Observational studyJournal of neurology2020
Cardiovascular autonomic testing in the work-up of cerebellar ataxia: insight from an observational single center study.
Observational study in Journal of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- A Review on the Clinical Diagnosis of Multiple System Atrophy.Cerebellum (London, England) · 2023Review
- The role of cardiovascular autonomic failure in the differential diagnosis of α-synucleinopathies.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Review
- Female sexual dysfunction in multiple system atrophy: a prospective cohort study.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021Article
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Authors and funding
9 authors.
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Abstract
backgroundCerebellar ataxias are a heterogeneous group of disorders of both genetic and non-genetic origin. In sporadic cases, two entities are recognized: multiple system atrophy of cerebellar type (MSA-C) and SAOA (sporadic adult-onset ataxia). The presence of severe cardiovascular autonomic failure reliably distinguishes MSA-C from other ataxias, but it may appear only late in the disease course.
objectiveTo evaluate the diagnostic yield of cardiovascular autonomic function tests in the work-up of cerebellar ataxia.
methodsWe applied a cardiovascular autonomic tests battery in consecutive patients with neurodegenerative cerebellar ataxia and matched healthy controls. We recorded the presence of both orthostatic hypotension (OH) and blood pressure falls non-fulfilling the criteria of OH (non-OH BP). Sporadic cases were followed-up for an eventual conversion to MSA-C.
resultsForty-two patients were recruited, 19 of whom with sporadic disease (2 probable MSA-C, 6 possible MSA-C, 11 SAOA). Sporadic and hereditary cases showed no difference concerning ataxia severity at baseline. At head-up tilt, non-OH BP falls were detected in nine patients, but not in controls. This finding was significantly more frequent in sporadic cases (p = 0.006) and was detected in five out of seven patients that during follow-up converted to possible/probable MSA-C. Findings at standing test were normal in four out of nine cases with non-OH BP falls at head-up tilt.
conclusionsA complete cardiovascular autonomic battery with head-up tilt can detect early signs of BP dysregulation which may be missed at bed-side tests, thus warranting its application in the first line work-up of cerebellar ataxias.
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