Clinical validation of the 2008 and 2022 diagnostic criteria for early multiple system atrophy

Abstract Purpose The Movement Disorders Society criteria for multiple system atrophy (MDS-MSA) was recently proposed to improve the diagnostic accuracy, particularly the lack of sensitivity at early stages. We aimed to seek consistencies and discrepancies between the old and new criteria in early MSA-C. Methods Fifty patients with a cerebellar syndrome with duration less than two years were recruited. Either MSA or cerebellar ataxia (CA) was diagnosed according to the second consensus criteria and MDS-MSA criteria, respectively. Results Among the forty-one MSA-C patients diagnosed by the second consensus criteria, sixteen patients were diagnosed with CA by the MDS-MSA criteria due to lack of supportive clinical features. Eleven probable MSA patients were diagnosed with clinically probable MSA by the MDS-MSA criteria, due to absence of MRI biomarkers. Conclusion The MDS-MSA criteria seems to be stricter compared with the second consensus criteria, and modest sensitivity still proposes a challenge for early detection of MSA-C.