Multiple System Atrophy - new criteria for diagnosis

Multiple System Atrophy (MSA), a condition sometimes misdiagnosed as Parkinson's initially due to the similarities in early presentation, has had new diagnostic criteria published which should improve diagnosis rates in the rapidly-progressive condition.

Published by the Movement Disorders Society, this is the third iteration of diagnostic criteria for MSA, and whilst the criteria for neuropathologically established MSA remain unchanged, there is a new category for clinically established MSA.

Dr Jalesh Panicker highlighted the criteria at the recent Parkinson's Cutting Edge Science conference in his session on bladder management, due to the presence of voiding difficulties and unexplained urinary urge incontinence as one of its core clinical features. He noted that often, a patient with MSA may first present to a urologist and that the 'unexplained' element in incontinence is the real red flag here (fig 1).

The new criteria can be found at and the article is available in full online via the Movement Disorders Society.

The article citation is:

Wenning GK, Stankovic I, Vignatelli L, Fanciulli A, Calandra-Buonaura G, Seppi K, Palma JA, Meissner WG, Krismer F, Berg D, Cortelli P, Freeman R, Halliday G, Höglinger G, Lang A, Ling H, Litvan I, Low P, Miki Y, Panicker J, Pellecchia MT, Quinn N, Sakakibara R, Stamelou M, Tolosa E, Tsuji S, Warner T, Poewe W, Kaufmann H. The Movement Disorder Society Criteria for the Diagnosis of Multiple System Atrophy. Mov Disord. 2022 Apr 21. doi: 10.1002/mds.29005. Epub ahead of print. PMID: 35445419.