ArticleNeurology2015
When DLB, PD, and PSP masquerade as MSA: an autopsy study of 134 patients.
Article in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04496830 (Cerebrospinal Fluid-biomarkers-based Diagnostic and Prognostic Models for Multiple Sclerosis), which is not on this map. Cited by 205 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Cerebrospinal Fluid-biomarkers-based Diagnostic and Prognostic Models for Multiple Sclerosis
Who cites it
205 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Diagnostic biomarkers for α-synucleinopathies- state of the art and future developments: a systematic review.Molecular neurodegeneration · 2025Pooled it
- The Movement Disorder Society Criteria for the Diagnosis of Multiple System Atrophy.Movement disorders : official journal of the Movement Disorder Society · 2022Pooled it
- Cerebrospinal Fluid Biomarkers in Multiple System Atrophy Relative to Parkinson's Disease: A Meta-Analysis.Behavioural neurology · 2021Pooled it
- Progressive supranuclear palsy (PSP): Richardson syndrome and other PSP variants.Acta neurologica Scandinavica · 2016Pooled it
- Distinct EEG functional network alterations in Parkinson's disease and multiple system atrophy.NeuroImage. Clinical · 2026Article
- Etiology and therapeutics for cognitive dysfunction in multiple system atrophy.Neural regeneration research · 2026Article
- Multiple system atrophy: cure and care.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Standardized protocol to detect phosphorylated α-synuclein in skin biopsies: recommendations from an expert panel.Molecular neurodegeneration · 2026Article
- Multiple System Atrophy-Cerebellar Variant With Absence of Parkinsonian Motor Features.Cureus · 2026Article
- Subtypes and predictors of mild cognitive impairment in patients with multiple system atrophy.Chinese medical journal · 2026Article
- Serotonin Transporter Distribution in the Brainstem of Multiple-System Atrophy-Parkinsonian Type: Insights from Pathology andJournal of nuclear medicine : official publication, Society of Nuclear Medicine · 2026Article
- Diagnostic symptoms, treatment patterns, and healthcare resource utilization in multiple system atrophy in the United States.Neurodegenerative disease management · 2026Article
- Paired regional complementarity in diffusion MRI reveals disease-specific microstructural profiles in PD, MSA, and PSP: a feasibility study.Scientific reports · 2026Article
- From Diagnosis to Disease Staging: Multisite Validation of Cerebrospinal Fluid Molecular Tests in Multiple Sclerosis.Annals of neurology · 2026Article
- Locus coeruleus degeneration is associated with orthostatic hypotension in Parkinson's disease and multiple system atrophy.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- An eight-year follow-up of the CMSAR: assessing how the new MDS criteria and biomarkers impact diagnostic accuracy.NPJ Parkinson's disease · 2026Article
- Kynurenine pathway in Parkinson's disease: pathophysiological roles and therapeutic interventions.Inflammopharmacology · 2026Review
- Functional MRI in Multiple System Atrophy: A Promising Biomarker for Clinical Applications.Neuropsychiatric disease and treatment · 2026Review
- Generation and characterization of human induced pluripotent stem cells from neuropathologically confirmed multiple system atrophy patient-derived fibroblasts.Frontiers in immunology · 2026Article
145 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo determine ways to improve diagnostic accuracy of multiple system atrophy (MSA), we assessed the diagnostic process in patients who came to autopsy with antemortem diagnosis of MSA by comparing clinical and pathologic features between those who proved to have MSA and those who did not. We focus on likely explanations for misdiagnosis.
methodsThis is a retrospective review of 134 consecutive patients with an antemortem clinical diagnosis of MSA who came to autopsy with neuropathologic evaluation of the brain. Of the 134 patients, 125 had adequate medical records for review. Clinical and pathologic features were compared between patients with autopsy-confirmed MSA and those with other pathologic diagnoses, including dementia with Lewy bodies (DLB), Parkinson disease (PD), and progressive supranuclear palsy (PSP).
resultsOf the 134 patients with clinically diagnosed MSA, 83 (62%) had the correct diagnosis at autopsy. Pathologically confirmed DLB was the most common misdiagnosis, followed by PSP and PD. Despite meeting pathologic criteria for intermediate to high likelihood of DLB, several patients with DLB did not have dementia and none had significant Alzheimer-type pathology. Autonomic failure was the leading cause of misdiagnosis in DLB and PD, and cerebellar ataxia was the leading cause of misdiagnosis in PSP.
conclusionsThe diagnostic accuracy for MSA was suboptimal in this autopsy study. Pathologically confirmed DLB, PD, and PSP were the most common diseases to masquerade as MSA. This has significant implications not only for patient care, but also for research studies in MSA cases that do not have pathologic confirmation.
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