{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:46:51Z","timestamp":1791852411198,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2008,4,28]],"date-time":"2008-04-28T00:00:00Z","timestamp":1209340800000},"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":[[2008,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The clinical diagnosis of multiple system atrophy (MSA) is fraught with difficulty and there are no pathognomonic features to discriminate the parkinsonian variant (MSA\u2010P) 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 \u201cred flags\u201d or warning signs may raise the clinical suspicion of MSA. To study the diagnostic role of these features in MSA\u2010P versus PD patients, a standardized red flag check list (RFCL) developed by the European MSA Study Group (EMSA\u2010SG) was administered to 57 patients with probable MSA\u2010P 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\u2010P who on follow\u2010up fulfilled criteria of probable MSA\u2010P. 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\u2010P, 76.5% of them would have been correctly diagnosed as probable MSA\u2010P 15.9 (\u00b17.0) 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\u2010P. \u00a9 2008 Movement Disorder Society.<\/jats:p>","DOI":"10.1002\/mds.21992","type":"journal-article","created":{"date-parts":[[2008,4,28]],"date-time":"2008-04-28T18:46:37Z","timestamp":1209408397000},"page":"1093-1099","source":"Crossref","is-referenced-by-count":218,"title":["Red flags for multiple system 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