α-Synuclein forms in erythrocytes.Frontiers in aging neuroscience · 2025Article
- Current Perspectives on Olfactory Loss in Atypical Parkinsonisms-A Review Article.Biomedicines · 2024Review
- Epidemiologic and clinical features of multisystem atrophy: a population-based study in Navarre, Spain.Journal of neurology · 2024Observational
- Article
- Imaging Markers of Multiple System Atrophy and Their Association With Disease Severity: A Cross-Sectional Study.Cureus · 2024Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
purposeThe initial symptoms of multiple system atrophy (MSA) and, in particular, early autonomic symptoms, have received less attention than motor symptoms. Whereas pathognomonic motor signs are essential to diagnostic specificity, early symptoms important to recognition of a neurodegenerative disorder may be less apparent or diagnostically ambiguous. This observational study sought to identify the very earliest symptoms in the natural history of MSA.
methodsDetailed clinical histories focusing on early symptoms were obtained from 30 subjects recently diagnosed with MSA. Historical data were correlated with neurological examinations and laboratory autonomic testing.
resultsSubjects' mean age was 63.9 years. Ten were classified as having MSA-P and 20 MSA-C. The evaluations occurred 2.9 ± 0.4 months after diagnosis. The first symptom of MSA was autonomic in 22 (73%) and motor in 3 (10%) subjects (p < 0.0001). The most frequent first symptom was erectile failure, which occurred in all men beginning 4.2 ± 2.6 years prior to diagnosis. After erectile failure, postural lightheadness or fatigue following exercise, urinary urgency or hesitancy, and violent dream enactment behavior consistent with REM behavioral sleep disorder were the most frequent initial symptoms. Neither the order of symptom progression, which was highly variable, nor autonomic severity scores differentiated between MSA-P and MSA-C.
conclusionsThe first symptoms of MSA are frequently autonomic and may predate recognition of motor manifestations. Orthostatic hypotension and, in men, erectile failure are among the first symptoms that, when evaluated in the context of associated clinical findings, may facilitate accurate and earlier diagnosis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.