Abstract Details

Title Distinct clinical features of predominant pre-synaptic and trans-synaptic nigrostriatal dysfunction in multiple system atrophy

Topic Movement Disorders

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-012

Objective

To investigate the difference in clinical features between multiple system atrophy (MSA) patients with predominantly pre-synaptic nigrostriatal dysfunction and those with trans-synaptic nigrostriatal dysfunction.

Background The severity of parkinsonism and response to levodopa vary in patients with MSA because of the heterogeneity of nigrostriatal neuropathology.

Design/Methods We retrospectively analyzed clinical data of 63 patients with MSA who underwent both [¹⁸F]FP-CIT PET and [¹⁸F]FDG PET within 3 months of clinical evaluation, and who had ≤ 3 years of disease duration. Tracer uptake of the striatum on [¹⁸F]FP-CIT PET and glucose metabolism of the striatum on [¹⁸F]FDG PET were analyzed using eight striatal subregional volumes-of-interest templates. The patients were classified into two subgroups according to the predominant pre-synaptic tracer uptake loss of the posterior putamen on [¹⁸F]FP-CIT PET (MSA-SNpc, n = 21) and trans-synaptic dopaminergic dysfunction reflected by both [¹⁸F]FP-CIT PET and [¹⁸F]FDG PET (MSA-STR, n = 42).

Results

Parkinsonian features were significantly more severe in the MSA-STR group than in the MSA-SNpc group (P= 0.015) and cerebellar ataxia was significantly more severe in the MSA-SNpc group (P= 0.029). The cerebellar type of MSA was significantly more common in the MSA-SNpc group (P = 0.001). There was no difference in age at onset, disease duration at the time of study, or Mini-Mental Status Examination scores between the groups.

Conclusions Patients with MSA showed distinct clinical features depending on whether the pattern of nigrostriatal dysfunction was predominantly pre-synaptic or trans-synaptic.

Authors/Disclosures
Sun Ju Chung, MD, PhD, FAAN (Neurology, Asan Medical Center) PRESENTER	Dr. Chung has nothing to disclose.
	No disclosure on file
	No disclosure on file
Kye Won Park, MD (Uijeongbu Eulji University Hospital)	Dr. Park has nothing to disclose.
Chaewon Lee, MD (Asan Medical Center)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

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