Abnormal Baroreceptor-mediated Vasopressin Release As Possible Marker in Early Diagnosis of Multiple System Atrophy

Overview

Journal J Neurol Neurosurg Psychiatry

Publisher BMJ Publishing Group

Specialties Neurology
Neurosurgery
Psychiatry

Date 2004 Jan 7

PMID 14707318

Citations 2

Authors

K Deguchi

I Sasaki

T Touge

M Tsukaguchi

H Takeuchi

S Kuriyama

Affiliations

Soon will be listed here.

Abstract

Background: Although autonomic failure (AF) is a critical symptom of multiple system atrophy (MSA), it may not appear until late in the disease process.

Objectives: To clarify whether a detailed investigation of the autonomic nervous system in patients with MSA without overt AF demonstrates latent lesions of central cardiovascular control circuits and facilitates the early diagnosis of MSA.

Methods: Autonomic function tests, and plasma noradrenaline (NA) and vasopressin (AVP) responses to head-up tilt (HUT), were studied in 12 patients with MSA with AF (probable MSA), 12 with MSA without overt AF (possible MSA), and 24 controls.

Results: Abnormalities of cardiovascular autonomic function tests were prominent in the first group but mild in the second. Plasma NA and AVP increments upon HUT differed significantly among all three groups.

Conclusions: These results indicate that probable MSA involves diffuse degeneration of central cardiovascular control circuits. On the other hand, the discrepancies in possible MSA suggest a vulnerability of the noradrenergic (A1) neurones of the caudal ventrolateral medulla that are involved in AVP secretion. This finding also suggests that AVP increment may be useful as a diagnostic tool in the early stages of MSA.

Citing Articles

An update on MSA: premotor and non-motor features open a window of opportunities for early diagnosis and intervention.

Chelban V, Catereniuc D, Aftene D, Gasnas A, Vichayanrat E, Iodice V J Neurol. 2020; 267(9):2754-2770.

PMID: 32436100 PMC: 7419367. DOI: 10.1007/s00415-020-09881-6.

Significance of the hot-cross bun sign on T2*-weighted MRI for the diagnosis of multiple system atrophy.

Deguchi K, Ikeda K, Kume K, Takata T, Kokudo Y, Kamada M J Neurol. 2015; 262(6):1433-9.

PMID: 25845765 DOI: 10.1007/s00415-015-7728-1.

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