Falls in spinocerebellar ataxias: Results of the EuroSCA Fall Study.
To investigate the frequency, details, and consequences of falls in patients with autosomal dominant spinocerebellar ataxias (SCAs) and to derive specific disease-related risk factors that are associated with an increased fall frequency. Two hundred twenty-eight patients with SCA1, SCA2, SCA3, or SCA6, recruited from the EuroSCA natural history study, completed a fall questionnaire that assessed the frequency, consequences, and several details of falls in the previous 12 months. Relevant disease characteristics were retrieved from the EuroSCA registry. The database of the natural history study provided the ataxia severity scores as well as the number and nature of non-ataxia symptoms. Patients (73.6%) reported at least one fall in the preceding 12 months. There was a high rate of fall-related injuries (74%). Factors that were associated with a higher fall frequency included: disease duration, severity of ataxia, the presence of pyramidal symptoms, the total number of non-ataxia symptoms, and the genotype SCA3. Factors associated with a lower fall frequency were: the presence of extrapyramidal symptoms (more specifically dystonia of the lower limbs) and the genotype SCA2. The total number of non-ataxia symptoms and longer disease duration were independently associated with a higher fall frequency in a logistic regression analysis, while the presence of extrapyramidal symptoms was independently associated with a lower fall frequency. Our findings indicate that, in addition to more obvious factors that are associated with frequent falls, such as disease duration and ataxia severity, non-ataxia manifestations in SCA play a major role in the fall etiology of these patients.
Fonteyn
Ella M R
EM
Department of Neurology, Radboud University Nijmegen Medical Centre, The Netherlands.
Schmitz-Hübsch
Tanja
T
Verstappen
Carla C
CC
Baliko
Laslo
L
Bloem
Bastiaan R
BR
Boesch
Silvia
S
Bunn
Lisa
L
Charles
Perrine
P
Dürr
Alexandra
A
Filla
Allesandro
A
Giunti
Paola
P
Globas
Christoph
C
Klockgether
Thomas
T
Melegh
Bela
B
Pandolfo
Massimo
M
De Rosa
Anna
A
Schöls
Ludger
L
Timmann
Dagmar
D
Munneke
Marten
M
Kremer
Berry P H
BP
van de Warrenburg
Bart P C
BP
D000328:Adult; D000368:Aged; D005060:Europe / Q000453:epidemiology; D005260:Female; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020754:Spinocerebellar Ataxias / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology / Q000517:prevention & control*; D011795:Surveys and Questionnaires