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Updated: Jun 28, 2025
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Published on: July 24, 2019
Early Screening for the Parkinson Variant of Multiple System Atrophy: A 6-Item Score
Alessandra Fanciulli1, Iva Stankovic2,3, Omer Avraham4,5
1Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
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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