Clinical characteristics and quality of life in Chinese patients with multiple system atrophy

Abstract

ObjectivesMultiple system atrophy (MSA) is a progressive neurodegenerative disorder that causes early sustained disability and poor health‐related quality of life (HrQoL). The clinical features and their effects on the HrQoL of patients in China have received little attention in the research literature. We evaluated the clinical characteristics and HrQoL of Chinese patients with MSA.Materials and MethodsA total of 143 patients with MSA from the Department of Neurology, Shanghai Ruijin Hospital, were enrolled in the study from March 2014 to May 2017. Basic demographic data, motor symptoms, non‐motor symptoms, and HrQoL were assessed and compared with data from 198 patients with idiopathic Parkinson's disease (PD) who were matched by age, gender, and disease duration. Factors influencing the HrQoL of MSA patients were also analyzed.ResultsThe ratio of patients with predominant parkinsonism (MSA‐P) and prominent cerebellar ataxia (MSA‐C) was 95:48 among the 143 MSA patients. MSA‐P patients had a longer disease duration (p = 0.002), higher levodopa equivalent daily dose (p < 0.001), higher scores on the Unified Multiple System Atrophy Rating Scale (UMSARS) I (p = 0.026), UMSARS II (p < 0.001), UMSARS IV (p = 0.019), the Hamilton Rating Scale for Depression (p = 0.001), the Hamilton Anxiety Scale (p = 0.013), and lower scores on measures of olfaction (p = 0.021) and cognitive function (p = 0.044) than the MSA‐C patients. Stepwise regression analysis showed that depression, anxiety, degree of disability, and disease severity were independent predictors of decreased HrQoL.ConclusionsThe results indicate that MSA‐P patients have more severe motor impairment, hyposmia, depression, anxiety, cognitive impairment, and lower HrQoL than MSA‐C patients. Depression, anxiety, degree of disability, and disease severity are predictors of poor HrQoL among Chinese patients with MSA.

Health-related quality of life in multiple system atrophy using EQ-5D-5L: a large cross-sectional study in China

“…[3,4,26,27] In our study, the depressive emotion was related to the EQ-VAS score of MSA-C. We also found that anxiety played an important role in the decreasing EQ-VAS score of MSA. [3] Attempts to treat these symptoms are important to improve the HRQoL of patients with MSA. Similar to the result of the previous study, we found that female sex was a negative determinant of health utility values of MSA.…”

“…[3][4][5]10] These studies found that the most frequently affected dimensions in MSA were mobility, self-care, and usual activities. [3][4][5]10] Besides the severity of the disease [4][5][6]11], some studies found that depression was the determinant of HRQoL of MSA. [3,5] No study on QoL of MSA evaluated by using EQ-5D-5L was available.…”

“…In addition, non-motor symptoms such as depression, anxiety, and autonomic de cit have a negative impact on the patients' lives and lead to a heavy disease burden. [2][3][4][5] Patients with MSA were reported to have a poorer health-related quality of life (HRQoL) than healthy controls and patients with Parkinson's disease (PD). [5,6] Compared to the common scale such as Parkinson's disease Questionnaire-39 item version (PDQ-39) which was used to measure the quality of life (QoL) of PD patients, the common symptoms of autonomic and cerebellar in MSA were not adequately re ected by PDQ-39.…”

“…[9] However, there were only a few studies focused on the HRQoL of MSA by using EQ-5D-3L. [3][4][5]10] These studies found that the most frequently affected dimensions in MSA were mobility, self-care, and usual activities. [3][4][5]10] Besides the severity of the disease [4][5][6]11], some studies found that depression was the determinant of HRQoL of MSA.…”

“…[3][4][5]10] Besides the severity of the disease [4][5][6]11], some studies found that depression was the determinant of HRQoL of MSA. [3,5] No study on QoL of MSA evaluated by using EQ-5D-5L was available. Moreover, there was no study focused on the impact of non-motor symptoms measuring by comprehensive assessment scales on the QoL evaluated by using EQ-5D-5L in MSA.…”