Treatment for Multiple System Atrophy (MSA)
Multiple System Atrophy (MSA) is a rare neurodegenerative disorder that belongs to the group of synucleinopathies and is also classified as an “atypical parkinsonism” disorder. Pathologically, MSA is characterized by abnormal deposits of the α-synuclein protein mainly in oligodendroglial cells and also in certain nerve cells. Typically, there is a dysfunction of the autonomic nervous system, i.e. disturbances of bladder function, erectile function, intestinal mobility, or the regulation of blood pressure and body temperature. Often, additional PD-like symptoms, such as slowness of movement and stiffness of the muscles, or a disturbance of cerebellar function with a progressive loss of balance or speech problems are experienced by the patient.
Cognitive impairments (disturbances in thinking and memory), on the other hand, are relatively rare. In contrast to PD, the most common synucleinopathy, the symptoms are usually symmetrical and progress faster. Depending on the symptomatology, a distinction is made between MSA-P (parkinsonian-type MSA) with predominantly PD-like symptoms and MSA-C (cerebellar type MSA) with predominantly cerebellar dysfunction. The two clinical manifestations, MSA-P and MSA-C, occur in a 3:2 ratio.
Approx. 4-5 out of 100,000 people suffer from MSA. The mean age of onset of the disease is in the sixth decade of life. Men and women are affected approximately equally and do not differ in the clinical course of the disease. So far, there is no cure and no specific drug treatment for MSA. The mean survival period after diagnosis is six to ten years.
Diagnosis is largely based on clinical examinations as well as imaging techniques. In brain imaging (cMRI, cCT), structural changes in the cerebellum, brain stem or basal ganglia can be present. In contrast to many other neurodegenerative diseases MSA has a few clearly defined hallmarks that support clinical evaluation and help to provide a clearer diagnosis for patients.