title: Assessment of the Scopa-Aut questionnaire in multiple system atrophy: relation to UMSARS scores and progression over time.
abstract: Autonomic failure is a key feature of multiple system atrophy (MSA). Moreover, early autonomic failure is an independent predictive factor for rapid disease progression and shorter survival. The assessment of autonomic failure is therefore important for both, the diagnosis and prognosis of MSA. Here, we evaluate autonomic dysfunction in MSA patients by the Scopa-Aut questionnaire. Potential associations between the Scopa-Aut questionnaire and established markers of disease progression - that is the Unified MSA Rating Scale (UMSARS) - were further assessed. The results confirm early and prominent autonomic failure in MSA patients. Relative scores were highest for the sexual and urinary subdomains. Surprisingly, relative scores in the cardiovascular subdomain were lowest suggesting that the Scopa-Aut questionnaire is suboptimal for the screening and evaluation of cardiovascular symptoms in MSA. A multivariate regression showed an association between total Scopa-Aut and UMSARS I scores. No significant changes in Scopa-Aut scores were observed during follow-up except for the urinary subdomain, while UMSARS I, II and IV scores significantly increased over time. In conclusion, Scopa-Aut can be used as a simple auto-questionnaire for the screening of autonomic symptoms in multiple system atrophy. It seems not useful as endpoint for disease-modification or neuroprotection trials.
authors.affiliation: Service de Neurologie, CHU de Bordeaux, Pessac, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Damon-Perrière
authors.forename: Alexandra
authors.initials: A
authors.lastname: Foubert-Samier
authors.forename: Valérie Cochen
authors.initials: VC
authors.lastname: De Cock
authors.forename: Angélique
authors.initials: A
authors.lastname: Gerdelat-Mas
authors.forename: Rachel
authors.initials: R
authors.lastname: Debs
authors.forename: Anne
authors.initials: A
authors.lastname: Pavy-Le Traon
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Senard
authors.forename: Olivier
authors.initials: O
authors.lastname: Rascol
authors.forename: François
authors.initials: F
authors.lastname: Tison
authors.forename: Wassilios G
authors.initials: WG
authors.lastname: Meissner
mesh_terms: D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004185:Disability Evaluation; D015259:Dopamine Agents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000145:classification / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D012044:Regression Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D015259:Dopamine Agents