Objective: Evaluating the usefulness of clinical acrostic for the differential diagnosis of atypical Parkinsonian syndromes

Background: Differentiate Parkinson’s disease from atypical parkinsonian syndromes  is challenging mostly in early stages, due to the wide variability of phenotypes and clinical signs. The ATYPICAL acrostic has been proposed to help healthcare professionals systematically identify the key signs and symptoms

Method: This was a retrospective, descriptive, exploratory  inlcuide reviewing the medical records of consecutive patients, diagnosed by movement disorder specialists by international criteria during their routine clinical practice (1-4).The patients were seen at  medical center in Cali, Colombia, between March 2023 and January 2026. The signs described by the ATYPICAL acrostic. The group was divided according to diagnosis (Parkinson’s disease and atypical parkinsonism) and the clinical correlations were compared. Descriptive data   were presented as mean and standard deviation, or frequencies where appropriate. Pearson’s chi square and t test, were used for comparison. Statistical significance was set at 0.05. Statistical analysis was performed with the SPSS statistical package (version 25; Chicago, IL, USA)

Results: One hundred patients were evaluated, 50 with Parkinson’s disease (PD) and 50 with atypical Parkinsonism (APS), 68 y 64 % were man respectively, and  of the latter group, 18 (36%) had progressive supranuclear palsy (PSP), 10 (20%) had multiple system atrophy (MSA), and 20 (40%) had Lewy Body dementia (DCL) and 4% other parkinsonisms.The APS group had a higher mean age (71.6 (SD 8.6)   vs. 65 (SD 9.6) years in the PD group), while the PD group had a longer disease duration (9.4 (SD 6)  years vs. 5.9 (SD 3.1)  years in the AP group). The AP group showed a marked predominance of positive clinical signs according to the ATYPICAL classification, most of which were statistically significant (Table 1).

Conclusion: The ATYPICAL acrostic has great potential as a simple and easy-to-remember tool to help physicians systematically assess the characteristics that differentiate APS from PD in routine clinical practice. A ​​prospective, multicenter validation study with diagnostic performance metrics and reliability assessment is recommended.

Table 1. Clinical signs

References: 1. Wenning GK, Stankovic I, Vignatelli L, et al. The Movement Disorder Society criteria for the diagnosis of multiple system atrophy. Mov Disord 2022; 37: 1131–48.
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