{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:16:06Z","timestamp":1783433766499,"version":"3.54.6"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple system atrophy (MSA) is characterized by progressive autonomic\/motor dysfunction, but robust biomarkers do not exist. Electrochemical skin conductance (ESC) provides a noninvasive measure of sudomotor function, but its longitudinal predictive value and prognostic relevance in MSA remain insufficiently studied. We aimed to comprehensively evaluate ESC in a large longitudinal cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 175 patients with MSA followed for a mean of 4.2\u2009\u00b1\u20092.1\u2009years. Disease severity was assessed using UMSARS Parts 1 and 2, COMPASS31, SCOPA\u2010AUT, and orthostatic blood pressure (BP) measurements. Hand and foot ESC were measured using Sudoscan. Cross\u2010sectional and longitudinal associations were examined using linear mixed\u2010effects models, repeated\u2010measures correlations, and grouped 10\u2010fold cross\u2010validation. Mortality predictors were assessed with time\u2010varying Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ESC was strongly inversely associated with UMSARS 1 and 2 (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.58 to \u22120.65;\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.67 to \u22120.75; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), whereas associations with orthostatic BP, autonomic symptom scales, and disease duration were weaker or inconsistent. ESC declined significantly over time (feet \u22126.88\u2009\u00b1\u20090.60\u2009\u03bcS\/year; hands \u22125.41\u2009\u00b1\u20090.46\u2009\u03bcS\/year; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), paralleling UMSARS progression. ESC outperformed orthostatic BP drops in predicting UMSARS scores in mixed\u2010effects models and cross\u2010validation. Higher ESC independently predicted lower mortality, while higher UMSARS scores and greater orthostatic BP drops predicted increased risk. Median survival was 46.2\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ESC is a sensitive biomarker of disease severity, progression, and survival in MSA, substantially outperforming orthostatic BP measures. Its simplicity and prognostic value support incorporation into routine monitoring and clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70620","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T10:18:01Z","timestamp":1781864281000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Decline in Electrochemical Skin Conductance Reflects Disease Progression in Multiple System Atrophy"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1195-3611","authenticated-orcid":false,"given":"Paulo","family":"Bastos","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology and Neurosciences Toulouse University Hospital  Toulouse France"},{"name":"French Clinical Research Network (F\u2010CRIN) for Parkinson's Disease and Movement Disorders (NS\u2010Park\u2013F\u2010CRIN)  Toulouse France"},{"name":"Clinical Investigation Center CIC 1436, CHU de Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Kermorgant","sequence":"additional","affiliation":[{"name":"Clinical Investigation Center CIC 1436, CHU de Toulouse  Toulouse France"},{"name":"Neurology Department, French MSA Reference Center Toulouse University Hospital  Toulouse France"},{"name":"ToNIC\u2014Toulouse Neuro Imaging Center\u2014INSERM\u2014UMR 1214  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Ory\u2010Magne","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Neurosciences Toulouse University Hospital  Toulouse France"},{"name":"Clinical Investigation Center CIC 1436, CHU de Toulouse  Toulouse France"},{"name":"Centre de r\u00e9f\u00e9rence constitutif des syndromes paran\u00e9oplasiques et enc\u00e9phalites auto\u2010immunes, CHU Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9mence","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Neurosciences Toulouse University Hospital  Toulouse France"},{"name":"Clinical Investigation Center CIC 1436, CHU de Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Neurosciences Toulouse University Hospital  Toulouse France"},{"name":"French Clinical Research Network (F\u2010CRIN) for Parkinson's Disease and Movement Disorders (NS\u2010Park\u2013F\u2010CRIN)  Toulouse France"},{"name":"Clinical Investigation Center CIC 1436, CHU de Toulouse  Toulouse France"},{"name":"Neurology Department, French MSA Reference Center Toulouse University Hospital  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Rascol","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Neurosciences Toulouse University Hospital  Toulouse France"},{"name":"French Clinical Research Network (F\u2010CRIN) for Parkinson's Disease and Movement Disorders (NS\u2010Park\u2013F\u2010CRIN)  Toulouse France"},{"name":"Clinical Investigation Center CIC 1436, CHU de Toulouse  Toulouse France"},{"name":"Neurology Department, French MSA Reference Center Toulouse University Hospital  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Foubert\u2010Samier","sequence":"additional","affiliation":[{"name":"CHU Bordeaux, Service de Neurologie des Maladies Neurod\u00e9g\u00e9n\u00e9ratives, IMNc, CRMR AMS  Bordeaux France"},{"name":"University of Bordeaux, CNRS, IMN, UMR 5293  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bendetowicz","sequence":"additional","affiliation":[{"name":"CHU Bordeaux, Service de Neurologie des Maladies Neurod\u00e9g\u00e9n\u00e9ratives, IMNc, CRMR AMS  Bordeaux France"},{"name":"University of Bordeaux, CNRS, IMN, UMR 5293  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2172-7527","authenticated-orcid":false,"given":"Wassilios G.","family":"Meissner","sequence":"additional","affiliation":[{"name":"CHU Bordeaux, Service de Neurologie des Maladies Neurod\u00e9g\u00e9n\u00e9ratives, IMNc, CRMR AMS  Bordeaux France"},{"name":"University of Bordeaux, CNRS, IMN, UMR 5293  Bordeaux France"},{"name":"Department of Medicine University of Otago  Christchurch New Zealand"},{"name":"New Zealand Brain Research Institute  Christchurch New 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