What is the accuracy of the clinical diagnosis of multiple system atrophy? A clinicopathologic study.
Identifieur interne : 000286 ( PubMed/Corpus ); précédent : 000285; suivant : 000287What is the accuracy of the clinical diagnosis of multiple system atrophy? A clinicopathologic study.
Auteurs : I. Litvan ; C Goetz ; J. Jankovic ; G Wenning ; V. Booth ; J Bartko ; A. Mckee ; K. Jellinger ; E Lai ; J Brandel ; M. Verny ; K Chaudhuri ; R Pearce ; Y. AgidSource :
- Archives of neurology [ 0003-9942 ] ; 1997.
English descriptors
- KwdEn :
- MESH :
- pathology : Atrophy, Dementia, Olivopontocerebellar Atrophies, Parkinson Disease, Secondary, Shy-Drager Syndrome.
- Aged, Female, Humans, Male, Middle Aged.
Abstract
The presentation of symptoms for multiple system atrophy (MSA) varies. Because there are no specific markers for its clinical diagnosis, the diagnosis rests on the results of the neuropathologic examination. Despite several clinicopathologic studies, the diagnostic accuracy for MSA is unknown.
PubMed: 9267967
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">What is the accuracy of the clinical diagnosis of multiple system atrophy? A clinicopathologic study.</title><author><name sortKey="Litvan, I" sort="Litvan, I" uniqKey="Litvan I" first="I" last="Litvan">I. Litvan</name><affiliation><nlm:affiliation>Neuroepidemiology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20814-3559, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Goetz, C G" sort="Goetz, C G" uniqKey="Goetz C" first="C" last="Goetz">C Goetz</name></author><author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">J. Jankovic</name></author><author><name sortKey="Wenning, G K" sort="Wenning, G K" uniqKey="Wenning G" first="G" last="Wenning">G Wenning</name></author><author><name sortKey="Booth, V" sort="Booth, V" uniqKey="Booth V" first="V" last="Booth">V. Booth</name></author><author><name sortKey="Bartko, J J" sort="Bartko, J J" uniqKey="Bartko J" first="J" last="Bartko">J Bartko</name></author><author><name sortKey="Mckee, A" sort="Mckee, A" uniqKey="Mckee A" first="A" last="Mckee">A. Mckee</name></author><author><name sortKey="Jellinger, K" sort="Jellinger, K" uniqKey="Jellinger K" first="K" last="Jellinger">K. Jellinger</name></author><author><name sortKey="Lai, E C" sort="Lai, E C" uniqKey="Lai E" first="E" last="Lai">E Lai</name></author><author><name sortKey="Brandel, J P" sort="Brandel, J P" uniqKey="Brandel J" first="J" last="Brandel">J Brandel</name></author><author><name sortKey="Verny, M" sort="Verny, M" uniqKey="Verny M" first="M" last="Verny">M. Verny</name></author><author><name sortKey="Chaudhuri, K R" sort="Chaudhuri, K R" uniqKey="Chaudhuri K" first="K" last="Chaudhuri">K Chaudhuri</name></author><author><name sortKey="Pearce, R K" sort="Pearce, R K" uniqKey="Pearce R" first="R" last="Pearce">R Pearce</name></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y" last="Agid">Y. Agid</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1997">1997</date><idno type="RBID">pubmed:9267967</idno><idno type="pmid">9267967</idno><idno type="wicri:Area/PubMed/Corpus">000286</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">What is the accuracy of the clinical diagnosis of multiple system atrophy? A clinicopathologic study.</title><author><name sortKey="Litvan, I" sort="Litvan, I" uniqKey="Litvan I" first="I" last="Litvan">I. Litvan</name><affiliation><nlm:affiliation>Neuroepidemiology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20814-3559, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Goetz, C G" sort="Goetz, C G" uniqKey="Goetz C" first="C" last="Goetz">C Goetz</name></author><author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">J. Jankovic</name></author><author><name sortKey="Wenning, G K" sort="Wenning, G K" uniqKey="Wenning G" first="G" last="Wenning">G Wenning</name></author><author><name sortKey="Booth, V" sort="Booth, V" uniqKey="Booth V" first="V" last="Booth">V. Booth</name></author><author><name sortKey="Bartko, J J" sort="Bartko, J J" uniqKey="Bartko J" first="J" last="Bartko">J Bartko</name></author><author><name sortKey="Mckee, A" sort="Mckee, A" uniqKey="Mckee A" first="A" last="Mckee">A. Mckee</name></author><author><name sortKey="Jellinger, K" sort="Jellinger, K" uniqKey="Jellinger K" first="K" last="Jellinger">K. Jellinger</name></author><author><name sortKey="Lai, E C" sort="Lai, E C" uniqKey="Lai E" first="E" last="Lai">E Lai</name></author><author><name sortKey="Brandel, J P" sort="Brandel, J P" uniqKey="Brandel J" first="J" last="Brandel">J Brandel</name></author><author><name sortKey="Verny, M" sort="Verny, M" uniqKey="Verny M" first="M" last="Verny">M. Verny</name></author><author><name sortKey="Chaudhuri, K R" sort="Chaudhuri, K R" uniqKey="Chaudhuri K" first="K" last="Chaudhuri">K Chaudhuri</name></author><author><name sortKey="Pearce, R K" sort="Pearce, R K" uniqKey="Pearce R" first="R" last="Pearce">R Pearce</name></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y" last="Agid">Y. Agid</name></author></analytic><series><title level="j">Archives of neurology</title><idno type="ISSN">0003-9942</idno><imprint><date when="1997" type="published">1997</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Atrophy (pathology)</term><term>Dementia (pathology)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Olivopontocerebellar Atrophies (pathology)</term><term>Parkinson Disease, Secondary (pathology)</term><term>Shy-Drager Syndrome (pathology)</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Atrophy</term><term>Dementia</term><term>Olivopontocerebellar Atrophies</term><term>Parkinson Disease, Secondary</term><term>Shy-Drager Syndrome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The presentation of symptoms for multiple system atrophy (MSA) varies. Because there are no specific markers for its clinical diagnosis, the diagnosis rests on the results of the neuropathologic examination. Despite several clinicopathologic studies, the diagnostic accuracy for MSA is unknown.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">9267967</PMID><DateCreated><Year>1997</Year><Month>10</Month><Day>02</Day></DateCreated><DateCompleted><Year>1997</Year><Month>10</Month><Day>02</Day></DateCompleted><DateRevised><Year>2004</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0003-9942</ISSN><JournalIssue CitedMedium="Print"><Volume>54</Volume><Issue>8</Issue><PubDate><Year>1997</Year><Month>Aug</Month></PubDate></JournalIssue><Title>Archives of neurology</Title><ISOAbbreviation>Arch. Neurol.</ISOAbbreviation></Journal><ArticleTitle>What is the accuracy of the clinical diagnosis of multiple system atrophy? A clinicopathologic study.</ArticleTitle><Pagination><MedlinePgn>937-44</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The presentation of symptoms for multiple system atrophy (MSA) varies. Because there are no specific markers for its clinical diagnosis, the diagnosis rests on the results of the neuropathologic examination. Despite several clinicopathologic studies, the diagnostic accuracy for MSA is unknown.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To determine the accuracy for the clinical diagnosis of MSA and to identify, as early as possible, those features that would best predict MSA.</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">One hundred five autopsy-confirmed cases of MSA and related disorders (MSA [n=16], non-MSA [n=89]) were presented as clinical vignettes to 6 neurologists (raters) who were unaware of the study design. Raters identified the main clinical features and provided a diagnosis based on descriptions of the patients' first and last clinic visits.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Interrater reliability was evaluated with the use of kappa statistics. Raters' diagnoses and those of the primary neurologists (who followed up the patients) were compared with the autopsy-confirmed diagnoses to estimate the sensitivity and positive predictive values at the patients' first and last visits. Logistic regression analysis was used to determine the best predictors to diagnose MSA.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">For the first visit (median, 42 months after the onset of symptoms), the raters' sensitivity (median, 56%; range, 50%-69%) and positive predictive values (median, 76%; range, 61%-91%) for the clinical diagnosis of MSA were not optimal. For the last visit (74 months after the onset of symptoms), the raters' sensitivity (median, 69%; range, 56%-94%) and positive predictive values (median, 80%; range, 77%-92%) improved. Primary neurologists correctly identified 25% and 50% of the patients with MSA at the first and last visits, respectively. False-negative and -positive misdiagnoses frequently occurred in patients with Parkinson disease and progressive supranuclear palsy. Early severe autonomic failure, absence of cognitive impairment, early cerebellar symptoms, and early gait disturbances were identified as the best predictive features to diagnose MSA.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The low sensitivity for the clinical diagnosis of MSA, particularly among neurologists who followed up these patients in the tertiary centers, suggests that this disorder is underdiagnosed. The misdiagnosis of MSA is usually due to its confusion with Parkinson disease or progressive supranuclear palsy, thus compromising the research on all 3 disorders.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Litvan</LastName><ForeName>I</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Neuroepidemiology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20814-3559, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Goetz</LastName><ForeName>C G</ForeName><Initials>CG</Initials></Author><Author ValidYN="Y"><LastName>Jankovic</LastName><ForeName>J</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Wenning</LastName><ForeName>G K</ForeName><Initials>GK</Initials></Author><Author ValidYN="Y"><LastName>Booth</LastName><ForeName>V</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Bartko</LastName><ForeName>J J</ForeName><Initials>JJ</Initials></Author><Author ValidYN="Y"><LastName>McKee</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Jellinger</LastName><ForeName>K</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Lai</LastName><ForeName>E C</ForeName><Initials>EC</Initials></Author><Author ValidYN="Y"><LastName>Brandel</LastName><ForeName>J P</ForeName><Initials>JP</Initials></Author><Author ValidYN="Y"><LastName>Verny</LastName><ForeName>M</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Chaudhuri</LastName><ForeName>K R</ForeName><Initials>KR</Initials></Author><Author ValidYN="Y"><LastName>Pearce</LastName><ForeName>R K</ForeName><Initials>RK</Initials></Author><Author ValidYN="Y"><LastName>Agid</LastName><ForeName>Y</ForeName><Initials>Y</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>UNITED STATES</Country><MedlineTA>Arch Neurol</MedlineTA><NlmUniqueID>0372436</NlmUniqueID><ISSNLinking>0003-9942</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D001284">Atrophy</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000473">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D003704">Dementia</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000473">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005260">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008297">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008875">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D009849">Olivopontocerebellar Atrophies</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000473">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010302">Parkinson Disease, Secondary</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000473">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012791">Shy-Drager Syndrome</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000473">pathology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1997</Year><Month>8</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1997</Year><Month>8</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1997</Year><Month>8</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">9267967</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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