Objective:

Evaluate the Urinary Symptom Profile (USP) in patients with multiple system atrophy (MSA).

Background:

MSA is a rapidly progressive neurodegenerative disease that presents with motor and autonomic symptoms. Urinary symptoms can occur at any time along the disease process; however, no study has characterized patient reported urinary symptoms in MSA. The Urinary Symptom Profile (USP) is a validated, patient-reported assessment for stress urinary incontinence (SUI), overactive bladder (OAB), and low stream (LS). We applied this scale to a cohort of early MSA patients from the bioMUSE Natural history study.

Design/Methods:

16 participants, (8 females), mean age 62 (range 49-79), mean duration of motor symptoms of 3 years, completed the Unified Multiple System Atrophy Rating Scale (UMSARS) Part I, the Natural History and Neuroprotection in Parkinson Plus Syndromes-Parkinson Plus scale (PPS), and the Urinary Symptom Profile (USP) questionnaire. The PPS and UMSARS total urinary symptom scores were correlated with the total USP score using a t-distribution and the Spearman’s rank correlation.

Results:

The mean USP score was 14.06, (4-30). One participant had a bladder stimulator and 3 were taking medications for urinary symptoms. Total USP scores positively correlated with total urinary symptom scores from the UMSARS (p = 0.075, r² = 0.458) and PPS (p = 0.002, r² = 0.713). Across this cohort, the most severe complaints were related to urinary urgency (OAB avg = 8.4), and reduced amount of time to hold urine (SUI avg = 2.63). Subscale analysis indicates the most common symptoms relate to OAB, and least common were SUI.

Conclusions:

In early MSA, urinary symptoms are greatest in relation to overactive bladder, specifically urgency and frequency. These results suggest that the USP can be used for comprehensive evaluation of urinary complaints and give important insights to the concerns of patients early in disease.