Development and validation of the Unified Multiple System Atrophy Rating Scale (UMSARS)

Gregor K. Wenning, François Tison, Klaus Seppi, Cristina Sampiao, Anja Diem, Farid Yekhlef, Imad Ghorayeb, Fabienne Ory, Monique Galitzky, Tommaso Scaravilli, Maria Bozi, Carlo Colosimo, Sid Gilman, Clifford W. Shults, Niall P. Quinn, Olivier Rascol, Werner Poewe, Erik Dupont, Karen Ostergaard, Eduardo TolosaThomas Klockgether, Richard Dodel, Michael Abele, Pierre Pollak, Felix Geser, Michaela Stamfer, Günther Deuschl, Christine Daniels, Miguel Coelho, Zvezdan Pirtosek, David J. Brooks, Claire Fowler, Andrew Lees, Christopher J. Mathias, Tamas Revesz, Alexander Gerhard, Janice Holton, Anette Schrag, Nick Wood, Olle Lindvall, Håkan Widner, Martin Grabowski, Christer F. Nilsson, Wolfgang Oertel, Karla Maria Eggert, Nicole Schimke, Alberto Albanese, Francesco del Sorbo, Paolo Barone, Francesco Carella, Ruth Djaljetti, Giuseppe Meco, Jose Berciano, Andres Gonzalez-Mandly, Nir Giladi, Tanya Gurevich, Thomas Gasser, Christoph Kamm, Sten Magnus Aquilonius, Jonas Bergquist

Research output: Contribution to journalArticlepeer-review


We aimed to develop and validate a novel rating scale for multiple system atrophy (Unified Multiple System Atrophy Rating Scale - UMSARS). The scale comprises the following components: Part I, historical, 12 items; Part II, motor examination, 14 items; Part III, autonomic examination; and Part IV, global disability scale. For validation purposes, 40 MSA patients were assessed in four centers by 4 raters per center (2 senior and 2 junior raters). The raters applied the UMSARS, as well as a range of other scales, including the Unified Parkinson's Disease Rating Scale (UPDRS) and the International Cooperative Ataxia Rating Scale (ICARS). Internal consistency was high for both UMSARS-1 (Crohnbach's alpha = 0.84) and UMSARS-II (Crohnbach's alpha = 0.90) sections. The interrater reliability of most of the UMSARS-I and -II items as well as of total UMSARS-I and -II subscores was substantial (k (w) = 0.6-0.8) to excellent (k (w) > 0.8). UMSARS-II correlated well with UPDRS-III and ICARS (rs > 0.8). Depending on the degree of the patient's disability, completion of the entire UMSARS took 30 to 45 minutes. Based on our findings, the UMSARS appears to be a multidimensional, reliable, and valid scale for semiquantitative clinical assessments of MSA patients.

Original languageEnglish
Pages (from-to)1391-1402
Number of pages12
JournalMovement Disorders
Issue number12
Publication statusPublished - Dec 2004


  • Internal consistency
  • Interrater Reliability
  • Unified Multiple System Atrophy Rating Scale
  • Validation

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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