Abstract

BackgroundSpinocerebellar ataxia type 3 (SCA3) is one of the most common hereditary neurodegenerative diseases. Postural control dysfunction is the main symptom of SCA3, and the proprioceptive system is a critical sensory component of postural control. Accordingly, proprioception quantification assessment is necessary in monitoring the progression of SCA3.ObjectiveWe aimed to quantitatively assess lower limb proprioception and investigate the relationship between proprioception and clinical characteristics in patients with SCA3.MethodsA total of 80 patients with SCA3 and 62 health controls were recruited, and their lower limb proprioception was measured using the Pro-kin system. Clinical characteristics of the SCA3 patients were collected. Multivariable linear regression was used to investigate potential affected factors for lower limb proprioception.ResultsWe found that the patients with SCA3 experience poorer lower limb proprioception characterized by significant impairment in the average trace error (ATE) and time to carry out the test time execution (TTE) compared to controls (P < 0.05). Moreover, there were significant differences in TTE between the right and left lower limbs (P < 0.05) of the patients. Regression analyses revealed that increasing age at onset (AAO) predicts poorer lower limb proprioception for both ATE (β = 2.006, P = 0.027) and TTE (β = 1.712, P = 0.043) and increasing disease duration predicts poorer lower limb proprioception for ATE (β = 0.874, P = 0.044). AAO (β = 0.328, P = 0.019) along with the expanded alleles (β = 0.565, P = 0.000) could affect the severity of ataxia. By contrast, ATE (β = 0.036, P = 0.800) and TTE (β = −0.025, P = 0.862) showed no significant predictors.ConclusionsLower limb proprioception in patients with SCA3 is significantly impaired when compared to healthy controls. Increasing AAO and disease duration are related to impaired lower limb proprioception.

Highlights

  • Spinocerebellar ataxia type 3 (SCA3), known as MachadoJoseph disease (MJD), is the most common inherited spinocerebellar ataxias and one of autosomal dominant neurodegenerative disorders with high clinical heterogeneity [1]

  • Average trace error (ATE) and time to carry out the test time execution (TTE) [s] were evaluated [15, 18, 19]

  • We found that ATE on the left limb and TTE on both lower limbs were significantly worse for patients compared to controls (P < 0.05)

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Summary

Introduction

Spinocerebellar ataxia type 3 (SCA3), known as MachadoJoseph disease (MJD), is the most common inherited spinocerebellar ataxias and one of autosomal dominant neurodegenerative disorders with high clinical heterogeneity [1]. The clinical characteristics of patients with SCA3 have various manifestations, including postural control dysfunction, gait ataxia, oculomotor abnormalities, dysarthria and peripheral neuropathy [4]. One of the main factors of SCA3 directly affecting gait, is associated with an increased incidence of falls in this population [5,6,7]. Spinocerebellar ataxia type 3 (SCA3) is one of the most common hereditary neurodegenerative diseases. Postural control dysfunction is the main symptom of SCA3, and the proprioceptive system is a critical sensory component of postural control. Proprioception quantification assessment is necessary in monitoring the progression of SCA3

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