TY  - INPR
N2  - BACKGROUND: The second consensus criteria for the diagnosis of multiple system atrophy (MSA) are widely recognized as the reference standard for clinical research, but lack sensitivity to diagnose the disease at early stages. OBJECTIVE: To develop novel Movement Disorder Society (MDS) criteria for MSA diagnosis using an evidence-based and consensus-based methodology. METHODS: We identified shortcomings of the second consensus criteria for MSA diagnosis and conducted a systematic literature review to answer predefined questions on clinical presentation and diagnostic tools relevant for MSA diagnosis. The criteria were developed and later optimized using two Delphi rounds within the MSA Criteria Revision Task Force, a survey for MDS membership, and a virtual Consensus Conference. RESULTS: The criteria for neuropathologically established MSA remain unchanged. For a clinical MSA diagnosis a new category of clinically established MSA is introduced, aiming for maximum specificity with acceptable sensitivity. A category of clinically probable MSA is defined to enhance sensitivity while maintaining specificity. A research category of possible prodromal MSA is designed to capture patients in the earliest stages when symptoms and signs are present, but do not meet the threshold for clinically established or clinically probable MSA. Brain magnetic resonance imaging markers suggestive of MSA are required for the diagnosis of clinically established MSA. The number of research biomarkers that support all clinical diagnostic categories will likely grow. CONCLUSIONS: This set of MDS MSA diagnostic criteria aims at improving the diagnostic accuracy, particularly in early disease stages. It requires validation in a prospective clinical and a clinicopathological study. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
PB  - Wiley
Y1  - 2022/04/21/
A1  - Wenning, Gregor K
A1  - Stankovic, Iva
A1  - Vignatelli, Luca
A1  - Fanciulli, Alessandra
A1  - Calandra-Buonaura, Giovanna
A1  - Seppi, Klaus
A1  - Palma, Jose-Alberto
A1  - Meissner, Wassilios G
A1  - Krismer, Florian
A1  - Berg, Daniela
A1  - Cortelli, Pietro
A1  - Freeman, Roy
A1  - Halliday, Glenda
A1  - Höglinger, Günter
A1  - Lang, Anthony
A1  - Ling, Helen
A1  - Litvan, Irene
A1  - Low, Phillip
A1  - Miki, Yasuo
A1  - Panicker, Jalesh
A1  - Pellecchia, Maria Teresa
A1  - Quinn, Niall
A1  - Sakakibara, Ryuji
A1  - Stamelou, Maria
A1  - Tolosa, Eduardo
A1  - Tsuji, Shoji
A1  - Warner, Tom
A1  - Poewe, Werner
A1  - Kaufmann, Horacio
ID  - discovery10147354
N1  - © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
JF  - Movement Disorders
AV  - public
UR  - https://doi.org/10.1002/mds.29005
KW  - Diagnosis
KW  -  diagnostic criteria
KW  -  multiple system atrophy
TI  - The Movement Disorder Society Criteria for the Diagnosis of Multiple System Atrophy
ER  -