Blinking in patients with clinically probable multiple system atrophy

Matteo Bologna, Luca Marsili, Nashaba Khan, Ahmad Khandker Parvez, Giulia Paparella, Nicola Modugno, Carlo Colosimo, Giovanni Fabbrini, Alfredo Berardelli

Research output: Contribution to journalArticlepeer-review


Background: Clinical studies in patients with MSA document facial motor abnormalities, but no studies have objectively assessed blinking abnormalities in this condition. Methods: We enrolled patients diagnosed as having clinically probable MSA, 20 patients of the parkinsonian phenotype (MSA-P) and 10 patients of the cerebellar phenotype (MSA-C) and 20 healthy controls (HCs). Blinking was recorded with a three-dimensional optoelectronic motion system equipped with dedicated software for data analysis. Results: During voluntary blinking, the interphase pause duration between the closing and opening phases lasted longer in MSA-P and in MSA-C patients than in HCs; the opening phase had increased duration and reduced peak velocity in MSA-P. During reflex blinking, the opening blink phase also lasted longer in MSA-P patients than in HCs. During spontaneous blinking, the rate and kinematics of the closing and opening blinking phases were lower in MSA-P and in MSA-C patients than in HCs. Blink reflex recovery was higher in patients than in HCs. No difference was found between MSA-P patients receiving or not receiving dopaminergic medication. Conclusions: Our objective assessment of upper facial movement documents abnormalities of voluntary, spontaneous, and reflex blinking in patients with MSA-P and MSA-C, reflecting cortical-basal ganglia and brainstem dysfunction.

Original languageEnglish
Pages (from-to)415-420
Number of pages6
JournalMovement Disorders
Issue number3
Publication statusPublished - 2014


  • Basal ganglia
  • Blinking
  • Brainstem
  • Movement control
  • Multiple system atrophy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Medicine(all)


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