Objective: The purpose of the study was to investigate the prevalence of and factors associated with cold hand sign in multiple system atrophy (MSA) patients, and the impact of early cold hand sign on survival.

Background: Few studies focused on the cold hand sign, a red flag sign, in MSA.

Method: 513 patients with MSA were classified into three different disease duration groups (≤ 3, 3-5, ≥ 5 years) at baseline, then compared the motor and non-motor symptoms between MSA patients with cold hand sign and without cold hand sign. For the patients with disease duration ≤3 years, we followed up to analysis the association between the cold hand sign and survival in MSA.

Results: The prevalence of cold hand sign in MSA patients was 17%, 21.1%, 34.5% at the disease duration ≤3, 3-5, ≥5 years, respectively. According to logistic regression, the diagnosis delay, sleep/fatigue and gastrointestinal tract were associated with cold hand sign in MSA. The multivariate Cox survival model suggested that cold hand sign, orthostatic hypotension(OH) and higher Non-Motor Symptom Scale(NMSS) score were associated with poor survival.

Conclusion: The prevalence of clod hand sign increased with the disease duration prolonged. The disease delay, sleep/fatigue and gastrointestinal tract were contributors to cold hand sign at the early stage of the disease. Patients with early CI had a poor prognosis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-cold-hand-sign-in-multiple-system-atrophy-prevalence-associated-factors-and-impact-on-survival/