Health-related quality of life in multiple system atrophy

Anette Schrag, Felix Geser, Michaela StampferKountchev, Klaus Seppi, Martin Sawires, Martin Köllensperger, Christoph Scherfler, Niall Quinn, Maria T. Pellecchia, Paolo Barone, Francesca del Sorbo, Alberto Albanese, Karen Ostegaard, Erik Dupont, Adriana Cardozo, Eduardo Tolosa, Christer F. Nilsson, Håkan Widner, Olle Lindvall, Nir GiladiTanya Gurevich, Christine Daniels, Günther Deuschl, Miguel Coelho, Cristina Sampaio, Michael Abele, Thomas Klockgether, Nicole Schimke, Karla M. Eggert, Wolfgang Oetel, Ruth Djaldetti, Carlo Colosimo, Giuseppe Meco, Werner Poewe, George K. Wenning, Richard Dodel, François Tison, Imad Ghorayeb, Farid Yekhlef, Pierre Pollak, Michaela Stampfer-Kountchev, Anja Diem, Jean Pierre Ndayisaba, Florian Kopper, Cristina Sampiao, Joaquim Ferreira, Mário M. Rosa, Zvezdan Pirtosek, Andrew J. Lees, Christopher J. Mathias, David J. Brooks, Clare Fowler, Tamas Revesz, Alexander Gerhard, Janice Holton, Nick Wood, Martin Grabowski, Wolfgang Oertel, Francesco Carella, Jose Barciano, Andres Gonzalez-Mandly, Tanya Guverich, Olivier Rascol, Monique Galitzky, Fabienne Ory, Thomas Gasser, Christoph Kamm, Katrin Buerk, Sylvia Maass, Sten Magnus Aquilonius, Jonas Berquist

Research output: Contribution to journalArticlepeer-review


Although multiple system atrophy (MSA) is a neurodegen rative disorder leading to progressive disability and decreased life expectancy, little is known about patients' own evaluation of their illness and factors associated with poor health-related quality of life (Hr-QoL). We, therefore, assessed Hr-QoL and its determinants in MSA. The following scales were applied to 115 patients in the European MSA-Study Group (EMSA-SG) Natural History Study: Medical Outcome Study Short Form (SF-36), EQ-5D, Beck Depression Inventory (BDI), Mini-Mental state examination (MMSE), Unified MSA Rating Scale (UMSARS), Hoehn & Yahr (H&Y) Parkinson's disease staging scale, Composite Autonomic Symptom Scale (COMPASS), and Parkinson's Disease Sleep Scale (PDSS). Forty-six percent of patients had moderate to severe depression (BDI ≥ 17); Hr-QoL scores on the SF-36 and EQ-5D were significantly impaired. Pain, the only domain with similar scores in MSA and published PD patients, was reported more frequently in patients with MSA-P (predominantly parkinsonian motor subtype) than MSA-C (predominantly cerebellar motor subtype; 76% vs. 50%; P = 0.005). Hr-QoL scores correlated most strongly with UMSARS motor, COMPASS, and BDI scores but not with MMSE scores, age at onset, or disease duration. The COMPASS and UMSARS activities of daily living scores were moderate-to-strong predictors for the SF-36 physical summary score and the BDI and UMSARS motor scores for the SF-36 mental summary score. This report is the first study to show that Hr-QoL is significantly impaired in MSA. Although not all possible factors related to impaired Hr-QoL in MSA could be assessed, autonomic dysfunction, motor impairment, and depression were most closely associated with poor Hr-QoL, and therapeutic management, therefore, should concentrate upon these aspects of the disease.

Original languageEnglish
Pages (from-to)809-815
Number of pages7
JournalMovement Disorders
Issue number6
StatePublished - 5 Jun 2006
Externally publishedYes


  • Autonomic dysfunction
  • Depression
  • Health-related quality of life
  • Multiple system atrophy


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