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

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. © 2024 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.