Multiple System Atrophy - Cerebellar Subtype (MSA-C) Clinical Trial
Official title:
Pathogenesis and Diagnosis of Multiple System Atrophy (MSA): PET Study of Neurochemical and Autonomic Disorders in MSA
Multiple system atrophy (MSA) is a disorder of the nervous system of unclear cause. In MSA
there is degeneration (progressive loss) of nerve cells in several brain and spinal cord
regions. The result is a variety of symptoms, from physical (parkinsonism, ataxia,
incoordination, falls, slowness) to autonomic (fainting, bladder incontinence, sexual
dysfunction) to sleep problems (dream enactment, sleep apnea).
This research aims to help us better understand the patterns and timing of nerve degeneration
relatively early in the disease, and how this affects symptoms and progression. For instance:
1. Does MSA affect certain nerves that stimulate heart pumping? If so, does the severity of
loss of heart nerves affect disease progression and survival?
2. It is thought that MSA does not affect memory and thinking much, unlike other diseases
(such as Parkinson's). Is this accurate? Is there loss of nerves that transmit
acetylcholine (a neurochemical important in mental functioning)?
3. What can we learn about mood and sleep in MSA, through visualizing the serotonin system
in the brain? How does this relate to symptoms that subjects report in these often
underappreciated areas?
To answer these and other questions, investigators will take images of specific nerves in the
brain and heart using Positron Emission Tomography (PET) scans. Such imaging gives us
information that cannot be obtained from MRIs and CT scans. We will measure the levels of
several nerve cell types: serotonin, acetylcholine, and norepinephrine. Subjects will also
have many standardized assessments including quality-of-life and symptom assessments,
neurological examination, autonomic assessments, neuropsychological assessments, coordination
tests, and even assessments of vision and sense of smell. By pooling these results from many
MSA patients, and comparing with other diseases (such as Parkinson's disease) we hope to gain
a better understanding of what is happening early in MSA. Such knowledge could be very
valuable in future efforts to develop better therapies in this rare disease.
Positron Emission Tomography (PET) imaging involves injection of radioactive tracers (small
amounts of biologically active molecules with radioactive atoms attached) and scanning the
body to see where the tracers localize, and how intensely they "stick" there.
The tracers are used in such small amounts that they do not affect brain or body functions.
The amount of radioactivity used is also very small and disappears quickly. Overall radiation
exposure for participants is low and well within accepted safety levels for the human body.
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