| 言語種別 | 英語 |
| 発表タイトル | The diagnostic utility of the new MDS criteria for multiple system atrophy: a retrospective autopsy cohort study |
| 会議名 | International Congress of Parkinson’s Disease and Movement Disorders |
| 学会区分 | 国際学会及び海外の学会 |
| 発表形式 | ポスター掲示 |
| 講演区分 | 一般 |
| 発表者・共同発表者 | ◎Sekiya H, Koga S, Murakami A, Kawazoe M, Martin NB, Uitti R, Cheshire W, Wszolek Z, Dickson D. |
| 発表年月日 | 2023/08 |
| 開催地 （都市, 国名） |
Copenhagen, Denmark |
| 開催期間 | 2023/08/27～2023/08/31 |
| 概要 | Objective: This study aimed to validate the clinical utility of the newly proposed criteria for multiple system atrophy (MSA) by the International Parkinson and Movement Disorder Society (MDS).
Background: The second consensus statement has been widely used to diagnose MSA; however, it has been pointed out that the diagnostic accuracy is suboptimal. The new MDS criteria developed 4 categories: neuropathologically established MSA, clinically established MSA, clinically probable MSA, and possible prodromal MSA. Clinically established MSA was designed to have maximum specificity with acceptable sensitivity and clinically probable MSA was then aimed to balance sensitivity and specificity. The sensitivity and specificity of the new diagnostic criteria have not been fully examined. Methods: We identified consecutive patients with a clinical or pathological diagnosis of MSA from the Mayo Clinic Brain Bank between 1998 and 2021. We restricted the cohort to 352 patients with medical charts by neurologists or movement disorder specialists. Clinical signs and symptoms were extracted by systematic medical chart review. The MDS criteria and the second consensus criteria were applied to the cohort. The sensitivity, specificity, and area under the curve (AUC) of receiver operating characteristic curves were compared between these criteria. Comparison was conducted between clinical subtypes and among clinically challenging cases (those with different clinical diagnoses or those with suspected but undiagnosed MSA before death). Results: The sensitivity and specificity of clinically established MSA and clinically probable MSA by the MDS criteria were 16% and 99% and 64% and 74%, respectively. The sensitivity and specificity of probable MSA and possible MSA by the second consensus criteria were 72% and 52% and 93% and 21%, respectively. Clinically established MSA exhibited the highest specificity and clinically probable MSA demonstrated the greatest AUC. The diagnostic performance did not differ between clinical subtypes. In clinically challenging cases, clinically established MSA kept high specificity and clinically probable MSA demonstrated the highest AUC. Conclusions: In this retrospective autopsy cohort study, the MDS criteria showed high specificity with clinically established MSA and moderate sensitivity and specificity with clinically probable MSA. |