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A validation exercise on the new consensus criteria for multiple system atrophy

Authors

  • Yasushi Osaki MD,

    1. National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
    2. Department of Geriatrics, Cardiology and Neurology, Kochi Medical School, Kochi, Japan
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  • Yoav Ben-Shlomo MD,

    1. Department of Social Medicine, University of Bristol, Bristol, United Kingdom
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  • Andrew J. Lees MD,

    1. Reta Lila Weston Institute for Neurological Studies, Royal Free and UCL Medical School, London, United Kingdom
    2. Queen Square Brain Bank for Neurological Disorders, London, United Kingdom
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  • Gregor K. Wenning MSc,

    1. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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  • Niall P. Quinn MD

    Corresponding author
    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
    • Box 147, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
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  • Potential conflict of interest: Nothing to report.

Abstract

The revised (new) consensus clinical diagnostic criteria for multiple system atrophy (MSA) were published in 2008. To validate these criteria, we utilized the same cohort that we reported previously, which included 59 patients with a clinical diagnosis of MSA that was confirmed neuropathologically in 51 of them at the Queen Square Brain Bank for Neurological Disorders. At the first clinic visit, sensitivity with new consensus possible category was higher, and PPV marginally higher, than for clinical diagnosis and old consensus possible category. New consensus probable category showed marginally higher sensitivity than, and the same PPV as, old consensus probable category. At the last clinic visit, new consensus possible category had exactly the same sensitivity and only marginally higher PPV compared with old consensus possible category. New consensus probable category showed the same sensitivity and PPV as old consensus probable category. Our data indicate that in this case material the new consensus criteria for possible MSA could improve diagnostic accuracy at first neurological evaluation compared with the old consensus criteria. Prospective clinicopathological validation studies of the new consensus criteria, particularly incorporating in vivo structural and functional imaging results, are required to extend the current findings. © 2009 Movement Disorder Society

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