Depression and anxiety in multiple system atrophy.

BACKGROUND: It has been noticed that the patients with multiple system atrophy (MSA) can accompany with depression and anxiety. This study aimed to establish the incidence and determinants of depression and anxiety symptoms in Chinese MSA patients. METHODS: A total of 237 MSA patients were enrolled in the study. Neuropsychological assessment was performed using Hamilton Depression Rating Scale-24 items and Hamilton Anxiety Rating Scale. RESULTS: We found that 62.0% and 71.7% patients had at least mild depression and anxiety symptoms, respectively. The severity of depression of MSA patients was associated with lower educational years (P=.024), longer disease duration (P<.001), and disease severity (P<.001). The severity of anxiety was associated with increased disease duration (P<.001), disease severity (P=.013), and orthostatic hypotension (P=.005). Binary logistic regression showed the determinants of depression and anxiety were female gender, longer disease duration, and disease severity. CONCLUSION: Depression and anxiety symptoms are common in patients with MSA. Neurologists should pay attention to depression and anxiety in patients with MSA, especially in female patients and those with longer disease duration and severe disease condition.

Non-motor symptoms and quality of life in tremor dominant vs postural instability gait disorder Parkinson's disease patients.

OBJECTIVES: To explore the differences in the features and impact on quality of life (QOL) of non-motor symptoms (NMS) of tremor dominant (TD) and postural instability gait disorder (PIGD) phenotypes early Parkinson's disease (PD), as well as the determinants of poor QOL for TD and PIGD phenotypes. METHODS: This cross-sectional study recruited 301 patients with early PD and 101 healthy controls. Specific assessments used for NMS included NMS scale (NMSS), the Hamilton Rating Scale for Depression (HRSD-24), the Hamilton Anxiety Scale (HAMA), the Mini-Mental state examination (MMSE), and Addenbrooke's Cognitive Exam-Revised (ACE-R). QOL was evaluated with the PD Quality of Life Questionnaire (PDQ-39). RESULTS: Tremor dominant phenotype patients were 117 (38.9%), and PIGD were 155 (51.5%). Compared with TD patients, patients with PIGD had higher frequency of NMS (9.0 ± 5.3 vs 6.7 ± 4.6, P < 0.001), NMSS total scores (39.6 ± 34.5 vs 24.4 ± 22.7, P < 0.001) and more poorly for PDQ-39 summary index (19.2 ± 14.0 vs 13.8 ± 11.5, P = 0.001). There was no difference in the impact of NMS measured with NMSS on QOL between PIGD and TD phenotypes. PIGD phenotype had little impact on poor QOL once the effect of depression was taken into account. Depression was a primary negative predictor for QOL in both TD and PIGD patients (Beta: 0.697 and 0.619, respectively, P < 0.001). CONCLUSIONS: PIGD phenotype had a higher prevalence of NMS and worse QOL than TD phenotype. Depression is related to a dramatic decline in QOL in both TD and PIGD phenotype patients with PD.

An association analysis of the rs1572931 polymorphism of the RAB7L1 gene in Parkinson's disease, amyotrophic lateral sclerosis and multiple system atrophy in China.

BACKGROUND AND PURPOSE: Recently, the rs1572931 single-nucleotide polymorphism (SNP) of the putative promoter of the member RAS oncogene family-like 1 (RAB7L1) gene was reported to be associated with reduced risk for Parkinson's disease (PD) in the Ashkenazi Jewish population. Ethnic-specific effects are an important consideration in genome-wide association studies. Considering that the clinical manifestations and pathological characteristics overlap between PD, amyotrophic lateral sclerosis (ALS) and multiple system atrophy (MSA), the possible associations between the rs1572931 SNP and these three diseases were studied in the Chinese population. METHODS: A total of 1011 PD patients, 778 sporadic ALS (SALS) patients, 264 MSA patients and 516 healthy controls (HC) were included in this study. All subjects were genotyped for the rs1572931 SNP by using polymerase chain reaction and direct sequencing. RESULTS: Significant differences were observed in the genotype and minor allele frequency (MAF) of rs1572931 between PD and HC (P = 0.0001 and P = 1.08E-04, respectively) and between late-onset PD and matched controls (P = 0.0011 and P = 0.0002, respectively). However, no differences were observed between early-onset PD and HC. The number of minor allele carriers was significantly lower in PD patients than in HC (P = 2.96E-05, odds ratio 0.63, 95% confidence interval 0.51-0.78). No differences were observed between groups with respect to sex, onset symptoms, absence or presence of cognition impairment, anxiety or depression. In addition, no differences were found in the genotype and MAF of rs1572931 between SALS and HC or between MSA and HC. CONCLUSION: Our results suggest that rs1572931 decreases the risk for PD but not for ALS and MSA in the Chinese population. However, the polymorphism is unlikely to be a common cause of SALS and MSA in the Chinese population.