{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:01:58Z","timestamp":1790834518356,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2002,4,10]],"date-time":"2002-04-10T00:00:00Z","timestamp":1018396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2002,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We analyzed parkinsonian features in multiple system atrophy (MSA) compared with age\u2010 and disease duration\u2010matched Parkinson's disease (PD) patients, and assessed the applicability of the Unified Parkinson's Disease Rating Scale (UPDRS) \u2010III motor scale as a means of rating their severity. Cross\u2010sectional analysis of parkinsonism was done using UPDRS\u2010III, International Cerebellar Atatia Rating Scale, and disability scales (Hoehn and Yahr [H&amp;A], Schwab and England, Katz and Lawton) in 50 unselected MSA patients and in 50 matched PD patients. At symptom onset, falls occurred 10 times more frequently in MSA, whereas limb tremor was 10 times more common in PD. At first visit (10.2 months), hemiparkinsonism and pill\u2010rolling rest tremor were less common in MSA. Hypomimia, atypical rest, postural or action tremor, as well as postural instability were more frequent in MSA. At study examination (62.4 months), parkinsonian signs in MSA patients were more frequently symmetrical and associated with axial rigidity, antecollis and postural instability. A levodopa response of &gt;50% was seen in &lt;10% of MSA patients. Modified H&amp;Y stages (3.2 \u00b1 1.3 vs. 2.2 \u00b1 0.78) and UPDRS\u2010III scores (48.14 \u00b1 19.5 vs. 31.74 \u00b1 12.9) were significantly (<jats:italic>P<\/jats:italic> = 0.0001) higher in MSA. The internal consistency of the UPDRS\u2010III was fair in MSA patients (Cronbach's \u03b1 &gt;0.90), and correlated well with marked dependency on the Schwab and England and Katz and Lawton scales. Factor structure analysis of UPDRS\u2010III in MSA showed five clinically distinct subscores accounting for 74% of the variance, differing from PD by the dependency of the face\u2013speech and limb bradykinesia items and independence of the postural\u2013action tremor from the rest tremor items. There was a significant correlation (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.70, <jats:italic>P<\/jats:italic> = 0.001) between ICARS ataxia and UPDRS\u2010III scores in MSA patients. Results confirm a distinct profile of parkinsonism in MSA and greater severity and disability compared with PD. It also indicates that the UPDRS\u2010III provides a useful severity measure of parkinsonism in MSA, albeit contaminated by additional cerebellar dysfunction. \u00a9 2002 Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.10171","type":"journal-article","created":{"date-parts":[[2002,10,6]],"date-time":"2002-10-06T07:44:15Z","timestamp":1033890255000},"page":"701-709","source":"Crossref","is-referenced-by-count":75,"title":["Parkinsonism in multiple system atrophy: Natural history, severity (UPDRS\u2010III), and disability assessment compared with Parkinson's disease"],"prefix":"10.1002","volume":"17","author":[{"given":"Fran\u00e7ois","family":"Tison","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Yekhlef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Chrysostome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Balestre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall P.","family":"Quinn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Poewe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor K.","family":"Wenning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,7,22]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.52.Suppl.78"},{"key":"e_1_2_7_3_2","first-page":"262","volume-title":"Movement disorders III","author":"Quinn NP","year":"1994"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/117.4.835"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870120203"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1997.00550200007003"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870110207"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.1995.tb00153.x"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.57.2.129"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-199812000-00001"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(98)00304-9"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007020050050"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.56.12.1239"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.59.2.144"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870100310"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870130404"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8257(200003)15:2<335::AID-MDS1022>3.0.CO;2-V"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/10.1_Part_1.20"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01590.x"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.65.1.65"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8257(200011)15:6<1148::AID-MDS1014>3.0.CO;2-6"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.55.3.181"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870120612"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870100305"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(96)00231-6"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.314.7080.572"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8257(200003)15:2<276::AID-MDS1010>3.0.CO;2-Q"},{"key":"e_1_2_7_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.68.4.434"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.58.2.160"},{"key":"e_1_2_7_30_2","first-page":"187","article-title":"Multiple system atrophy","volume":"6","author":"Wenning GK","year":"1997","journal-title":"Bailliere Clin Neurol"},{"key":"e_1_2_7_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)82050-4"},{"key":"e_1_2_7_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8257(200011)15:6<1210::AID-MDS1022>3.0.CO;2-R"},{"key":"e_1_2_7_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.66.4.541"},{"key":"e_1_2_7_34_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0404.2001.d01-32.x"},{"key":"e_1_2_7_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8257(199911)14:6<947::AID-MDS1006>3.0.CO;2-O"},{"key":"e_1_2_7_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.55.11.1009"},{"key":"e_1_2_7_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870110125"},{"key":"e_1_2_7_38_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.40.10.1571"},{"key":"e_1_2_7_39_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.58.2.232"},{"key":"e_1_2_7_40_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.6.888"}],"container-title":["Movement Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmds.10171","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.10171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:26:51Z","timestamp":1760956011000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mds.10171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,7]]},"references-count":39,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2002,7]]}},"alternative-id":["10.1002\/mds.10171"],"URL":"https:\/\/doi.org\/10.1002\/mds.10171","archive":["Portico"],"relation":{},"ISSN":["0885-3185","1531-8257"],"issn-type":[{"value":"0885-3185","type":"print"},{"value":"1531-8257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,7]]}}}