Multiple System Atrophy

Continuum (Minneap Minn). 2022 Oct 1;28(5):1350-1363. doi: 10.1212/CON.0000000000001154.


Purpose of review: Patients with multiple system atrophy (MSA) can present with diverse clinical manifestations, and the clinical care required is complex and requires a thoughtful approach to emerging symptoms and treatment decisions.

Recent findings: Even though it is a rare disease, MSA is often encountered in clinical practice. New developments in biofluid biomarkers and diagnostic assessments offer potential for earlier and more accurate diagnosis. This article describes recent findings, such as the use of skin biopsies, neuroimaging, and novel treatment concepts (eg, central noradrenergic augmentation).

Summary: MSA is a complex disease. This article provides a summary of treatment options for diverse symptoms that include autonomic, sleep, mood, and motor manifestations of the disease to help clinicians care for patients with MSA. Providing comprehensive care for patients with MSA requires an understanding of the diverse symptomatology that patients develop over time and should include an interdisciplinary team.

Publication types

  • Review

MeSH terms

  • Autonomic Nervous System
  • Autonomic Nervous System Diseases* / diagnosis
  • Biomarkers
  • Humans
  • Multiple System Atrophy* / diagnosis
  • Multiple System Atrophy* / therapy
  • Neuroimaging


  • Biomarkers