Send to

Choose Destination
Nat Rev Neurol. 2017 Apr;13(4):232-243. doi: 10.1038/nrneurol.2017.26. Epub 2017 Mar 17.

Multiple system atrophy: insights into a rare and debilitating movement disorder.

Author information

Department of Neurology, Medical University Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.


Multiple system atrophy (MSA) is a devastating and fatal neurodegenerative disorder. The clinical presentation of this disease is highly variable, with parkinsonism, cerebellar ataxia and autonomic failure being the most common - and often debilitating - symptoms. These symptoms progress rapidly, and patients die from MSA-related complications after 9 years of symptom duration on average. Unfortunately, the course of the disease cannot be improved by drug or surgical treatment. In addition, symptomatic treatment options are currently limited, and therapeutic benefits are often only transient. Thus, further interventional studies of candidate disease-modifying and symptomatic therapies are essential to improve patient care. In the past 15 years, the understanding of MSA-specific requirements in trial methodology has improved, resulting in a substantial increase in high-quality interventional studies. In this Review, we discuss MSA risk factors, clinical presentation and neuropathology, and we provide a hypothesis on key pathophysiological events, a summary of recent randomized controlled trials, and an overview of ongoing international collaborations.


Supplemental Content

Full text links

Icon for Nature Publishing Group
Loading ...
Support Center