Red flags for multiple system atrophy
Identifieur interne : 002653 ( Main/Exploration ); précédent : 002652; suivant : 002654Red flags for multiple system atrophy
Auteurs : Martin Köllensperger [Autriche] ; Felix Geser [Autriche] ; Klaus Seppi [Autriche] ; Michaela Stampfer-Kountchev [Autriche] ; Martin Sawires [Autriche] ; Christoph Scherfler [Autriche] ; Sylvia Boesch [Autriche] ; Joerg Mueller [Autriche] ; Vasiliki Koukouni [Royaume-Uni] ; Niall Quinn [Royaume-Uni] ; Maria Teresa Pellecchia [Italie] ; Paolo Barone [Italie] ; Nicole Schimke [Allemagne] ; Richard Dodel [Allemagne] ; Wolfgang Oertel [Allemagne] ; Erik Dupont [Danemark] ; Karen Stergaard [Danemark] ; Christine Daniels [Allemagne] ; Günther Deuschl [Allemagne] ; Tanya Gurevich [Israël] ; Nir Giladi [Israël] ; Miguel Coelho [Portugal] ; Cristina Sampaio [Portugal] ; Christer Nilsson [Suède] ; H Kan Widner [Suède] ; Francesca Del Sorbo [Italie] ; Alberto Albanese [Italie] ; Adriana Cardozo [Espagne] ; Eduardo Tolosa [Espagne] ; Michael Abele [Allemagne] ; Thomas Klockgether [Allemagne] ; Christoph Kamm [Allemagne] ; Thomas Gasser [Allemagne] ; Ruth Djaldetti [Israël] ; Carlo Colosimo [Italie] ; Giuseppe Meco [Italie] ; Anette Schrag [Royaume-Uni] ; Werner Poewe [Autriche] ; Gregor K. Wenning [Autriche]Source :
- Movement Disorders [ 0885-3185 ] ; 2008-06-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Cerebellar Ataxia (diagnosis), Cohort Studies, Diagnosis, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Multiple System Atrophy (classification), Multiple System Atrophy (diagnosis), Multiple system atrophy, Nervous system diseases, Neurologic Examination (statistics & numerical data), Parkinson Disease (classification), Parkinson Disease (diagnosis), Parkinsonian Disorders (classification), Parkinsonian Disorders (diagnosis), Sensitivity and Specificity, Shy-Drager Syndrome (diagnosis), Sign, diagnosis, multiple system atrophy, red flags, warning signs.
- MESH :
- classification : Multiple System Atrophy, Parkinson Disease, Parkinsonian Disorders.
- diagnosis : Cerebellar Ataxia, Multiple System Atrophy, Parkinson Disease, Parkinsonian Disorders, Shy-Drager Syndrome.
- statistics & numerical data : Neurologic Examination.
- Aged, Cohort Studies, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Sensitivity and Specificity.
Abstract
The clinical diagnosis of multiple system atrophy (MSA) is fraught with difficulty and there are no pathognomonic features to discriminate the parkinsonian variant (MSA‐P) from Parkinson's disease (PD). Besides the poor response to levodopa, and the additional presence of pyramidal or cerebellar signs (ataxia) or autonomic failure as major diagnostic criteria, certain other clinical features known as “red flags” or warning signs may raise the clinical suspicion of MSA. To study the diagnostic role of these features in MSA‐P versus PD patients, a standardized red flag check list (RFCL) developed by the European MSA Study Group (EMSA‐SG) was administered to 57 patients with probable MSA‐P and 116 patients with probable PD diagnosed according to established criteria. Those red flags with a specifity over 95% were selected for further analysis. Factor analysis was applied to reduce the number of red flags. The resulting set was then applied to 17 patients with possible MSA‐P who on follow‐up fulfilled criteria of probable MSA‐P. Red flags were grouped into related categories. With two or more of six red flag categories present specificity was 98.3% and sensitivity was 84.2% in our cohort. When applying these criteria to patients with possible MSA‐P, 76.5% of them would have been correctly diagnosed as probable MSA‐P 15.9 (±7.0) months earlier than with the Consensus criteria alone. We propose a combination of two out of six red flag categories as additional diagnostic criteria for probable MSA‐P. © 2008 Movement Disorder Society.
Url:
DOI: 10.1002/mds.21992
Affiliations:
- Allemagne, Autriche, Danemark, Espagne, Israël, Italie, Portugal, Royaume-Uni, Suède
- Angleterre, Bade-Wurtemberg, District de Giessen, District de Tübingen, Grand Londres, Hesse (Land), Latium, Schleswig-Holstein, Tyrol (Land)
- Innsbruck, Kiel, Londres, Marbourg, Rome, Tübingen
- Université de médecine d'Innsbruck
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Le document en format XML
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last="Stampfer-Kountchev">Michaela Stampfer-Kountchev</name><affiliation wicri:level="1"><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Neurology, Innsbruck Medical University</wicri:regionArea><wicri:noRegion>Innsbruck Medical University</wicri:noRegion></affiliation></author><author><name sortKey="Sawires, Martin" sort="Sawires, Martin" uniqKey="Sawires M" first="Martin" last="Sawires">Martin Sawires</name><affiliation wicri:level="1"><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Neurology, Innsbruck Medical University</wicri:regionArea><wicri:noRegion>Innsbruck Medical University</wicri:noRegion></affiliation></author><author><name sortKey="Scherfler, Christoph" sort="Scherfler, Christoph" uniqKey="Scherfler C" first="Christoph" last="Scherfler">Christoph Scherfler</name><affiliation wicri:level="1"><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Neurology, Innsbruck Medical University</wicri:regionArea><wicri:noRegion>Innsbruck Medical University</wicri:noRegion></affiliation></author><author><name sortKey="Boesch, Sylvia" sort="Boesch, Sylvia" uniqKey="Boesch S" first="Sylvia" last="Boesch">Sylvia Boesch</name><affiliation wicri:level="1"><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Neurology, Innsbruck Medical University</wicri:regionArea><wicri:noRegion>Innsbruck Medical University</wicri:noRegion></affiliation></author><author><name sortKey="Mueller, Joerg" sort="Mueller, Joerg" uniqKey="Mueller J" first="Joerg" last="Mueller">Joerg Mueller</name><affiliation wicri:level="1"><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Neurology, Innsbruck Medical University</wicri:regionArea><wicri:noRegion>Innsbruck Medical University</wicri:noRegion></affiliation></author><author><name sortKey="Koukouni, Vasiliki" sort="Koukouni, Vasiliki" uniqKey="Koukouni V" first="Vasiliki" last="Koukouni">Vasiliki Koukouni</name><affiliation wicri:level="3"><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><wicri:orgArea>Institute of Neurology, University College</wicri:orgArea></affiliation></author><author><name sortKey="Quinn, Niall" sort="Quinn, Niall" uniqKey="Quinn N" first="Niall" last="Quinn">Niall Quinn</name><affiliation wicri:level="3"><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><wicri:orgArea>Institute of Neurology, University College</wicri:orgArea></affiliation></author><author><name sortKey="Pellecchia, Maria Teresa" sort="Pellecchia, Maria Teresa" uniqKey="Pellecchia M" first="Maria Teresa" last="Pellecchia">Maria Teresa Pellecchia</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neurological Sciences, University Federico II, Naples</wicri:regionArea><wicri:noRegion>Naples</wicri:noRegion></affiliation></author><author><name sortKey="Barone, Paolo" sort="Barone, Paolo" uniqKey="Barone P" first="Paolo" last="Barone">Paolo Barone</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neurological Sciences, University Federico II, Naples</wicri:regionArea><wicri:noRegion>Naples</wicri:noRegion></affiliation></author><author><name sortKey="Schimke, Nicole" sort="Schimke, Nicole" uniqKey="Schimke N" first="Nicole" last="Schimke">Nicole Schimke</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Philipps‐University, Marburg</wicri:regionArea><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Giessen</region><settlement type="city">Marbourg</settlement></placeName></affiliation></author><author><name sortKey="Dodel, Richard" sort="Dodel, Richard" uniqKey="Dodel R" first="Richard" last="Dodel">Richard Dodel</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Philipps‐University, Marburg</wicri:regionArea><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Giessen</region><settlement type="city">Marbourg</settlement></placeName></affiliation></author><author><name sortKey="Oertel, Wolfgang" sort="Oertel, Wolfgang" uniqKey="Oertel W" first="Wolfgang" last="Oertel">Wolfgang Oertel</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Philipps‐University, Marburg</wicri:regionArea><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Giessen</region><settlement type="city">Marbourg</settlement></placeName></affiliation></author><author><name sortKey="Dupont, Erik" sort="Dupont, Erik" uniqKey="Dupont E" first="Erik" last="Dupont">Erik Dupont</name><affiliation wicri:level="1"><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurology, University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey=" Stergaard, Karen" sort=" Stergaard, Karen" uniqKey=" Stergaard K" first="Karen" last=" Stergaard">Karen Stergaard</name><affiliation wicri:level="1"><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurology, University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Daniels, Christine" sort="Daniels, Christine" uniqKey="Daniels C" first="Christine" last="Daniels">Christine Daniels</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Christian‐Albrechts‐University, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Christian‐Albrechts‐University, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Gurevich, Tanya" sort="Gurevich, Tanya" uniqKey="Gurevich T" first="Tanya" last="Gurevich">Tanya Gurevich</name><affiliation wicri:level="1"><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Neurology, Sourasky Medical Center, Tel Aviv</wicri:regionArea><wicri:noRegion>Tel Aviv</wicri:noRegion></affiliation></author><author><name sortKey="Giladi, Nir" sort="Giladi, Nir" uniqKey="Giladi N" first="Nir" last="Giladi">Nir Giladi</name><affiliation wicri:level="1"><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Neurology, Sourasky Medical Center, Tel Aviv</wicri:regionArea><wicri:noRegion>Tel Aviv</wicri:noRegion></affiliation></author><author><name sortKey="Coelho, Miguel" sort="Coelho, Miguel" uniqKey="Coelho M" first="Miguel" last="Coelho">Miguel Coelho</name><affiliation wicri:level="1"><country xml:lang="fr">Portugal</country><wicri:regionArea>Department of Neuroscience, Faculdade de Medicina de Lisboa</wicri:regionArea><wicri:noRegion>Faculdade de Medicina de Lisboa</wicri:noRegion></affiliation></author><author><name sortKey="Sampaio, Cristina" sort="Sampaio, Cristina" uniqKey="Sampaio C" first="Cristina" last="Sampaio">Cristina Sampaio</name><affiliation wicri:level="1"><country xml:lang="fr">Portugal</country><wicri:regionArea>Department of Neuroscience, Faculdade de Medicina de Lisboa</wicri:regionArea><wicri:noRegion>Faculdade de Medicina de Lisboa</wicri:noRegion></affiliation></author><author><name sortKey="Nilsson, Christer" sort="Nilsson, Christer" uniqKey="Nilsson C" first="Christer" last="Nilsson">Christer Nilsson</name><affiliation wicri:level="1"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Neuroscience, University of Lund</wicri:regionArea><wicri:noRegion>University of Lund</wicri:noRegion></affiliation></author><author><name sortKey="Widner, H Kan" sort="Widner, H Kan" uniqKey="Widner H" first="H Kan" last="Widner">H Kan Widner</name><affiliation wicri:level="1"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Neuroscience, University of Lund</wicri:regionArea><wicri:noRegion>University of Lund</wicri:noRegion></affiliation></author><author><name sortKey="Sorbo, Francesca Del" sort="Sorbo, Francesca Del" uniqKey="Sorbo F" first="Francesca Del" last="Sorbo">Francesca Del Sorbo</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Instituto Carlo Besta, Milano</wicri:regionArea><wicri:noRegion>Milano</wicri:noRegion></affiliation></author><author><name sortKey="Albanese, Alberto" sort="Albanese, Alberto" uniqKey="Albanese A" first="Alberto" last="Albanese">Alberto Albanese</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Instituto Carlo Besta, Milano</wicri:regionArea><wicri:noRegion>Milano</wicri:noRegion></affiliation></author><author><name sortKey="Cardozo, Adriana" sort="Cardozo, Adriana" uniqKey="Cardozo A" first="Adriana" last="Cardozo">Adriana Cardozo</name><affiliation wicri:level="1"><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Neurology, University of Barcelona</wicri:regionArea><wicri:noRegion>University of Barcelona</wicri:noRegion></affiliation></author><author><name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name><affiliation wicri:level="1"><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Neurology, University of Barcelona</wicri:regionArea><wicri:noRegion>University of Barcelona</wicri:noRegion></affiliation></author><author><name sortKey="Abele, Michael" sort="Abele, Michael" uniqKey="Abele M" first="Michael" last="Abele">Michael Abele</name><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, University of Bonn</wicri:regionArea><wicri:noRegion>University of Bonn</wicri:noRegion><wicri:noRegion>University of Bonn</wicri:noRegion></affiliation></author><author><name sortKey="Klockgether, Thomas" sort="Klockgether, Thomas" uniqKey="Klockgether T" first="Thomas" last="Klockgether">Thomas Klockgether</name><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, University of Bonn</wicri:regionArea><wicri:noRegion>University of Bonn</wicri:noRegion><wicri:noRegion>University of Bonn</wicri:noRegion></affiliation></author><author><name sortKey="Kamm, Christoph" sort="Kamm, Christoph" uniqKey="Kamm C" first="Christoph" last="Kamm">Christoph Kamm</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurodegenerative Diseases, University of Tübingen, Tübingen</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Gasser, Thomas" sort="Gasser, Thomas" uniqKey="Gasser T" first="Thomas" last="Gasser">Thomas Gasser</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurodegenerative Diseases, University of Tübingen, Tübingen</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Djaldetti, Ruth" sort="Djaldetti, Ruth" uniqKey="Djaldetti R" first="Ruth" last="Djaldetti">Ruth Djaldetti</name><affiliation wicri:level="1"><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Neurology, Rabin Medical Centre, Petach‐Tiqva</wicri:regionArea><wicri:noRegion>Petach‐Tiqva</wicri:noRegion></affiliation></author><author><name sortKey="Colosimo, Carlo" sort="Colosimo, Carlo" uniqKey="Colosimo C" first="Carlo" last="Colosimo">Carlo Colosimo</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neuroscience, University La Sapienza, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Meco, Giuseppe" sort="Meco, Giuseppe" uniqKey="Meco G" first="Giuseppe" last="Meco">Giuseppe Meco</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neuroscience, University La Sapienza, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Schrag, Anette" sort="Schrag, Anette" uniqKey="Schrag A" first="Anette" last="Schrag">Anette Schrag</name><affiliation wicri:level="3"><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><wicri:orgArea>Institute of Neurology, University College</wicri:orgArea></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation wicri:level="1"><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Neurology, Innsbruck Medical University</wicri:regionArea><wicri:noRegion>Innsbruck Medical University</wicri:noRegion><placeName><settlement type="city">Innsbruck</settlement><region nuts="2" type="region">Tyrol (Land)</region></placeName><orgName type="university">Université de médecine d'Innsbruck</orgName></affiliation></author><author><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name><affiliation wicri:level="1"><country xml:lang="fr">Autriche</country><wicri:regionArea>Section for Clinical Neurobiology, Department of Neurology, Innsbruck Medical University</wicri:regionArea><wicri:noRegion>Innsbruck Medical University</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2008-06-15">2008-06-15</date><biblScope unit="vol">23</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1093">1093</biblScope><biblScope unit="page" to="1099">1099</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">71B6B09D8EA90C87CF4826196DE238FE66B66F9C</idno><idno type="DOI">10.1002/mds.21992</idno><idno type="ArticleID">MDS21992</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Cerebellar Ataxia (diagnosis)</term><term>Cohort Studies</term><term>Diagnosis</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Multiple System Atrophy (classification)</term><term>Multiple System Atrophy (diagnosis)</term><term>Multiple system atrophy</term><term>Nervous system diseases</term><term>Neurologic Examination (statistics & numerical data)</term><term>Parkinson Disease (classification)</term><term>Parkinson Disease (diagnosis)</term><term>Parkinsonian Disorders (classification)</term><term>Parkinsonian Disorders (diagnosis)</term><term>Sensitivity and Specificity</term><term>Shy-Drager Syndrome (diagnosis)</term><term>Sign</term><term>diagnosis</term><term>multiple system atrophy</term><term>red flags</term><term>warning signs</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Multiple System Atrophy</term><term>Parkinson Disease</term><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Cerebellar Ataxia</term><term>Multiple System Atrophy</term><term>Parkinson Disease</term><term>Parkinsonian Disorders</term><term>Shy-Drager Syndrome</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Neurologic Examination</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Cohort Studies</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Sensitivity and Specificity</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Atrophie multisystématisée</term><term>Diagnostic</term><term>Pathologie du système nerveux</term><term>Signe</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The clinical diagnosis of multiple system atrophy (MSA) is fraught with difficulty and there are no pathognomonic features to discriminate the parkinsonian variant (MSA‐P) from Parkinson's disease (PD). Besides the poor response to levodopa, and the additional presence of pyramidal or cerebellar signs (ataxia) or autonomic failure as major diagnostic criteria, certain other clinical features known as “red flags” or warning signs may raise the clinical suspicion of MSA. To study the diagnostic role of these features in MSA‐P versus PD patients, a standardized red flag check list (RFCL) developed by the European MSA Study Group (EMSA‐SG) was administered to 57 patients with probable MSA‐P and 116 patients with probable PD diagnosed according to established criteria. Those red flags with a specifity over 95% were selected for further analysis. Factor analysis was applied to reduce the number of red flags. The resulting set was then applied to 17 patients with possible MSA‐P who on follow‐up fulfilled criteria of probable MSA‐P. Red flags were grouped into related categories. With two or more of six red flag categories present specificity was 98.3% and sensitivity was 84.2% in our cohort. When applying these criteria to patients with possible MSA‐P, 76.5% of them would have been correctly diagnosed as probable MSA‐P 15.9 (±7.0) months earlier than with the Consensus criteria alone. We propose a combination of two out of six red flag categories as additional diagnostic criteria for probable MSA‐P. © 2008 Movement Disorder Society.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Autriche</li><li>Danemark</li><li>Espagne</li><li>Israël</li><li>Italie</li><li>Portugal</li><li>Royaume-Uni</li><li>Suède</li></country><region><li>Angleterre</li><li>Bade-Wurtemberg</li><li>District de Giessen</li><li>District de Tübingen</li><li>Grand Londres</li><li>Hesse (Land)</li><li>Latium</li><li>Schleswig-Holstein</li><li>Tyrol (Land)</li></region><settlement><li>Innsbruck</li><li>Kiel</li><li>Londres</li><li>Marbourg</li><li>Rome</li><li>Tübingen</li></settlement><orgName><li>Université de médecine d'Innsbruck</li></orgName></list><tree><country name="Autriche"><noRegion><name sortKey="Kollensperger, Martin" sort="Kollensperger, Martin" uniqKey="Kollensperger M" first="Martin" last="Köllensperger">Martin Köllensperger</name></noRegion><name sortKey="Boesch, Sylvia" sort="Boesch, Sylvia" uniqKey="Boesch S" first="Sylvia" last="Boesch">Sylvia Boesch</name><name sortKey="Geser, Felix" sort="Geser, Felix" uniqKey="Geser F" first="Felix" last="Geser">Felix Geser</name><name sortKey="Mueller, Joerg" sort="Mueller, Joerg" uniqKey="Mueller J" first="Joerg" last="Mueller">Joerg Mueller</name><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><name sortKey="Sawires, Martin" sort="Sawires, Martin" uniqKey="Sawires M" first="Martin" last="Sawires">Martin Sawires</name><name sortKey="Scherfler, Christoph" sort="Scherfler, Christoph" uniqKey="Scherfler C" first="Christoph" last="Scherfler">Christoph Scherfler</name><name sortKey="Seppi, Klaus" sort="Seppi, Klaus" uniqKey="Seppi K" first="Klaus" last="Seppi">Klaus Seppi</name><name sortKey="Stampfer Ountchev, Michaela" sort="Stampfer Ountchev, Michaela" uniqKey="Stampfer Ountchev M" first="Michaela" last="Stampfer-Kountchev">Michaela Stampfer-Kountchev</name><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Koukouni, Vasiliki" sort="Koukouni, Vasiliki" uniqKey="Koukouni V" first="Vasiliki" last="Koukouni">Vasiliki Koukouni</name></region><name sortKey="Quinn, Niall" sort="Quinn, Niall" uniqKey="Quinn N" first="Niall" last="Quinn">Niall Quinn</name><name sortKey="Schrag, Anette" sort="Schrag, Anette" uniqKey="Schrag A" first="Anette" last="Schrag">Anette Schrag</name></country><country name="Italie"><noRegion><name sortKey="Pellecchia, Maria Teresa" sort="Pellecchia, Maria Teresa" uniqKey="Pellecchia M" first="Maria Teresa" last="Pellecchia">Maria Teresa Pellecchia</name></noRegion><name sortKey="Albanese, Alberto" sort="Albanese, Alberto" uniqKey="Albanese A" first="Alberto" last="Albanese">Alberto Albanese</name><name sortKey="Barone, Paolo" sort="Barone, Paolo" uniqKey="Barone P" first="Paolo" last="Barone">Paolo Barone</name><name sortKey="Colosimo, Carlo" sort="Colosimo, Carlo" uniqKey="Colosimo C" first="Carlo" last="Colosimo">Carlo Colosimo</name><name sortKey="Meco, Giuseppe" sort="Meco, Giuseppe" uniqKey="Meco G" first="Giuseppe" last="Meco">Giuseppe Meco</name><name sortKey="Sorbo, Francesca Del" sort="Sorbo, Francesca Del" uniqKey="Sorbo F" first="Francesca Del" last="Sorbo">Francesca Del Sorbo</name></country><country name="Allemagne"><region name="Hesse (Land)"><name sortKey="Schimke, Nicole" sort="Schimke, Nicole" uniqKey="Schimke N" first="Nicole" last="Schimke">Nicole Schimke</name></region><name sortKey="Abele, Michael" sort="Abele, Michael" uniqKey="Abele M" first="Michael" last="Abele">Michael Abele</name><name sortKey="Daniels, Christine" sort="Daniels, Christine" uniqKey="Daniels C" first="Christine" last="Daniels">Christine Daniels</name><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name><name sortKey="Dodel, Richard" sort="Dodel, Richard" uniqKey="Dodel R" first="Richard" last="Dodel">Richard Dodel</name><name sortKey="Gasser, Thomas" sort="Gasser, Thomas" uniqKey="Gasser T" first="Thomas" last="Gasser">Thomas Gasser</name><name sortKey="Kamm, Christoph" sort="Kamm, Christoph" uniqKey="Kamm C" first="Christoph" last="Kamm">Christoph Kamm</name><name sortKey="Klockgether, Thomas" sort="Klockgether, Thomas" uniqKey="Klockgether T" first="Thomas" last="Klockgether">Thomas Klockgether</name><name sortKey="Oertel, Wolfgang" sort="Oertel, Wolfgang" uniqKey="Oertel W" first="Wolfgang" last="Oertel">Wolfgang Oertel</name></country><country name="Danemark"><noRegion><name sortKey="Dupont, Erik" sort="Dupont, Erik" uniqKey="Dupont E" first="Erik" last="Dupont">Erik Dupont</name></noRegion><name sortKey=" Stergaard, Karen" sort=" Stergaard, Karen" uniqKey=" Stergaard K" first="Karen" last=" Stergaard">Karen Stergaard</name></country><country name="Israël"><noRegion><name sortKey="Gurevich, Tanya" sort="Gurevich, Tanya" uniqKey="Gurevich T" first="Tanya" last="Gurevich">Tanya Gurevich</name></noRegion><name sortKey="Djaldetti, Ruth" sort="Djaldetti, Ruth" uniqKey="Djaldetti R" first="Ruth" last="Djaldetti">Ruth Djaldetti</name><name sortKey="Giladi, Nir" sort="Giladi, Nir" uniqKey="Giladi N" first="Nir" last="Giladi">Nir Giladi</name></country><country name="Portugal"><noRegion><name sortKey="Coelho, Miguel" sort="Coelho, Miguel" uniqKey="Coelho M" first="Miguel" last="Coelho">Miguel Coelho</name></noRegion><name sortKey="Sampaio, Cristina" sort="Sampaio, Cristina" uniqKey="Sampaio C" first="Cristina" last="Sampaio">Cristina Sampaio</name></country><country name="Suède"><noRegion><name sortKey="Nilsson, Christer" sort="Nilsson, Christer" uniqKey="Nilsson C" first="Christer" last="Nilsson">Christer Nilsson</name></noRegion><name sortKey="Widner, H Kan" sort="Widner, H Kan" uniqKey="Widner H" first="H Kan" last="Widner">H Kan Widner</name></country><country name="Espagne"><noRegion><name sortKey="Cardozo, Adriana" sort="Cardozo, Adriana" uniqKey="Cardozo A" first="Adriana" last="Cardozo">Adriana Cardozo</name></noRegion><name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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