title: Pan-American Consortium of Multiple System Atrophy (PANMSA). A Pan-American multicentre cohort study of multiple system atrophy.
abstract: BACKGROUND
  Multiple system atrophy (MSA) is an adult-onset and rapidly progressive, neurodegenerative condition that presents with autonomic dysfunction, parkinsonism, cerebellar ataxia and corticospinal deficits. Clinical, demographic and epidemiological data from different regions have provided valuable information concerning the natural history of MSA. There are no published data of Multiple System Atrophy (MSA) in Latin American countries.
  
  
  OBJECTIVE
  To describe clinical and epidemiological data of patients with "possible" MSA from seven referral movement disorders centers from Argentina, Chile, Mexico, Peru and United States.
  
  
  METHODS
  We conducted a retrospective, observational, cross-sectional Pan-American multicentre cohort study of MSA.
  
  
  RESULTS
  The sample was composed of 82 females and 77 men with the diagnosis of "possible" MSA with a mean age at onset of 65 ± 10 years. 67.29% of the individuals had a MSA-P variant with a mean age at onset of 61.47 ± 10.28 years, whereas the mean age at onset in the MSA-C patients was 57.44 ± 10.58 years. Interestingly, MSA-C-was more prevalent in Non-Caucasian (50-Mestizo and 2 Asian patients) than Caucasians (51.92% vs. 20.79%, p = 0.0001). Dysautonomic symptoms were present in 95.6% of the patients, parkinsonism in 85.5%, pyramidal signs in 25.8% and depression in 48.4% of the patients.
  
  
  CONCLUSIONS
  Our epidemiological and clinical data appears to be similar to other Western international series, however, of note, the MSA-C phenotype was predominant in Non-Caucasians, more specifically the Mestizo population. This observation opens a new path to explore. Larger prospective epidemiologic studies in Latin America may provide valuable information concerning MSA in the region.
authors.affiliation: Department of Movement Disorders, Instituto Neurociencias de Buenos Aires, INEBA, Buenos Aires, Argentina Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina.
authors.forename: Emilia
authors.initials: E
authors.lastname: Gatto
authors.affiliation: Instituto Nacional de Neurología y Neurocirugía, México City, Mexico.
authors.forename: Mayela
authors.initials: M
authors.lastname: Rodríguez-Violante
authors.affiliation: Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Carlos
authors.initials: C
authors.lastname: Cosentino
authors.affiliation: CETRAM, Facultad de Ciencias Médicas, Universidad de Santiagode Chile, Santiago, Chile.
authors.forename: Pedro
authors.initials: P
authors.lastname: Chana-Cuevas
authors.affiliation: Clínica Las Condes, Santiago, Chile.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Miranda
authors.affiliation: Clinical Research Services and Support (OCRSS) University of Louisville, Louisville, KY, USA.
authors.forename: Ellin
authors.initials: E
authors.lastname: Gallin
authors.affiliation: Department of Movement Disorders, Instituto Neurociencias de Buenos Aires, INEBA, Buenos Aires, Argentina.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Etcheverry
authors.affiliation: Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Yesenia
authors.initials: Y
authors.lastname: Nuñez
authors.affiliation: Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina.
authors.forename: Virginia
authors.initials: V
authors.lastname: Parisi
authors.affiliation: Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Persi
authors.affiliation: Department of Movement Disorders, Instituto Neurociencias de Buenos Aires, INEBA, Buenos Aires, Argentina.
authors.forename: Celeste
authors.initials: C
authors.lastname: Vecchi
authors.affiliation: Department of Movement Disorders, Instituto Neurociencias de Buenos Aires, INEBA, Buenos Aires, Argentina.
authors.forename: Ana
authors.initials: A
authors.lastname: Sanguinetti
authors.affiliation: Servicio Neurología, Hospital Tornú, Buenos Aires, Argentina.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Alleva
authors.affiliation: Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Juliana
authors.initials: J
authors.lastname: Aparcana
authors.affiliation: Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Luis
authors.initials: L
authors.lastname: Torres
authors.affiliation: UC San Diego Movement Disorder Center, La Jolla, CA, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Litvan
mesh_terms: D000368:Aged; D000569:Americas / Q000453:epidemiology; D054022:Cerebrum / Q000473:pathology; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*
keywords: Latin America; MSA; Parkinsonism; multiple system atrophy; synucleinopathies