Progress and Prospects in Parkinson's Research/Atypical Parkinsonism/Multiple System Atrophy
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Multiple System Atrophy is a neurological disease which is distinct pathologically from PD but presents with the same symptoms and can result in misdiagnosis.. Its cause(s) are unknown and there is no known cure or effective treatment. Other distinctive features are:-
- Failure to respond to dopamine replacement therapy;
- Severe problems with balance, drops in blood pressure and bladder control.
- Reduced life expectancy (average 7.9 years after onset)
- Men are more likely to succumb to it than women
- 80% of patients have to use wheel chairs within 5 years.
Gilman et al  set out the results of a conference which was set up in order to achieve a consensus in the criteria use to diagnose MSA.
Lipp et al  used careful measurements of the rate of autonomic failure to distinguish between PD and MSA patients. Their conclusions were:-
The main findings of this prospective study to date are that functional status (UMSARS_1) and especially certain select autonomic symptom domains (COMPASS_Select) and deficits (CASS; TST%) will distinguish PD from MSA. Additionally, a repeat study in 12 months will further differentiate the two conditions, since MSA is characterized by a much more rapid progression of dysautonomia and functional status. This two-step approach of systematic evaluation at entry and at one year enhances the ability of the clinician to diagnose MSA with greater sensitivity and specificity.
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- MSA diagnosis.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
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- S Gilman, S.; Wenning, G.K.; Low, P.A. Brooks, D.J.; C J. Mathias, C. J. ; Trojanowski, J. Q.; Wood, N, W,; Colosimo, C.; Dürr, A.; Fowler, C.j.; Kaufmann, H.; Klockgether, T.; A Lees, S.; Poewe, W.; Quinn, N.; FRCP, T Revesz, T.; Robertson,D.; P Sandroni, P.; K Seppi, K. and Vidailhet, M.(2008) Full TextNeurology. 71(9): 670–676. Second consensus statement on the diagnosis of multiple system atrophy. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2676993/?tool=pmcentrez
- Lipp, Axel; Paola Sandroni, Paola; Ahlskog, Eric; Fealey, Robert D.; Kimpinski, Kurt; Iodice, Valeria Gehrking, Tonette L.: Weigand, Stephen D.; Sletten, David M.; Gehrking, Jade A.; Nickander, Kim K.; Singer, Wolfgang; Maraganore, Demetrius M.; Sid Gilman, Sid.; Wenning, Gregor K.; Shults, Clifford M. and Low, Phillip A. (2009) Full Text Arch. Neurol. 66(6): 742–750. Prospective Differentiation of Multiple System Atrophy from Parkinson’s Disease, with and without Autonomic Failure. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2838493/?tool=pmcentrez