Multiple System Atrophy (MSA) is a progressive, neurodegenerative disorder characterized by the suspension of the standard function of the autonomic nervous system with a presentation of symptoms usually arising in the 50s or 60s of one’s adulthood (Mayo Clinic, 2020). The autonomic division of the nervous system regulates involuntary movements of an organism’s internal organs in response to environmental stimuli such as breathing patterns, heart rate, digestion, and metabolism (Kandola, 2020). An individual with MSA most commonly experiences frequent fluctuations in blood pressure, such as low blood pressure when one stands or sits up (orthostatic hypotension) or high blood pressure when lying down (supine hypertension) (2020). One may additionally experience a loss of urinary or bowel control, dysfunction in body temperature regulation due to reduced sweat production, and difficulty maintaining sexual function with a loss of libido (Mayo Clinic, 2020).
MSA is divided into two categories: MSA-P, parkinsonian, and MSA-C, cerebellar (MedlinePlus, 2016). The most common form, MSA-P, is grouped by movement abnormalities such as rigid muscles, slow movement, trouble bending arms and legs, and difficulty keeping the body in a sustained, balanced position (2016). MSA-C is defined by cerebellar ataxia in which an individual faces complications with muscle coordination (2016). This may present as speech slurring, trouble focusing one’s eyes, or difficulty swallowing or chewing (Mayo Clinic, 2020).
As of right now, there is no conclusive reasoning for why MSA occurs in the population; however, it is thought for the cause of the disorder to be a conglomerate of genetic and environmental elements (2020). By examining the brain and spinal cord of those who were impacted by MSA, researchers saw a significant shrinkage of the cerebellum, basal ganglia, and brainstem (Mayo Clinic, 2020). All three structures are crucial in their involvement for motor learning, balance, and coordination of body movements (Johns Hopkins Medicine, n.d.). Affected brain tissue has been revealed for neurons in the brain and spinal cord to be composed of an abnormal amount of alpha-synuclein protein, which form clumps, or inclusions, throughout the nervous system (n.d.). Accumulations of alpha-synuclein protein over nerve cells can block proper cell signaling, leading to a progressive loss of control in coordination and motor functions (n.d.). Studies suggest that variations in the SNCA gene, which encodes for the alpha-synuclein protein, have been associated with a greater risk of MSA (MedlinePlus, 2016).
Unfortunately, no cure has been found for MSA. Although all individuals with MSA experience varying levels of the disorder throughout their years, the symptoms do not decrease in severity. The progression of the condition leads to a greater degree of difficulty in maintaining daily activities with further secondary complications (Mayo Clinic, 2020).
Johns Hopkins Medicine. (n.d.). Brain anatomy and how the brain works. https://www.hopkinsmedicine.org/health/conditions-and-diseases/anatomy-of-the-brain
Kandola, A. (2020, January 10). What is the autonomic nervous system? Medical News Today. https://www.medicalnewstoday.com/articles/327450#function
Mayo Clinic. (2020, May 21). Multiple system atrophy (MSA). https://www.mayoclinic.org/diseases-conditions/multiple-system-atrophy/symptoms-causes/syc-20356153
MedlinePlus. (2016, July 1). Multiple system atrophy. National Library of Medicine. https://medlineplus.gov/genetics/condition/multiple-system-atrophy/