Depression and anxiety in multiple system atrophy

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Multiple system atrophy (MSA) is characterized by a variable combination of autonomic dysfunction, parkinsonism that is poorly responsive to levodopa, cerebellar ataxia, and pyramidal tract symptoms.1 There is only symptomatic treatment, which mainly targets parkinsonism and autonomic failure.2 It has been reported that the median time from onset to aid‐requiring walking, wheelchair requirement, and a bedridden state was nearly 3, 5, and 8 years, respectively,3 which not only lead to reduced life expectancy but also lead to a heavy burden on their caregivers.
Besides motor symptoms and autonomic symptoms, many other non‐motor manifestations have been observed in MSA, including sleep dysfunction, constipation, depression, and anxiety.4 An increasing number of studies have noted that mood dysfunction was common in patients with MSA, especially for depression (ranging from 46% to 80%) and anxiety (37%‐54%).5 It is important to understand which factors contribute to the development of depression and anxiety symptoms. However, no studies have explored the potential determinants related to depression and anxiety symptoms in MSA. Additionally, there were no studies on the incidence and determinants of depression and anxiety symptoms in MSA patients in the Chinese population.
Therefore, this study is to explore: (1) the frequency of depression and anxiety symptoms in patients with MSA; (2) the determinants of depression and anxiety symptoms in patients with MSA.
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