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Movement disorders
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Association of autonomic symptoms with disease progression and survival in progressive supranuclear palsy
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  • Published on: 7 January 2020
    Autonomic symptoms as a predictor of disease progression and survival in patients with progressive supranuclear palsy

    Oliveira et al. evaluated the association between autonomic symptoms and progressive supranuclear palsy (PSP) with special reference to disease progression and survival (1). Adjusted hazard ratios (HRs) (95% confidence interval [CIs]) of early constipation and early urinary symptoms for the risk of first disease milestone of PSP were 0.88 (0.83 to 0.92) and 0.80 (0.75 to 0.86), respectively. In addition, adjusted HRs (95% CIs) of early constipation and early urinary symptoms for survival were 0.73 (0.64 to 0.84) and 0.88 (0.80 to 0.96), respectively. Furthermore, Richardson syndrome phenotype was significantly associated with shorter survival. The authors concluded that earlier urinary symptoms and constipation are closely associated with rapid disease progression and shorter survival in patients with PSP. I have two comments about their study.

    First, Glasmacher et al. conducted a meta-analysis to explore prognostic factors and survival in patients with PSP and multiple system atrophy (MSA) (2). In patients with PSP, adjusted HR (95% CI) of Richardson's phenotype against Parkinson's phenotype for shorter survival was 2.37 (1.21 to 4.64). In addition, adjusted HR (95% CI) of early fall for shorter survival in patients with PSP and MSA was 2.32 (1.94 to 2.77). Although some clinical symptoms are overlapping by common neurological damages, risk assessment for PSP and for MSA should be separately conducted. Stable estimates with enough number of samples and ev...

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    Conflict of Interest:
    None declared.