TY - JOUR AV - public JF - Movement Disorders EP - 12 N1 - This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ ID - discovery10152453 PB - WILEY A1 - Maas, Roderick PPWM A1 - Teerenstra, Steven A1 - Lima, Manuela A1 - Pires, Paula A1 - Pereira de Almeida, Luis A1 - van Gaalen, Judith A1 - Timmann, Dagmar A1 - Infante, Jon A1 - Onyike, Chiadi A1 - Bushara, Khalaf A1 - Jacobi, Heike A1 - Reetz, Kathrin A1 - Santana, Magda M A1 - Afonso Ribeiro, Joana A1 - Huebener-Schmid, Jeannette A1 - de Vries, Jeroen J A1 - Synofzik, Matthis A1 - Schoels, Ludger A1 - Garcia-Moreno, Hector A1 - Giunti, Paola A1 - Faber, Jennifer A1 - Klockgether, Thomas A1 - van de Warrenburg, Bart PC Y1 - 2022/07/08/ N2 - Background: Disease severity in spinocerebellar ataxia type 3 (SCA3) is commonly defined by the Scale for the Assessment and Rating of Ataxia (SARA) sum score, but little is known about the contributions and progression patterns of individual items. Objectives: To investigate the temporal dynamics of SARA item scores in SCA3 patients and evaluate if clinical and demographic factors are differentially associated with evolution of axial and appendicular ataxia. Methods: In a prospective, multinational cohort study involving 11 European and 2 US sites, SARA scores were determined longitudinally in 223 SCA3 patients with a follow-up assessment after 1 year. Results: An increase in SARA score from 10 to 20 points was mainly driven by axial and speech items, with a markedly smaller contribution of appendicular items. Finger chase and nose-finger test scores not only showed the lowest variability at baseline, but also the least deterioration at follow-up. Compared with the full set of SARA items, omission of both tests would result in lower sample size requirements for therapeutic trials. Sex was associated with change in SARA sum score and appendicular, but not axial, subscore, with a significantly faster progression in men. Despite considerable interindividual variability, the average annual progression rate of SARA score was approximately three times higher in subjects with a disease duration over 10 years than in those within 10 years from onset. Conclusion: Our findings provide evidence for a difference in temporal dynamics between axial and appendicular ataxia in SCA3 patients, which will help inform the design of clinical trials and development of new (etiology-specific) outcome measures. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. KW - Science & Technology KW - Life Sciences & Biomedicine KW - Clinical Neurology KW - Neurosciences & Neurology KW - spinocerebellar ataxia type 3 KW - natural history KW - Scale for the Assessment and Rating of Ataxia KW - disease progression KW - DISEASE PROGRESSION KW - CEREBELLAR-ATAXIA KW - NATURAL-HISTORY KW - SPINOCEREBELLAR TI - Differential Temporal Dynamics of Axial and Appendicular Ataxia in SCA3 UR - https://doi.org/10.1002/mds.29135 ER -