title: Does the Type of Multisystem Atrophy, Parkinsonism, or Cerebellar Ataxia Impact on the Nature of Sleep Disorders?
abstract: Multiple system atrophy (MSA) is a neurodegenerative disease characterized by a combination of autonomic failure, parkinsonism, and/or cerebellar ataxia. The cause of MSA is unknown, but neuropathologically the disease is characterized by widespread α-synuclein-positive glial cytoplasmic inclusions and striatonigral and/or olivopontocerebellar neurodegeneration. Two motor phenotypes have been clinically identified: parkinsonian (MSA-P) and cerebellar (MSA-C). In order to elucidate if in addition to the motor abnormalities there are other significant differences between these two phenotypes, we performed a review of the studies on sleep disorders in the two MSA subtypes. Substantially, any significant difference in the sleep structure, as well as in the frequency and severity of the sleep disorders, has been found between MSA-P and MSA-C patients. Recent studies clearly showed similarities between the two MSA subtypes in terms of demographic distributions, natural history of the disease, and survivals. These findings suggest that although the dominant clinical presentations differ between MSA-C and MSA-P, a common pathophysiology may underlie both subtypes of MSA.
authors.affiliation: Department of Clinical Neurosciences, San Raffaele Scientific Institute, Sleep Disorders Center, Università Vita-Salute San Raffaele, Milan, Italy. ferinistrambi.luigi@hsr.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferini-Strambi
authors.affiliation: Department of Clinical Neurosciences, San Raffaele Scientific Institute, Sleep Disorders Center, Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Marelli
authors.affiliation: Department of Surgery and Translational Medicine, Università of Milano-Bicocca, Milan, Italy.
authors.forename: Romina
authors.initials: R
authors.lastname: Combi
mesh_terms: D002524:Cerebellar Ataxia / Q000150:complications* / Q000503:physiopathology; D002531:Cerebellum / Q000503:physiopathology*; D006801:Humans; D019578:Multiple System Atrophy / Q000150:complications* / Q000503:physiopathology; D020734:Parkinsonian Disorders / Q000150:complications* / Q000503:physiopathology; D010641:Phenotype; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology
keywords: MSA-C; MSA-P; Multisystem atrophy; REM sleep behavior disorder; Sleep disorders; Stridor