@article{ce5a0d66e9f84ec6ab4b94068585941b,
title = "Lower Vitamin B12 Level at Multiple System Atrophy Diagnosis Is Associated With Shorter Survival",
abstract = "Background: Multiple system atrophy (MSA) is a neurodegenerative disorder from α-synuclein aggregation. in vitro studies suggest vitamin B12 may interrupt α-synuclein-mediated neurodegeneration. The objective of this study was to determine whether serum vitamin B12 level at MSA diagnosis is associated with survival. Methods: One hundred eighty-two MSA patients evaluated at Mayo Clinic with vitamin B12 testing were studied. We determined the risk of death in relationship to serum vitamin B12 levels at MSA diagnosis, adjusting for predictors of poor survival. Results: Predictors of shorter survival included vitamin B12 < 367 ng/L (HR, 1.8; 95% CI, 1.3–2.7), falls within 3 years of MSA diagnosis (HR, 1.6; 95% CI, 1.1–2.3), bladder symptoms (HR, 1.6; 95% CI, 1.0–2.6), urinary catheter requirement (HR, 1.7; 95% CI, 1.0–2.8), male sex (HR, 1.4; 95% CI, 1.0–2.0), and MSA-P subtype (HR, 1.5; 95% CI, 1.0–2.0). Conclusions: Low vitamin B12 levels are associated with shorter survival in MSA. Additional studies to explore this observation and assess the potential role of vitamin B12 as a modifiable survival factor are needed.",
keywords = "autonomic, cyanocobalamin, multiple system atrophy, survival, vitamin B12",
author = "McCarter, {Stuart J.} and Coon, {Elizabeth A.} and Rodolfo Savica and {St Louis}, {Erik K.} and Bower, {James H.} and Benarroch, {Eduardo E.} and Paola Sandroni and Phillip Low and Wolfgang Singer",
note = "Funding Information: S.J. McCarter, E.A. Coon, R. Savica, J.H. Bower, E.E. Benarroch, P. Sandroni, and P. Low report no disclosures. E.K. St. Louis reports that he receives research support from the Mayo Clinic Center for Translational Science Activities (CCaTS), supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through grant 1 UL1 RR024150‐01; from the Mayo Clinic Alzheimer's Disease Research Center grant award from the National Institute on Aging (P50 AG016574); from Michael J. Fox Foundation; and from Sunovion, Inc. He has also served as a consultant for Axovant, Inc., but received no personal fees. W. Singer serves on the editorial board of , as an associate editor for , as a consultant for Biohaven Pharmaceuticals, and on an advisory board for Lundbeck. Dr. Singer receives research/grant support from Dysautonomia International, the US Food and Drug Administration (R01 FD4789), and the National Institutes of Health (R01 NS092625, U54 NS65736). Autonomic Neuroscience: Basic & Clinical Clinical Autonomic Research Funding Information: agencies: Supported in part by NIH (P01NS44233, U54NS065736, K23NS075141, R01 FD004789, R01 NS092625, NS 65736 FP00101673) and Mayo CCaTS (UL1TR000135), and Cure PSP Foundation. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH. Publisher Copyright: {\textcopyright} 2020 International Parkinson and Movement Disorder Society",
year = "2020",
month = aug,
day = "1",
doi = "10.1002/mds.28070",
language = "English (US)",
volume = "35",
pages = "1462--1466",
journal = "Movement Disorders",
issn = "0885-3185",
publisher = "John Wiley and Sons Inc.",
number = "8",
}