Background: Multiple system atrophy (MSA) patients present a variety of symptoms other than autonomic dysfunctions, parkinsonism, and cerebellar ataxia. The aim of this study was to evaluate the frequency of various motor and non-motor symptoms including so-called “red flags” in patients with early MSA and to determine whether the frequency of these symptoms was different between the parkinsonian (MSA-P) and cerebellar (MSA-C) subtypes. Methods: Sixty-one probable or possible MSA patients with disease duration of 3 years or less were included. Patients were classified into MSA-P, MSA-C, and MSA-PC. The frequency of 13 features including various motor and non-motor symptoms that commonly occur in MSA was assessed. Results: Dysarthria was the most prevalent feature (98.4%) followed by sexual dysfunction (95.1%). Probable REM sleep behavior disorder was present in 90.2%. The frequency of constipation (82.0%), dysphagia (68.9%), and snoring (70.5%) was also high. Stridor was present in 42.6% and more common in MSA-C than in MSA-P. Conclusions: Increasing awareness of various motor and non-motor symptoms may assist clinicians to make an early, accurate diagnosis and to improve management of patients with MSA. We suggest that the diagnostic accuracy can be improved if these features are appropriately reflected in the new diagnostic criteria for MSA.

中文翻译：

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早期多系统萎缩的各种运动和非运动症状

背景：多系统萎缩 (MSA) 患者除了自主神经功能障碍、帕金森症和小脑共济失调外，还表现出多种症状。本研究的目的是评估早期 MSA 患者各种运动和非运动症状的频率，包括所谓的“红旗”，并确定这些症状的频率在帕金森病 (MSA-P)和小脑 (MSA-C) 亚型。方法：包括 61 名可能或可能的 MSA 患者，病程为 3 年或更短。患者分为 MSA-P、MSA-C 和 MSA-PC。评估了 13 个特征的频率，包括 MSA 中常见的各种运动和非运动症状。结果：构音障碍是最普遍的特征（98.4%），其次是性功能障碍（95.1%）。90.2% 的患者可能存在 REM 睡眠行为障碍。便秘 (82.0%)、吞咽困难 (68.9%) 和打鼾 (70.5%) 的频率也很高。喘鸣的出现率为 42.6%，并且在 MSA-C 中比在 MSA-P 中更常见。结论：提高对各种运动和非运动症状的认识可以帮助临床医生做出早期、准确的诊断并改善 MSA 患者的管理。我们建议，如果这些特征在新的 MSA 诊断标准中得到适当反映，则可以提高诊断准确性。准确诊断并改善 MSA 患者的管理。我们建议，如果这些特征在新的 MSA 诊断标准中得到适当反映，则可以提高诊断准确性。准确诊断并改善 MSA 患者的管理。我们建议，如果这些特征在新的 MSA 诊断标准中得到适当反映，则可以提高诊断准确性。