Objective: To determine the correlation between UMSARS II and MDS-UPDRS III.

Background: Despite the availability of the Unified Multiple System Atrophy Rating Scale (UMSARS) [1] and its motor section (UMSARS II), many studies still report motor impairment of MSA patients using UPDRS or MDS-UPDRS III.[2] Although UMSARS is strongly correlated to UPDRS (r=0.93, p<0.001),[1] to our knowledge, there are no reports of its correlation to MDS-UPDRS III.

Method: Retrospective study of consecutive MSA patients [3] with at least one UMSARS II evaluation and one MDS-UPDRS III evaluation, performed within ±6 months of each other. An equivalent version was calculated for both scales using the common items to both  (UMSARS II 1,2,4-9,11-14; and MDS-UPDRS III 1, 2, 9, 10, 12, 13). Spearman correlations were sought between both total and equivalent versions of UMSARS and MDS-UPDRS III.

Results: We included 15 patients, (male 10, female 5), with a mean±SD age 63.1±8.5 years, age at onset of 59.9±9.0, and median(IQR) 1.0(2.9) months between evaluations. Mean Total UMSARS II score was 23.7±5.9 points, and MDS-UPDRS III was 37.2±13.5. Mean equivalent UMSARS II was 20.4±5.5 and equivalent MDS-UPDRS III was 15.8±6.7. We found a strong correlation between total UMSARS II and MDS-UPDRS III both total (r=0.61, p=0.015) and excluding domains not evaluated in the MDS UPDRS (r=0.72, p=0.003).

Conclusion: Despite UMSARS II having a strong correlation to MDS-UPDRS III, it is still weaker than the one reported for UPDRS. Restricting the correlation to the domains included in both scales does not improve the correlation so its equivalent use is not supported.

References: [1] Wenning GK, Tison F, Seppi K, et al. Development and validation of the Unified Multiple System Atrophy Rating Scale (UMSARS). Mov Disord 2004;19(12):1391-1402.
[2] Ferreirós A, Castillo-Torres SA, Merello M. Motor assessment of patients with multiple system atrophy: underuse of the Unified Multiple System Atrophy Rating Scale (UMSARS). Clin Auton Res 2023 (Accepted for publication).
[3] Gilman S, Wenning GK, Low PA, et al. Second consensus statement on the diagnosis of multiple system atrophy. Neurology 2008;71(9):670-676.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/correlation-between-motor-sections-of-umsars-and-mds-updrs/