Objective: To assess the psychometric properties of the Chinese version of the Unified Multiple System Atrophy Rating Scale (UMSARS).

Background: The UMSARS is the gold‑standard measure of clinical progression in MSA. Although available in multiple languages, the Chinese version has not yet undergone formal linguistic validation, cultural adaptation, or psychometric validation.

Method: The TALISMAN study (NCT05453058) was a 12‑month, multicenter observational study of Chinese adults (40–75y) with possible or probable MSA‑P or MSA‑C and a UMSARS Part I score ≤16 (excluding item 11). The Chinese UMSARS was developed using a stepwise process involving forward–backward translation, followed by linguistic validation through cognitive debriefing interviews with patients (n=5) and their care partners (n=5). This process identified that UMSARS item 4 (“Cutting food and handling utensils”) was culturally interpreted as food preparation rather than eating, leading to its adaptation to “feeding/eating/consuming” in the Chinese version.

Results: At baseline, participants reported mild MSA signs and symptoms, with floor effects observed for UMSARS Part I items (swallowing, falling, orthostatic symptoms), Part II items (tremor at rest, ocular motor dysfunction, action tremor, arising from chair), and Part IV (36.0% of participants rated as completely independent). By Months 6 and 12, score distributions shifted toward greater severity and approximated normal distributions, with severe responses remaining uncommon. UMSARS scores showed moderate to strong correlations with absolute values at baseline for CGI‑S and the Schwab and England ADL scale (|r|=0.306–0.874). Good internal consistency was demonstrated for all UMSARS parts (I–IV) and total score at Months 6 and 12 (Cronbach’s α = 0.789–0.927); sensitivity to change was supported by correlations ≥0.30 between changes in UMSARS scores and CGI‑S.

Conclusion: These analyses support the psychometric robustness of the Chinese version of the UMSARS in early‑stage MSA, demonstrating sound cross‑sectional validity and reliability, and longitudinal sensitivity to change in this population and is therefore fit-for-purpose as an outcome measure in clinical trials in Chinese patients. The observed baseline floor effects are consistent with previous reports of reduced sensitivity in early disease.

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/validation-of-the-chinese-version-of-the-unified-multiple-system-atrophy-rating-scale/