A call for multiple system atrophy centers of excellence

Coon, Elizabeth A.; Golden, Elisabeth P.; Bryarly, Meredith; McGregor, Tamara; Nguyen, Benjamin N; Moutvic, Margaret A; Cutsforth‐Gregory, Jeremy K.; Stevens, Patricia M; Chou, Claudia Z; Rhee, Laura; Vernino, Steven

doi:10.1007/s10286-022-00866-1

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…The increased sensitivity is likely due to the fact that an OH diagnosis based on a standing test 17 and a history of urinary disturbances were sufficient to assign a point for the respective items of the MSA‐P score in the present study. Such methodological decision was consciously taken bearing in mind that access to autonomic function testing 18 is often limited outside of MSA referral centers, 19 yet bedside screening measures like the standing test provide significant diagnostic and therapeutic guidance when included in the work‐up of individuals with early parkinsonism. This same decision however also likely explains the lower specificity observed, since non‐neurogenic causes of OH and urinary disturbances such as polypharmacy, perineal laxity in women or prostate hypertrophy in men were not systematically excluded like in the previous study.…”

Section: Discussionmentioning

confidence: 99%

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

Fanciulli,

Stankovic,

Avraham

et al. 2024

Movement Disord Clin Pract

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BackgroundA 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.ObjectivesTo replicate and improve the 4‐item MSA‐P score.MethodsWe 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.ResultsThe 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.ConclusionsThe 6‐item MSA‐P score is a cost‐effective tool to pinpoint individuals with early‐stage MSA‐P.

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Section: Discussionmentioning

confidence: 99%