Early Screening for the Parkinson Variant of Multiple System Atrophy: A 6-Item Score

Alessandra Fanciulli*, Iva Stankovic, Omer Avraham, Milica Jecmenica Lukic, Adi Ezra, Fabian Leys, Georg Goebel, Florian Krismer, Igor Petrovic, Marina Svetel, Klaus Seppi, Vladimir Kostic, Nir Giladi, Werner Poewe, Gregor K. Wenning, Tanya Gurevich

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A 4-item score based on ≥2 features out of orthostatic hypotension, overactive bladder, urinary retention and postural instability was previously shown to early distinguish the Parkinson-variant of multiple system atrophy (MSA-P) from Parkinson's disease (PD) with 78% sensitivity and 86% specificity. Objectives: To replicate and improve the 4-item MSA-P score. Methods: We retrospectively studied 161 patients with early parkinsonism [ie, ≤2 years disease duration or no postural instability, aged 64 (57; 68) years, 44% females] and a diagnosis of clinically established MSA-P (n = 38) or PD (n = 123) after ≥24 months follow-up. Results: The 4-item MSA-P score had a 92% sensitivity and 78% specificity for a final MSA-P diagnosis. By including dopaminergic responsiveness and postural deformities into a 6-item score (range: 0–6), reaching ≥3 points at early disease identified MSA-P patients with 89% sensitivity and 98% specificity. Conclusions: The 6-item MSA-P score is a cost-effective tool to pinpoint individuals with early-stage MSA-P.

Original languageEnglish
Pages (from-to)867-873
Number of pages7
JournalMovement Disorders Clinical Practice
Volume11
Issue number7
DOIs
StatePublished - Jul 2024

Keywords

  • Parkinson's disease
  • bladder dysfunction
  • multiple system atrophy
  • orthostatic hypotension
  • postural instability

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