Multiple system atrophy (MSA): diagnostic criteria

Levels of diagnostic certainty

• Neuropathologically established MSA
• Clinically established MSA
• Clinically probable MSA
• Possible prodromal MSA

Essential diagnostic criteria for clinically established MSA

Core diagnostic criteria for clinically established MSA

Supportive motor criteria for clinically established MSA

Supportive non-motor criteria for clinically established MSA

MRI markers for clinically established MSA-P

MRI markers for clinically established MSA-C

Exclusion criteria MSA

References

1. Wenning GK, Stankovic I, Vignatelli L, et al. The Movement Disorder Society Criteria for the diagnosis of multiple system atrophy. Mov Disord 2022; 37:1131-1148.
2. Zhang L, Hou Y, Wei Q, et al. Diagnostic utility of movement disorder society criteria for multiple system atrophy. Front Aging Neurosci 2023; 15:1200563.
3. Sugiyama A, Riku Y, Koga S, et al. Revisiting 'hot cross bun' sign: a multicentre MRI study of 97 patients with autopsy-confirmed multiple system atrophy. J Neurol Neurosurg Psychiatry 2025 (Online ahead of print).

Related checklists

• Multiple system atrophy (MSA): clinical features
• Multiple system atrophy (MSA): differential diagnosis
• Multiple system atrophy (MSA): investigations
• Multiple system atrophy (MSA): treatments