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Parkinson, MSA-P May Be Differentiated With 3 Tests

December 22, 2017

Three rapid and non-invasive assessments for cardiovascular autonomic neuropathy (CAN) may help differentiate multiple system atrophy with predominant Parkinsonism (MSA-P) from Parkinson disease (PD), according to a recent retrospective study (Neurophysiol Clin. doi:10.1016/j.neucli.2017.11.003).

These tests include heart rate changes with deep breathing (HR-DB), blood pressure changes during stand test (BP-ST), and electrochemical skin conductance (ESC).

For their study, the researchers assessed patients with MSA-P (n = 62) and PD (n = 96) who were similar in age, body mass index (BMI), and sex ratio. Disease duration was 4.3 years for MSA-P patients and 11.5 years for PD patients.

Specifically, patients were tested for CAN using the HR-DB, the heart rate changes with stand test (HR-ST), and Valsalva maneuver (HR-VM), as well as the BPs-ST, BPdST, Valsalva maneuver (BPs-VM-II and IV), hand grip (BPd-HG) and the total "Ewing" score tests (EwS), and for sweating via ESC for hands (HESC) and feet (FESC).

Results from the study revealed that abnormal EwS, HR-DB, BP-ST and ESC were more frequent with MSA-P vs PD, despite longer disease duration for PD. Furthermore, according to findings from an adjusted model, odds ratios for having MSA-P vs PD based on EwS, HR-DB, BP-ST, and ESC were 2.71, 2.36, 2.87, and 4.94, respectively. The odds ratio for the HR-DB, BP-ST, and ESC in combination was 11.68.

“Assessment of HR-DB, BP-ST and ESC, that is, rapid and non-invasive could be helpful in combination as a first simple screening to differentiate MSA-P from PD,” the researchers concluded.

—Christina Vogt

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