HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Osaki, Y. Articles by Quinn, N. Search for Related Content PubMed PubMed Citation Articles by Osaki, Y. Articles by Quinn, N. Related Collections All Movement Disorders Parkinson's disease/Parkinsonism Multiple system atrophy

Do published criteria improve clinical diagnostic accuracy in multiple system atrophy?

From the National Hospital for Neurology and Neurosurgery (Dr. Osaki), London; the Department of Social Medicine University of Bristol (Dr. Ben-Shlomo), UK; the Department of Neurology (Dr. Wenning), University Hospital, Innsbruck, Austria; Queen Square Brain Bank for Neurological Disorders (Drs. Daniel and Lees), London, UK; Austin and Repatriation Medical Centre (Dr. Hughes), Heidelberg West, Victoria, Australia; Reta Lila Weston Institute for Neurological Studies (Dr. Lees), Royal Free and UCL Medical School, London; Neurovascular Medicine Unit (Dr. Mathias), Imperial College of Science, Technology & Medicine at St. Mary’s Hospital, London; and Sobell Department of Motor Neuroscience and Movement Disorders (Dr. Quinn), Institute of Neurology, London, UK.

Address correspondence and reprint requests to Prof. N. Quinn, Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London WC1N 3BG, UK; e-mail: n.quinn{at}ion.ucl.ac.uk

Objective: To assess the accuracy of a clinical diagnosis of multiple system atrophy (MSA) and compare it to the Quinn and Consensus criteria for MSA using neuropathologically examined cases from the Queen Square Brain Bank for Neurological Disorders.

Methods: Fifty-nine cases with a neurologic diagnosis of MSA when last assessed prior to death were studied.

Results: In 51 (86%) of these cases, the diagnosis of MSA was confirmed pathologically. False positive diagnoses included PD (n = 6), progressive supranuclear palsy (n = 1), and cerebrovascular disease (n = 1). When applying either set of diagnostic criteria, a diagnosis of probable MSA gave lower sensitivity but higher positive predictive value than one of possible MSA. Application of either set of diagnostic criteria was superior to actual clinical diagnosis made early in the disease, but there was little difference by the last clinic visit.

Conclusions: This study shows a high diagnostic accuracy for the clinical diagnosis of MSA by neurologists, with PD accounting for most of the false positive diagnoses. Application of either Quinn or Consensus criteria was superior to actual clinical diagnosis made early in the disease, but there was little difference by last clinic visit.

This article has been cited by other articles:

				G. Bensimon, A. Ludolph, Y. Agid, M. Vidailhet, C. Payan, P. N. Leigh, and for the NNIPPS Study Group Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: The NNIPPS Study Brain, January 1, 2009; 132(1): 156 - 171. [Abstract] [Full Text] [PDF]

				S. Gilman, G. K. Wenning, P. A. Low, D. J. Brooks, C. J. Mathias, J. Q. Trojanowski, N. W. Wood, C. Colosimo, A. Durr, C. J. Fowler, et al. Second consensus statement on the diagnosis of multiple system atrophy Neurology, August 26, 2008; 71(9): 670 - 676. [Abstract] [Full Text] [PDF]

				M. Tada, O. Onodera, M. Tada, T. Ozawa, Y.-S. Piao, A. Kakita, H. Takahashi, and M. Nishizawa Early Development of Autonomic Dysfunction May Predict Poor Prognosis in Patients With Multiple System Atrophy Arch Neurol, February 1, 2007; 64(2): 256 - 260. [Abstract] [Full Text] [PDF]

				K. Seppi, C. Scherfler, E. Donnemiller, I. Virgolini, M. F. H. Schocke, G. Goebel, K. J. Mair, S. Boesch, C. Brenneis, G. K. Wenning, et al. Topography of Dopamine Transporter Availability in Progressive Supranuclear Palsy: A Voxelwise [123I]beta-CIT SPECT Analysis. Arch Neurol, August 1, 2006; 63(8): 1154 - 1160. [Abstract] [Full Text] [PDF]

				K. S M Taylor and C. Counsell Is it Parkinson's disease, and if not, what is it? Practical Neurology, June 1, 2006; 6(3): 154 - 165. [Full Text] [PDF]

				V. Biancalana, M. Toft, I. Le Ber, F. Tison, E. Scherrer, S. Thibodeau, J. L. Mandel, A. Brice, M. J. Farrer, and A. Durr FMR1 Premutations Associated With Fragile X-Associated Tremor/Ataxia Syndrome in Multiple System Atrophy Arch Neurol, June 1, 2005; 62(6): 962 - 966. [Abstract] [Full Text] [PDF]

				J. Hemingway, K. Franco, and E. Chmelik Shy-Drager Syndrome: Multisystem Atrophy With Comorbid Depression Psychosomatics, February 1, 2005; 46(1): 73 - 76. [Full Text] [PDF]

				T. Ozawa, D. Paviour, N. P. Quinn, K. A. Josephs, H. Sangha, L. Kilford, D. G. Healy, N. W. Wood, A. J. Lees, J. L. Holton, et al. The spectrum of pathological involvement of the striatonigral and olivopontocerebellar systems in multiple system atrophy: clinicopathological correlations Brain, December 1, 2004; 127(12): 2657 - 2671. [Abstract] [Full Text] [PDF]