Is multiple system atrophy with cerebellar ataxia (MSA-C) like spinocerebellar ataxia and multiple system atrophy with parkinsonism (MSA-P) like Parkinson's disease? - A saccade study on pathophysiology.
OBJECTIVE
Patients with multiple system atrophy (MSA) are classified into those mainly manifesting cerebellar ataxia (MSA-C) and those mainly manifesting parkinsonism (MSA-P). Pathophysiological bases of these subtypes remain unclear. We hypothesized that MSA-C patients would resemble spinocerebellar degeneration patients and MSA-P patients would resemble Parkinson's disease (PD) patients in saccade abnormalities.


METHODS
We recorded visually guided and memory guided saccades (MGS) in 27 MSA-C and 15 MSA-P patients, as well as 50 age-matched normal subjects, 14 spinocerebellar degeneration patients showing pure cerebellar symptoms (SCD) and 61 Parkinson's disease (PD) patients.


RESULTS
Saccade parameters of both tasks showed similar changes with progressing disease in SCD and MSA-C patients, as did those of MSA-C and MSA-P patients, although hypometria was slightly more pronounced in MSA-P. In both subtypes of MSA, latency and success rate of MGS were stable throughout disease stages, whereas they deteriorated progressively with progressing disease in PD.


CONCLUSIONS
Pathophysiology underlying MSA-C and MSA-P is similar as viewed from saccade performance. The MGS performance in MSA was preserved. However, MSA-P patients showed more marked hypometria, suggesting a mixture of basal ganglia pathophysiology.


CONCLUSIONS
The similarity of saccade performance between MSA-C and MSA-P may reflect common olivopontocerebellar pathology, while the direct pathway of the basal ganglia is relatively spared compared with PD, even in MSA-P.
Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. Electronic address: yterao-tky@umin.ac.jp.
Yasuo
Y
Terao
Neurological Clinic for Children, Japan.
Hideki
H
Fukuda
Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Shinnichi
S
Tokushige
Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Satomi
S
Inomata-Terada
Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Akihiro
A
Yugeta
Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Masashi
M
Hamada
Department of Neurology, Kyorin University, Japan.
Yaeko
Y
Ichikawa
Department of Neurology, School of Medicine, Kitasato University, Japan.
Ritsuko
R
Hanajima
Department of Neurology, School of Medicine, Fukushima Medical University, Japan.
Yoshikazu
Y
Ugawa
D000368:Aged; D002524:Cerebellar Ataxia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D020734:Parkinsonian Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D012438:Saccades / Q000502:physiology*; D020754:Spinocerebellar Ataxias / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology
Basal ganglia; Cerebellum; Multiple system atrophy; Parkinson’s disease; Pathophysiology; Saccade