title: Non-motor symptoms and the quality of life in multiple system atrophy with different subtypes.
abstract: The differences in non-motor symptoms (NMS) and quality of life (QOL) between MSA patients with different subtypes remain unknown, so do the determinants of poor QOL in both subtypes.
  
  
  
  A total of 172 MSA patients were enrolled in the study. NMS of patients with MSA were assessed using the non-motor symptoms scale (NMSS) and Parkinson's Disease Questionnaire-39 item version (PDQ-39) was used to evaluate the QOL of patients with MSA.
  
  
  
  The most prevalent NMS domain was urinary (91.3%) in both subtypes. The mood/apathy domain was more severe in MSA-P than MSA-C patients (P < 0.05). Drooling, constipation, and pain symptoms were more prevalent and severe in the MSA-P patients compared to the MSA-C patients (P < 0.05). We found that the MSA-C patients had a higher score of mobility than the MSA-P patients (P = 0.002); However, the MSA-P patients had a higher score of bodily discomfort than the MSA-C patients (P = 0.036). There were close correlations between NMS and PDQ-39 in both subtypes. Disease severity, cardiovascular symptoms, sleep/fatigue symptoms and gastrointestinal symptoms were determinants of poor QOL in MSA-P patients. While in MSA-C patients, longer disease duration, disease severity and mood/apathy symptoms were determinants of poor QOL.
  
  
  
  NMS are more severe and prevalent in MSA-P patients, especially for mood/apathy and gastrointestinal symptoms. There is a close relationship between NMS and QOL in both MSA subtypes. Disease severity, longer disease duration and severe NMS are determinants of poor QOL in MSA.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: LingYu
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Cao
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: RuWei
authors.initials: R
authors.lastname: Ou
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Qian-Qian
authors.initials: QQ
authors.lastname: Wei
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Bi
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China. Electronic address: hfshang2002@126.com.
authors.forename: HuiFang
authors.initials: H
authors.lastname: Shang
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D019578:Multiple System Atrophy / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*
keywords: Multiple system atrophy; Multiple system atrophy with predominately cerebellar ataxia; Multiple system atrophy with predominately parkinsonism; Non-motor symptoms; Quality of life