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Abstract

Background: A consensus conference on multiple system atrophy (MSA) in 1998 established criteria for diagnosis that have been accepted widely. Since then, clinical, laboratory, neuropathologic, and imaging studies have advanced the field, requiring a fresh evaluation of diagnostic criteria. We held a second consensus conference in 2007 and present the results here.
Methods: Experts in the clinical, neuropathologic, and imaging aspects of MSA were invited to participate in a 2-day consensus conference. Participants were divided into five groups, consisting of specialists in the parkinsonian, cerebellar, autonomic, neuropathologic, and imaging aspects of the disorder. Each group independently wrote diagnostic criteria for its area of expertise in advance of the meeting. These criteria were discussed and reconciled during the meeting using consensus methodology.
Results: The new criteria retain the diagnostic categories of MSA with predominant parkinsonism and MSA with predominant cerebellar ataxia to designate the predominant motor features and also retain the designations of definite, probable, and possible MSA. Definite MSA requires neuropathologic demonstration of CNS α-synuclein–positive glial cytoplasmic inclusions with neurodegenerative changes in striatonigral or olivopontocerebellar structures. Probable MSA requires a sporadic, progressive adult-onset disorder including rigorously defined autonomic failure and poorly levodopa-responsive parkinsonism or cerebellar ataxia. Possible MSA requires a sporadic, progressive adult-onset disease including parkinsonism or cerebellar ataxia and at least one feature suggesting autonomic dysfunction plus one other feature that may be a clinical or a neuroimaging abnormality.
Conclusions: These new criteria have simplified the previous criteria, have incorporated current knowledge, and are expected to enhance future assessments of the disease.

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REFERENCES

1.
Quinn N. Multiple system atrophy–the nature of the beast. J Neurol Neurosurg Psychiatry 1989;(suppl):78–89.
2.
Wenning GK, Tison F, Ben Shlomo Y, Daniel SE, Quinn NP. Multiple system atrophy: a review of 203 pathologically proven cases. Mov Disord 1997;12:133–147.
3.
Gilman S, Low PA, Quinn N, et al. Consensus statement on the diagnosis of multiple system atrophy. J Neurol Sci 1999;163:94–98.
4.
Geser F, Wenning GK, Seppi K, et al. Progression of multiple system atrophy (MSA): a prospective natural history study by the European MSA Study Group (EMSA SG). Mov Disord 2006;21:179–186.
5.
Kirchhof K, Apostolidis AN, Mathias CJ, Fowler CJ. Erectile and urinary dysfunction may be the presenting features in patients with multiple system atrophy: a retrospective study. Int J Impot Res 2003;15:293–298.
6.
Papp MI, Kahn JE, Lantos PL. Glial cytoplasmic inclusions in the CNS of patients with multiple system atrophy (striatonigral degeneration, olivopontocerebellar atrophy and Shy-Drager syndrome). J Neurol Sci 1989;94:79–100.
7.
Spillantini MG, Crowther RA, Jakes R, Cairns NJ, Lantos PL, Goedert M. Filamentous alpha-synuclein inclusions link multiple system atrophy with Parkinson's disease and dementia with Lewy bodies. Neurosci Lett 1998;251:205–208.
8.
Ozawa T, Healy DG, Abou-Sleiman PM, et al. The alpha-synuclein gene in multiple system atrophy. J Neurol Neurosurg Psychiatry 2006;77:464–467.
9.
Osaki Y, Wenning GK, Daniel SE, et al. Do published criteria improve clinical diagnostic accuracy in multiple system atrophy? Neurology 2002;59:1486–1491.
10.
Colosimo C, Vanacore N, Bonifati V, et al. Clinical diagnosis of multiple system atrophy: level of agreement between Quinn's criteria and the consensus conference guidelines. Acta Neurol Scand 2001;103:261–264.
11.
Ozawa T, Paviour D, Quinn NP, et al. The spectrum of pathological involvement of the striatonigral and olivopontocerebellar systems in multiple system atrophy: clinicopathological correlations. Brain 2004;127:2657–2671.
12.
Seppi K, Schocke MF, Mair KJ, et al. Progression of putaminal degeneration in multiple system atrophy: a serial diffusion MR study. Neuroimage 2006;31:240–245.
13.
Seppi K, Schocke MF, Donnemiller E, et al. Comparison of diffusion-weighted imaging and [123I]IBZM-SPECT for the differentiation of patients with the Parkinson variant of multiple system atrophy from those with Parkinson's disease. Mov Disord 2004;19:1438–1445.
14.
Gilman S. Functional imaging with positron emission tomography in multiple system atrophy. J Neural Transm 2005;112:1647–1655.
15.
Trojanowski JQ, Revesz T. Proposed neuropathological criteria for the post mortem diagnosis of multiple system atrophy. Neuropathol Appl Neurobiol 2007;33:615–620.
16.
Oertel WH, Wachter T, Quinn NP, Ulm G, Brandstadter D. Reduced genital sensitivity in female patients with multiple system atrophy of parkinsonian type. Mov Disord 2003;18:430–432.
17.
Allcock LM, Ullyart K, Kenny RA, Burn DJ. Frequency of orthostatic hypotension in a community based cohort of patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 2004;75:1470–1471.
18.
Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Neurology 1996;46:1470.
19.
Suarez GA, Opfer-Gehrking TL, Offord KP, Atkinson EJ, O'Brien PC, Low PA. The Autonomic Symptom Profile: a new instrument to assess autonomic symptoms. Neurology 1999;52:523–528.
20.
Sandroni P, Ahlskog JE, Fealey RD, Low PA. Autonomic involvement in extrapyramidal and cerebellar disorders. Clin Auton Res 1991;1:147–155.
21.
Courbon F, Brefel-Courbon C, Thalamas C, et al. Cardiac MIBG scintigraphy is a sensitive tool for detecting cardiac sympathetic denervation in Parkinson's disease. Mov Disord 2003;18:890–897.
22.
Nagayama H, Hamamoto M, Ueda M, Nagashima J, Katayama Y. Reliability of MIBG myocardial scintigraphy in the diagnosis of Parkinson's disease. J Neurol Neurosurg Psychiatry 2005;76:249–251.
23.
Raffel DM, Koeppe RA, Little R, et al. PET measurement of cardiac and nigrostriatal denervation in parkinsonian syndromes. J Nucl Med 2006;47:1769–1777.
24.
Fahn S, Elton RL, UPDRS Development Committee. Unified Parkinson Disease Rating Scale. Floral Park, NJ: Macmillan, 1987.
25.
Seppi K, Yekhlef F, Diem A, et al. Progression of parkinsonism in multiple system atrophy. J Neurol 2005;252:91–96.
26.
Hughes AJ, Colosimo C, Kleedorfer B, Daniel SE, Lees AJ. The dopaminergic response in multiple system atrophy. J Neurol Neurosurg Psychiatry 1992;55:1009–1013.
27.
Wenning GK, Tison F, Seppi K, et al. Development and validation of the Unified Multiple System Atrophy Rating Scale (UMSARS). Mov Disord 2004;19:1391–1402.
28.
Iranzo A, Santamaria J, Rye DB, et al. Characteristics of idiopathic REM sleep behavior disorder and that associated with MSA and PD. Neurology 2005;65:247–252.
29.
Seppi K, Schocke MF, Wenning GK, Poewe W. How to diagnose MSA early: the role of magnetic resonance imaging. J Neural Transm 2005;112:1625–1634.
30.
Gilman S, Koeppe RA, Junck L, et al. Decreased striatal monoaminergic terminals in multiple system atrophy detected with positron emission tomography. Ann Neurol 1999;45:769–777.
31.
Nicoletti G, Lodi R, Condino F, et al. Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy. Brain 2006;129:2679–2687.
32.
Abdo WF, Bloem BR, Van Geel WJ, Esselink RA, Verbeek MM. CSF neurofilament light chain and tau differentiate multiple system atrophy from Parkinson's disease. Neurobiol Aging 2007;28:742–747.
33.
Klockgether T, Ludtke R, Kramer B, et al. The natural history of degenerative ataxia: a retrospective study in 466 patients. Brain 1998;121(pt 4):589–600.
34.
Berry-Kravis E, Abrams L, Coffey SM, et al. Fragile X-associated tremor/ataxia syndrome: Clinical features, genetics, and testing guidelines. Mov Disord 2007;22:2018–2030.
35.
Kamm C, Healy DG, Quinn NP, et al. The fragile X tremor ataxia syndrome in the differential diagnosis of multiple system atrophy: data from the EMSA Study Group. Brain 2005;128:1855–1860.
36.
Abele M, Minnerop M, Urbach H, Specht K, Klockgether T. Sporadic adult onset ataxia of unknown etiology: a clinical, electrophysiological and imaging study. J Neurol 2007;254:1384–1389.
37.
Hara K, Momose Y, Tokiguchi S, et al. Multiplex families with multiple system atrophy. Arch Neurol 2007;64:545–551.
38.
Nirenberg MJ, Libien J, Vonsattel JP, Fahn S. Multiple system atrophy in a patient with the spinocerebellar ataxia 3 gene mutation. Mov Disord 2007;22:251–254.

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Published In

Neurology®
Volume 71Number 9August 26, 2008
Pages: 670-676
PubMed: 18725592

Publication History

Published online: August 25, 2008
Published in print: August 26, 2008

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Authors

Affiliations & Disclosures

S. Gilman, MD, FRCP
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
G. K. Wenning, MD, PhD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
P. A. Low, MD, FRACP, FRCP(Hon)
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
D. J. Brooks, MD, DSc, FRCP, FMedSci
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
C. J. Mathias, MBBS, DPhil, DSc, FRCP, FMedSci
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
J. Q. Trojanowski, MD, PhD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
N. W. Wood, MB, ChB, PhD, FRCP
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
C. Colosimo, MD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
A. Dürr, MD, PhD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
C. J. Fowler, FRCP
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
H. Kaufmann, MD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
T. Klockgether, MD, PhD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
A. Lees, MD, FRCP
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
W. Poewe, MD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
N. Quinn, MD, FRCP
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
T. Revesz, MD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
D. Robertson, MD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
P. Sandroni, MD, PhD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
K. Seppi, MD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.
M. Vidailhet, MD, PhD
AFFILIATIONS From the Departments of Neurology, University of Michigan (S.G.), Ann Arbor, MI; Medical University of Innsbruck (G.K.W., W.P., K.S.), Austria; Mayo Clinic Rochester (P.A.L., P.S), Minnesota; and University Hospital Bonn (T.K.), Germany; Hammersmith Hospital and Department of Clinical Neuroscience (D.B.), Imperial College London, UK; Neurovascular Medicine (Pickering) Unit Faculty of Medicine (C.J.M.), Imperial College London, UK; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia, PA; National Hospital Queen Square (N.W.W., C.F., A.L., N.Q., T.R.), London, UK; Department of Neurological Sciences (C.C.), University of Rome La Sapienza, Italy; INSERM U289 Hôpital de la Salpêtrière (A.D.), Paris, France; New York University School of Medicine (H.K.), New York, NY; Vanderbilt University Clinical Research Center (D.R.), Nashville, TN; and Federation of Neurology and INSERM U679 (M.V.), Pierre Marie Curie Paris-6 University, France.

Notes

Address correspondence and reprint requests to Dr. Sid Gilman, Department of Neurology, University of Michigan, 300 N. Ingalls St., 3D15, Ann Arbor, MI 48109-5489 [email protected]

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