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Prospective Analysis of Falls in Dominant AtaxiasFonteyn E.M.R.a, c · Schmitz-Hübsch T.b · Verstappen C.C.P.c · Baliko L.d · Bloem B.R.a · Boesch S.e · Bunn L.f · Giunti P.f · Globas C.g · Klockgether T.b, k · Melegh B.h · Pandolfo M.i · Schöls L.g, l · Timmann D.j · van de Warrenburg B.P.C.a
aDepartment of Neurology and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; bDepartment of Neurology, University Hospital of Bonn, Bonn, Germany; cDepartment of Neurology, Canisius Wilhemina Hospital, Nijmegen, The Netherlands; dDepartment of Neurology and Stroke, County Hospital, Veszprém, Hungary; eDepartment of Neurology, Medical University Innsbruck, Innsbruck, Austria; fDepartment of Molecular Neuroscience, Institute of Neurology, London, UK; gDepartment of Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; hDepartment of Medical Genetics and Child Development, University of Pécs, Pécs, Hungary; iDepartment of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; jDepartment of Neurology, University of Duisburg-Essen, Essen, kGerman Center for Neurodegenerative Diseases (DZNE), Bonn, and lGerman Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
In a previous retrospective study, we demonstrated that falls are common and often injurious in dominant spinocerebellar ataxias (SCAs) and that nonataxia features play an important role in these falls. Retrospective surveys are plagued by recall bias for the presence and details of prior falls. We therefore sought to corroborate and extend these retrospective findings by means of a prospective extension of this fall study. 113 patients with SCA1, SCA2, SCA3 or SCA6, recruited from the EuroSCA natural history study, were asked to keep a fall diary in between their annual visits to the participating centres. Additionally, patients completed a detailed questionnaire about the first three falls, to identify specific fall circumstances. Relevant disease characteristics were retrieved from the EuroSCA registry. 84.1% of patients reported at least one fall during a time period of 12 months. Fall-related injuries were common and their frequency increased with that of falls. The presence of nonataxia symptoms was associated with a higher fall frequency. This study confirms that falls are a frequent and serious complication of SCA, and that the presence of nonataxia symptoms is an important etiological factor in its occurrence.
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