What is the clinical evidence from this study?

Study design: Observational. Population: Parkinsonism and autonomic symptoms (n=47). Intervention: Parkinson's disease vs. Multiple system atrophy (MSA). Primary outcome: Performance on five autonomic tests (RR variation, Valsalva manoeuvre, tilt table, sudomotor axon reflex, and thermoregulatory sweat testing).

What does this research mean for the field?

Formal laboratory autonomic nervous system testing does not reliably distinguish multiple system atrophy from Parkinson's disease when clinical diagnosis is established independently of autonomic dysfunction. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

December 16, 2002Journal of Neurology Neurosurgery & PsychiatryOpen Access

Autonomic nervous system testing may not distinguish multiple system atrophy from Parkinson's disease

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Key result

Formal autonomic testing fails to distinguish between Parkinson's disease and multiple system atrophy.

n=47

Why the study?

Formal autonomic function testing is reported to distinguish Parkinson's disease from multiple system atrophy, but prior studies selected MSA patients based on autonomic dysfunction criteria.

Does autonomic nervous system testing distinguish multiple system atrophy from Parkinson's disease in patients with parkinsonism and autonomic symptoms?

Population

47 patients with parkinsonism and autonomic symptoms

Comparison

Parkinson's disease vs multiple system atrophy on autonomic laboratory tests

Design

Observational study with clinical classification into three diagnostic groups

Authors

DRDavid E. RileyStevens Institute of Technology

Discussion

Member takes

Implication

Autonomic testing may not reliably differentiate PD from MSA; leaves open need for better biomarkers in unbiased cohorts.

Study Design

Type

Observational (n=47)

Structured PICO

Does autonomic nervous system testing distinguish multiple system atrophy from Parkinson's disease in patients with parkinsonism and autonomic symptoms?

Population

47 patients with parkinsonism and autonomic symptoms who had undergone autonomic laboratory testing, classified into Parkinson's disease, MSA, and uncertain groups.

Exposure

Autonomic laboratory testing (RR variation on deep breathing, heart rate changes with the Valsalva manoeuvre, tilt table testing, sudomotor axon reflex test, and thermoregulatory sweat testing)

Comparator

Comparison between patients with Parkinson's disease and those with multiple system atrophy (MSA)

Outcome

Ability of autonomic tests to distinguish between Parkinson's disease and MSAsurrogate

Formal autonomic nervous system testing does not reliably distinguish multiple system atrophy from Parkinson's disease in patients presenting with parkinsonism and dysautonomia.

Cite This Study

David E. Riley (2002) conducted an observational in Parkinsonism and autonomic symptoms (n=47). Parkinson's disease vs. Multiple system atrophy (MSA) was evaluated on Performance on five autonomic tests (RR variation, Valsalva manoeuvre, tilt table, sudomotor axon reflex, and thermoregulatory sweat testing). Formal autonomic nervous system testing did not significantly distinguish between patients with Parkinson's disease and multiple system atrophy.

synapsesocial.com/papers/6aaa137cf6e8aa835a481f37 https://doi.org/10.1136/jnnp.74.1.56

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Autonomic nervous system testing may not distinguish multiple system atrophy from Parkinson's disease

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

Autonomic nervous system testing may not distinguish multiple system atrophy from Parkinson's disease

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

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