ABSTRACT
BACKGROUND@#Sleep disorders are common but under-researched symptoms in patients with multiple system atrophy (MSA). We investigated the frequency and factors associated with sleep-related symptoms in patients with MSA and the impact of sleep disturbances on disease severity.@*METHODS@#This cross-sectional study involved 165 patients with MSA. Three sleep-related symptoms, namely Parkinson's disease (PD)-related sleep problems (PD-SP), excessive daytime sleepiness (EDS), and rapid eye movement sleep behavior disorder (RBD), were evaluated using the PD Sleep Scale-2 (PDSS-2), Epworth Sleepiness Scale (ESS), and RBD Screening Questionnaire (RBDSQ), respectively. Disease severity was evaluated using the Unified MSA Rating Scale (UMSARS).@*RESULTS@#The frequency of PD-SP (PDSS-2 score of ≥18), EDS (ESS score of ≥10), and RBD (RBDSQ score of ≥5) in patients with MSA was 18.8%, 27.3%, and 49.7%, respectively. The frequency of coexistence of all three sleep-related symptoms was 7.3%. Compared with the cerebellar subtype of MSA (MSA-C), the parkinsonism subtype of MSA (MSA-P) was associated with a higher frequency of PD-SP and EDS, but not of RBD. Binary logistic regression revealed that the MSA-P subtype, a higher total UMSARS score, and anxiety were associated with PD-SP; that male sex, a higher total UMSARS score, the MSA-P subtype, and fatigue were associated with EDS; and that male sex, a higher total UMSARS score, and autonomic onset were associated with RBD in patients with MSA. Stepwise linear regression showed that the number of sleep-related symptoms (PD-SP, EDS, and RBD), disease duration, depression, fatigue, and total Montreal Cognitive Assessment score were predictors of disease severity in patients with MSA.@*CONCLUSIONS@#Sleep-related disorders were associated with both MSA subtypes and the severity of disease in patients with MSA, indicating that sleep disorders may reflect the distribution and degree of dopaminergic/non-dopaminergic neuron degeneration in MSA.
Subject(s)
Humans , Male , Cross-Sectional Studies , Multiple System Atrophy , REM Sleep Behavior Disorder , Severity of Illness Index , SleepABSTRACT
<p><b>OBJECTIVE</b>To increase the probability of successful renal artery angiography with a three-dimensional contrast-enhanced magnetic resonance angiography (3D CE-MRA).</p><p><b>METHODS</b>3D CE-MRA was performed in 33 patients with hypertension. To calculate the scan delay time, a testing contrast agent bolus of 2 ml was injected for single sagittal slice real-time scanning, followed by oblique coronal 3D Fast TOF SPGRE. With maximum intensity projection, a set of images was acquired.</p><p><b>RESULTS</b>Exact scan delay time was obtained in all the cases from which clear images were acquired with the exception of two cases in which failure of breath-holding occurred during the scanning.</p><p><b>CONCLUSION</b>This examination enhances the performance by adopting elliptical-centric k-space recording for data acquisition for the center in k-space at the beginning of acquisition, and utilizing preceding testing bolus injection and signal intensity/time curve for determining the scan delay time, using slice selection and multiview image reconstruction.</p>