ArticleJournal of neurology2025
Early onset sleep disorders predict severity, progression and death in multiple system atrophy.
Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Sleep-Autonomic Interactions in Parkinson's Disease and Multiple System Atrophy: A Comparative Study Using Structural Equation Modeling.Movement disorders clinical practice · 2026Article
- Elevated plasma neurofilament light chain in isolated REM sleep behavior disorder: Associations with neurogenic orthostatic hypotension and implications for phenoconversion.Journal of Parkinson's disease · 2026Article
- Stridor Is an Independent Risk Factor for Mortality and Disease Progression in Patients with Multiple System Atrophy.Movement disorders : official journal of the Movement Disorder Society · 2026Article
- Predictive clinical factors for the progression from idiopathic late-onset cerebellar ataxia to multiple system atrophy cerebellar type.Journal of neurology · 2025Article
- Automated EEG-based sleep staging in REM sleep behavior disorder using MSIF-Net: epoch-level validation and whole-night clinical agreement.Frontiers in neurologyArticle
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Authors and funding
11 authors.
Funding
Abstract
backgroundEarly stridor onset (≤ 3 years from disease onset) is a predictor of shorter survival in Multiple System Atrophy (MSA), but its role on disease progression is not yet established. In MSA, previous studies on trajectories of disease did not include stridor and REM sleep behavior disorder (RBD) as clinical variable. The aims of the study were: (1) to investigate disease progression in MSA patients with early stridor onset and with early stridor and/or RBD onset; (2) to assess cerebrospinal fluid (CSF) levels of neurofilament light chain protein (NfL) in MSA patients with early onset sleep disorders.
methodsThis is a retrospective and prospective cohort study including 208 (120 males) MSA patients. Occurrence of symptoms/signs, milestones of disease progression, and their latency from disease onset were collected. RBD and stridor were video-polysomnography (VPSG)-confirmed. CSF NfL levels were analyzed. Survival data and predictors of mortality were calculated.
resultsOut of 208 MSA patients (157 deceased), 91 were diagnosed with stridor and 160 with VPSG-confirmed RBD. Patients with early stridor onset (n = 41) and with early stridor and/or RBD onset (n = 132) showed an early autonomic involvement, developed a more progressive and severe disease and presented higher CSF NfL than those with late stridor and RBD onset. Early stridor and early RBD were independent risk factors on MSA survival.
conclusionsThe evidence of a more rapid and severe disease progression and of high CSF NfL levels in patients who early developed sleep disorders could define a different MSA phenotype with a widespread impairment of central-brainstem circuits.
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