Date: Monday, June 20, 2016
Session Title: Parkinsonism, MSA, PSP (secondary and parkinsonism-plus)
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: The International Parkinson and Movement Disorder Society (MDS)-endorsed MSA study group (MODIMSA) identified an urgent need to develop evidence-based recommendations for the diagnostic work-up of multiple system atrophy (MSA).
Background: An early and correct diagnosis of MSA is a prerequisite for patient counseling and therapeutic management. The diagnosis of MSA remains a primarily clinical exercise, despite development of numerous ancillary tests that differ in their diagnostic performance, availability and costs.
Methods: We will systematically review original reports and meta-analyses to identify, select, and critically analyze the relevant studies.
Results: The report will be divided into the following ten sections addressing key aspects of the diagnostic work-up of patients with suspected MSA: clinical diagnostic criteria, autonomic function testing, biomarkers, genetics, imaging, neuroendocrine tests, neurophysiological tests, neuropsychological tests, sleep studies, other tests (including levodopa challenge test, olfactory tests, skin biopsy, neuro-ophthalmological tests). Groups of experts will be allocated to each section to provide an evidence-based recommendation level for the assigned diagnostic category. MEDLINE (PubMed) will be searched for relevant citations up to November 1st, 2015, according to the following inclusion criteria: (1) publications at full length in English, (2) at least one reference group of diseased subjects, (3) at least 10 subjects with MSA. Publications will be classified based on the evidence classification scheme for a diagnostic measure proposed by the “Guidance for the preparation of neurological management guidelines by EFNS scientific task forces”1. Recommendations for diagnostic measures in MSA will be graded as follows: (1) Level A – effective, (2) Level B – probably effective (3) Level C – possibly effective1.
Conclusions: This is an ongoing project. Well-defined search terms, inclusion criteria for relevant studies and methodology for validity assessment will eventually yield a reliable guideline for diagnostic work-up of patients with MSA. Reference: 1. Brainin, M., M. Barnes, et al. (2004). Guidance for the preparation of neurological management guidelines by EFNS scientific task forces–revised recommendations 2004. Eur J Neurol 11(9): 577-581.
To cite this abstract in AMA style:I. Stankovic, A. Antonini, A. Berardelli, C. Colosimo, A. Fanciulli, S. Fox, B. Frauscher, H. Kaufmann, V.S. Kostic, F. Krismer, P. Low, W. Meissner, M.T. Pellecchia, W. Poewe, K. Seppi, S. Tsui, H. Watanabe, G.K. Wenning, On behalf of the MODIMSA EBM Working Group. EBM review on the diagnostic work-up of multiple system atrophy [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/ebm-review-on-the-diagnostic-work-up-of-multiple-system-atrophy/. Accessed December 7, 2023.
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