Objective: To evaluate respiratory rate and patterns in patients with Multiple Systems Atrophy (MSA).

Background: One of the primary clinical features of multiple system atrophy is the development of autonomic failure, including failure of adrenergic, thermoregulatory, gastrointestinal, and genitourinary autonomic pathways. We have observed abnormal respiratory rate and patterns of respiration in MSA patients. Abnormal respiratory control in MSA patients has been demonstrated during sleep studies but has not been well characterized as part of the autonomic evaluation of these patients.

Method: We reviewed the findings on autonomic testing in patients referred to our autonomic laboratory with a clinical diagnosis of MSA. Autonomic testing included heart rate and blood pressure responses to tilt table testing, cardiovagal assessment, sudomotor testing, blood pressure responses to the Valsalva maneuver, and assessment of respiratory pattern. Assessment of respiratory rate and rhythm was performed utilizing chest and abdominal recordings while supine and during head-up tilt table testing.

Results: Abnormal respiratory patterns were frequently seen in MSA patients and did not appear to correlate with the degree of autonomic failure demonstrated on autonomic testing. Abnormal respiratory patterns included tachypnea, ataxic respiratory pattern, and Cheyne-Stokes respiration. None of these patients had previously been identified as having abnormal respiratory patterns as part of their illness.

Conclusion: Abnormal respiratory rate and pattern of respiration occurs in MSA, most likely resulting from pathological involvement of brainstem centers involved in respiratory control. These abnormal respiratory patterns may have the potential to exacerbate symptoms of orthostatic intolerance by influencing cerebral blood flow.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/abnormal-respiratory-rate-and-patterns-in-msa/