Progressive Neurological Disorder Affecting Movement and Involuntary Processes

Multiple system atrophy (MSA) is a rare, progressive neurological disorder that affects parts of the brain responsible for controlling movement and involuntary processes, such as blood pressure, heartbeat, urination, bowel movement and sleep patterns. During the disease progression, abnormal deposits of the protein alpha-synuclein accumulate in glial cells causing nerve cells to not function properly and die. MSA may look like Parkinson’s disease in the way it affects movement, such as tremor, slowness, stiffness and shuffling gait.

Currently, the exact causes of MSA are unknown. Like many other diseases, it may not have a single cause, but a combination of genetic, environmental and behavioral factors.

Symptoms, Diagnosis & Outlook


The onset of MSA is gradual, making it difficult to pinpoint when and how symptoms first begin. At times, it may be difficult to distinguish from Parkinson’s disease, especially in the early stages. Symptoms generally occur after age 50 and may include:

  • Slowness of movement
  • Muscle stiffness
  • Shaking (tremor), particularly at rest
  • Impaired coordination and balance
  • Shuffling gait and susceptibility to falls
  • Speech difficulties, such as softness and lack of normal speaking rhythm
  • Lightheadedness or fainting spells, particularly upon standing
  • Impaired bladder control, such as, urgency, frequency and incontinence
  • Anxiety
  • Depression
  • Sleep disorders, which can include acting out dreams
  • Breathing disorders, such as, high-pitched respiratory sounds


A diagnosis of MSA is made after careful consideration of multiple factors, including review of extensive clinical histories and exams, symptom progression and responsiveness to medications. Although Parkinson’s medications, such as levodopa, may help some MSA patients, these drugs often are ineffective since MSA affects more parts of the brain than Parkinson’s disease. As multiple organ systems may be affected by MSA, a multidisciplinary team of Penn State Health physicians often provide care for these patients.


Currently, there is no cure for MSA and there are no treatments available to delay its progressive neurodegeneration. Instead, current treatment therapies are designed to help with symptoms.

Generally, MSA patients require a wheelchair within five years of symptom onset and later succumb to the disease within the following few years.

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Why Choose Penn State Health for Care

Along with researchers around the world, the clinicians and scientists at Penn State College of Medicine’s Translational Brain Research Center are devoted to identifying the causes of MSA and developing better diagnostic tools through partnership with the National Institute of Neurological Disorders and Stroke (NINDS) Parkinson’s Disease Biomarkers Program (PDBP) and clinical trials. By partnering with patients and their families, this multidisciplinary team is committed to developing effective therapies to ensure others do not have to endure this difficult journey.

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