What is multiple system atrophy?
Multiple system atrophy (MSA) is a rare, progressive neurological condition that affects the brain, interfering with how your brain communicates with the rest of your body. MSA also impacts the autonomic nervous system, which controls automatic bodily functions such as blood pressure regulation, digestion and urinary function.
Over time, MSA causes nerve cells in parts of the brain and spinal cord to break down and stop working. This leads to a range of symptoms that worsen over time.
MSA primarily affects two major systems in the body:
- The central nervous system, which controls muscle movement, coordination and balance
- The autonomic nervous system, which manages automatic functions like blood pressure, digestion, bladder control and breathing
Symptoms usually begin between the ages of 50 and 60, but the condition very rarely can develop in adults as young as 30. As the disease progresses, daily activities like walking, speaking and swallowing become increasingly difficult.
While there is no cure for MSA, treatments are available to help manage symptoms and improve quality of life. Early diagnosis and supportive care can make a meaningful difference.
Multiple system atrophy symptoms
Multiple system atrophy (MSA) affects many different parts of the body. Symptoms usually appear in adulthood, typically between the ages of 50 and 60. The exact symptoms vary depending on the type of MSA, and they can worsen over time as the disease progresses.
There are two main types of MSA: parkinsonian and cerebellar. The type is determined by the specific symptoms that are most noticeable at the time of diagnosis.
When to see a doctor
If you notice early symptoms of multiple system atrophy, it’s important to talk to your primary care provider.
If you’ve already been diagnosed with Parkinson’s disease and your symptoms change, let your healthcare provider know. Follow-up visits are a chance to check how you’re doing, adjust medications, and address any new or worsening symptoms. Sometimes, people initially diagnosed with Parkinson’s may be re-diagnosed with MSA, especially if medications like levodopa don’t help as expected.
Mental health concerns, like depression or anxiety, are also common in MSA. If you’re experiencing emotional distress, talk to your healthcare provider. They can help with treatments or refer you to a specialist for mental health support.
Multiple system atrophy causes
Experts don’t know exactly what causes multiple system atrophy, but they believe it’s connected to a protein called α-synuclein (alpha-synuclein) that can build up in different parts of the brain. This same protein is thought to play a role in the development of Parkinson’s disease.
Proteins are important for how your body works. They help different body systems communicate with each other, carry chemical compounds throughout the body, and more. But when proteins become damaged and build up in the wrong areas, they can become unhealthy and can lead cells to stop functioning properly. Experts believe this damage leads to the progressive breakdown of brain tissue in MSA.
Scientists are still trying to figure out why α-synuclein builds up in certain areas of the brain. They think it could be linked to genetic mutations that affect how some cells use this protein. There’s also some evidence that MSA-C may run in families. However, researchers haven’t found any strong genetic connection with MSA-P yet.
Multiple system atrophy treatment
While there’s currently no cure for multiple system atrophy, treatment focuses on helping you manage symptoms and maintain the best possible quality of life. Because MSA affects different systems in the body, treatment plans are often personalized and may include medication, lifestyle changes and supportive therapies.
Working closely with your care team—which may include a neurologist, physical therapist, speech therapist and other specialists—can help you find strategies that make everyday life more manageable.
Lifestyle modifications
Simple lifestyle changes can make a big difference in managing some of the daily challenges of MSA. Your doctor may recommend:
- Eating small, frequent meals to help with digestion and blood pressure regulation
- Using extra pillows or an adjustable bed to ease breathing and prevent nighttime blood pressure drops
- Wearing compression garments or using support stockings to help with blood pressure
- Adding grab bars, ramps or mobility aids at home to reduce the risk of falls
- Staying hydrated and eating fiber-rich foods to prevent constipation
Planning ahead and adjusting your routine as symptoms progress can help you stay as independent as possible.
Medication
Medications used for Parkinson’s disease may offer some relief for MSA symptoms, especially in the early stages. The most common option is levodopa, which helps boost dopamine levels in the brain to improve movement. However, the benefit is often temporary and not as effective for people with MSA as it is for those with Parkinson’s disease.
Other medications may be used to target specific symptoms, such as:
- Medicines to help control bladder urgency or incontinence
- Medications for sleep disturbances or acting out dreams
- Drugs that support blood pressure if you experience lightheadedness or dizziness when standing
Your doctor will work with you to find the right combination of medications based on your symptoms and how they change over time.
Therapy
Supportive therapies can improve comfort, function and safety as symptoms progress. These therapies may include:
- Physical therapy: Helps improve strength, posture and balance, and can reduce muscle stiffness or spasms
- Occupational therapy: Teaches new ways to perform daily tasks, like dressing or bathing, to support independence
- Speech therapy: Helps with speech clarity, swallowing and communication tools if speaking becomes difficult
Therapy plans are often adjusted as the condition changes. Ongoing support from rehabilitation specialists can help you adapt and maintain your daily activities for as long as possible.
Find specialized care for multiple system atrophy close to home
When it comes to the care and treatment of multiple system atrophy, Baylor Scott & White offers several locations close to home, including neurology centers in North and Central Texas. From diagnosis to treatment plans personalized for you, we’re with you every step of the way.
