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Keywords:

  • multiple system atrophy;
  • Parkinson's disease;
  • circadian rhythm;
  • body temperature;
  • autonomic failure

Abstract

OBJECTIVE:

To evaluate whether the circadian rhythm of body core temperature (CRT°) can differentiate Multiple-System Atrophy (MSA) from Idiopathic Parkinson's disease (IPD).

METHODS:

We evaluated 14 patients with probable MSA, seven with IPD, and eight controls. After a preliminary evaluation of cardiovascular autonomic function, rectal temperature and sleep-wake cycle were monitored continuously for 48 hours in a temperature-controlled room, at constant bed rest with controlled food intake and fixed light-dark schedule.

RESULTS:

MSA patients showed cardiovascular autonomic sympathetic and parasympathetic failure. IPD had normal cardiovascular autonomic function. A 24-hour rhythm of body core temperature (BcT°) was present in all subjects. IPD had CRT° comparable to controls. In MSA the mesor was higher and mean BcT° of each hour was significantly higher from 11 p.m. to 7 a.m. The analysis of mean BcT° during the different sleep phases showed significantly higher values during both NREM (1–2, 3–4) and REM sleep stages in MSA.

CONCLUSIONS:

The physiological nocturnal fall of BcT° is blunted in MSA patients mainly because BcT° did not decrease during sleep. This CRT° pattern is not justified by differences in sleep structure and may reflect an impairment of central sympathetic nervous system function. © 2001 Movement Disorder Society.