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

Movement Disorders Clinical Practice Pub Date : 2024-04-24 DOI:10.1002/mdc3.14048

A. Fanciulli, Iva Stanković, Omer Avraham, Milica Jecmenica Lukic, A. Ezra, Fabian Leys, Georg Goebel, F. Krismer, Igor Petrović, M. Svetel, K. Seppi, Vladimir Kostić, Nir Giladi, W. Poewe, Gregor K Wenning, Tanya Gurevich

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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.

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多系统萎缩帕金森变异型的早期筛查：6 项评分。

背景以前曾有研究表明，基于正性低血压、膀胱过度活动症、尿潴留和姿势不稳定中≥2个特征的4项评分可早期区分多系统萎缩的帕金森变异型（MSA-P）和帕金森病（PD），敏感性为78%，特异性为86%。方法我们回顾性研究了161例早期帕金森病患者[即病程≤2年或无姿势不稳，年龄64（57；68）岁，44%为女性]，并在随访≥24个月后诊断为临床确诊的MSA-P（n = 38）或帕金森病（n = 123）。结果4项MSA-P评分对最终MSA-P诊断的敏感性为92%，特异性为78%。通过将多巴胺能反应性和姿势畸形纳入6项评分（范围：0-6），在疾病早期达到≥3分即可确定MSA-P患者，敏感性为89%，特异性为98%。

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Movement Disorders Clinical Practice

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