Fanciulli, Alessandra (37072222700)Alessandra (37072222700)FanciulliStankovic, Iva (58775209600)Iva (58775209600)StankovicAvraham, Omer (58752892300)Omer (58752892300)AvrahamJecmenica Lukic, Milica (35801126700)Milica (35801126700)Jecmenica LukicEzra, Adi (35094007300)Adi (35094007300)EzraLeys, Fabian (57216857911)Fabian (57216857911)LeysGoebel, Georg (7006610530)Georg (7006610530)GoebelKrismer, Florian (56589781100)Florian (56589781100)KrismerPetrovic, Igor (7004083314)Igor (7004083314)PetrovicSvetel, Marina (6701477867)Marina (6701477867)SvetelSeppi, Klaus (7004725975)Klaus (7004725975)SeppiKostic, Vladimir (35239923400)Vladimir (35239923400)KosticGiladi, Nir (7006084033)Nir (7006084033)GiladiPoewe, Werner (35373337300)Werner (35373337300)PoeweWenning, Gregor K. (21647300300)Gregor K. (21647300300)WenningGurevich, Tanya (6603737036)Tanya (6603737036)Gurevich2025-06-122025-06-122024https://doi.org/10.1002/mdc3.14048https://www.scopus.com/inward/record.uri?eid=2-s2.0-85191351151&doi=10.1002%2fmdc3.14048&partnerID=40&md5=891766205b8afd42040a5df02939fb7bhttps://remedy.med.bg.ac.rs/handle/123456789/1092Background: 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.bladder dysfunctionmultiple system atrophyorthostatic hypotensionParkinson's diseasepostural instability