Introduction
The following list is not exhaustive but is a starting point for understanding more about Multiple System Atrophy (MSA).
Reviews/Overviews of MSA
Makawita, Chulika, et al. “A Systematic Review of the Spectrum and Prevalence of Non-Motor Symptoms in Multiple System Atrophy.” Cerebellum (London, England), vol. 23, no. 4, Aug. 2024, pp. 1642–50. EBSCOhost, https://doi.org/10.1007/s12311-023-01642-1.
Foubert-Samier A, Traon AP, Guillet F et al. Disease progression and prognostic factors in
multiple system atrophy: A prospective cohort study. Neurobiol Dis 2020; 139: 104813
https://www.ncbi.nlm.nih.gov/pubmed/32087288 Free article
Goh YY, Saunders E, Pavey S, Rushton E, Quinn N, Houlden H, Chelban V. Multiple system atrophy. Pract Neurol. 2023 Mar 16:practneurol-2020-002797. doi: 10.1136/pn-2020-002797. Epub ahead of print. https://pubmed.ncbi.nlm.nih.gov/36927875/
Krismer F, Wenning GK. Multiple system atrophy: insights into a rare and debilitating movement disorder. Nat Rev Neurol 2017; 13: 232-243. https://www.ncbi.nlm.nih.gov/pubmed/28303913
Fanciulli A, Stankovic I, Krismer F, et al. Multiple system atrophy. Int Rev Neurobiol 2019; 149: 137-192. https://www.ncbi.nlm.nih.gov/pubmed/31779811
Poewe, W., Stankovic, I., Halliday, G. et al. Multiple system atrophy. Nat Rev Dis Primers 8, 56 (2022). https://doi.org/10.1038/s41572-022-00382-6 https://pubmed.ncbi.nlm.nih.gov/36008429/
Stankovic I, et al. “A Review on the Clinical Diagnosis of Multiple System Atrophy.” Cerebellum (London, England), vol. 22, no. 5, Oct. 2023, pp. 825–39. EBSCOhost, https://doi.org/10.1007/s12311-022-01453-w.
Kaplan, S. “Prevalence of Multiple System Atrophy: A Literature Review.” Revue Neurologique, vol. 180, no. 5, May 2024, pp. 438–50. EBSCOhost, https://doi.org/10.1016/j.neurol.2023.11.013.
Leys, Fabian, et al. “Sex-Related Differences in the Clinical Presentation of Multiple System Atrophy.” Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society, vol. 34, no. 2, Apr. 2024, pp. 253–68. EBSCOhost, https://doi.org/10.1007/s10286-024-01028-1.
Saulnier, Tiphaine, et al. “Disease Progression in Multiple System Atrophy: The Value of Clinical Cohorts with Long Follow‐Up.” Movement Disorders, vol. 38, no. 8, Aug. 2023, pp. 1567–69. EBSCOhost, https://doi.org/10.1002/mds.29534.
Eschlboeck, Sabine, et al. “Development and Validation of a Prognostic Model to Predict Overall Survival in Multiple System Atrophy.” Movement Disorders Clinical Practice, vol. 10, no. 9, July 2023, pp. 1368–76. EBSCOhost, https://doi.org/10.1002/mdc3.13822.
Stankovic I; Kuijpers M; Kaufman H An update on Multiple System Atrophy Current opinion in Neurology 2024 Aug 1, 37,4,400-408
Pathology
Woerman AL, Watts JC, Aoyagi A, et al. α-Synuclein: Multiple System Atrophy Prions. Cold Spring Harb Perspect Med 2018 Jul 2; 8(7). https://www.ncbi.nlm.nih.gov/pubmed/28213437
Free PMC article
Shahnawaz M, Mukherjee A, Pritzkow S et al Discriminating α-synuclein strains in Parkinson’s disease and multiple system atrophy. Nature 2020; 578: 273-277. https://www.ncbi.nlm.nih.gov/pubmed/32025029 Free PMC article
Heras-Garvin A, Weckbecker D, Ryazanov S, et al. Anle138b modulates α-synuclein oligomerization and prevents motor decline and neurodegeneration in a mouse model of multiple system atrophy. 2019; 34: 255-263. https://www.ncbi.nlm.nih.gov/pubmed/30452793
Free PMC article
Singer W, Schmeichel AM, Shahnawaz M, et al.
Alpha-Synuclein Oligomers and Neurofilament Light Chain in Spinal Fluid Differentiate Multiple System Atrophy from Lewy Body Synucleinopathies.
Ann Neurol 2020; 88: 503-512 https://pubmed.ncbi.nlm.nih.gov/32557811/
Free PMC article
Rossi M, Candelise N, Baiardi S, et al.
Acta Neuropathol. 2020; 140: 49-62. PMID: 32342188 https://pubmed.ncbi.nlm.nih.gov/32342188/ Free PMC article
Kon, Tomoya, et al. “SNCA and TPPP Transcripts Increase in Oligodendroglial Cytoplasmic Inclusions in Multiple System Atrophy.” Neurobiology of Disease, vol. 198, Aug. 2024, p. 106551. EBSCOhost, https://doi.org/10.1016/j.nbd.2024.106551.
Böing C; Di Fabrizio M; Burger D; Bol JGJM; Huisman E; Rozemuller AJM; van de Berg WDJ; Stahlberg H; Lewis AJ, Distinct ultrastructural phenotypes of glial and neuronal alpha-synuclein inclusions in multiple system atrophy. Brain : a journal of neurology [Brain], ISSN: 1460-2156, 2024 May 02;
Wakabayashi K, et al. “Neuropathology of Multiple System Atrophy, a Glioneuronal Degenerative Disease.” Cerebellum (London, England), vol. 23, no. 1, Feb. 2024, pp. 2–12. EBSCOhost, https://doi.org/10.1007/s12311-022-01407-2.
Stefanova, Nadia, and Gregor K. Wenning. “Multiple System Atrophy: At the Crossroads of Cellular, Molecular and Genetic Mechanisms.” Nature Reviews. Neuroscience, vol. 24, no. 6, June 2023, pp. 334–46. EBSCOhost, https://doi.org/10.1038/s41583-023-00697-7.
Multiple system atrophy: advances in pathophysiology, diagnosis, and treatment Florian Krismer, PhDa florian.krismer@i-med.ac.at ∙ Alessandra Fanciulli, PhDa ∙ Prof Wassilios G Meissnerb,c,d,e ∙ Elizabeth A Coon, MDf ∙ Prof Gregor K Wenning, PhD* www.thelancet.com/journals/laneur/article/PIIS1474-4422%2824%2900396-X/abstract?hss_channel=tw-27013292&utm_campaign=reviews24&utm_medium=social&dgcid=twitter_organic_reviews24_laneur&utm_content=318874945&utm_source=twitter
Diagnosis
Woerman AL, Watts JC, Aoyagi A, et al. α-Synuclein: Multiple System Atrophy Prions. Cold Spring Harb Perspect Med 2018 Jul 2; 8(7). https://www.ncbi.nlm.nih.gov/pubmed/28213437
Free PMC article
Shahnawaz M, Mukherjee A, Pritzkow S et al Discriminating α-synuclein strains in Parkinson’s disease and multiple system atrophy. Nature 2020; 578: 273-277. https://www.ncbi.nlm.nih.gov/pubmed/32025029 Free PMC article
Heras-Garvin A, Weckbecker D, Ryazanov S, et al. Anle138b modulates α-synuclein oligomerization and prevents motor decline and neurodegeneration in a mouse model of multiple system atrophy. 2019; 34: 255-263. https://www.ncbi.nlm.nih.gov/pubmed/30452793
Free PMC article
Singer W, Schmeichel AM, Shahnawaz M, et al.
Alpha-Synuclein Oligomers and Neurofilament Light Chain in Spinal Fluid Differentiate Multiple System Atrophy from Lewy Body Synucleinopathies.
Ann Neurol 2020; 88: 503-512 https://pubmed.ncbi.nlm.nih.gov/32557811/
Free PMC article
Rossi M, Candelise N, Baiardi S, et al.
Acta Neuropathol. 2020; 140: 49-62. PMID: 32342188 https://pubmed.ncbi.nlm.nih.gov/32342188/ Free PMC article
Kon, Tomoya, et al. “SNCA and TPPP Transcripts Increase in Oligodendroglial Cytoplasmic Inclusions in Multiple System Atrophy.” Neurobiology of Disease, vol. 198, Aug. 2024, p. 106551. EBSCOhost, https://doi.org/10.1016/j.nbd.2024.106551.
Böing C; Di Fabrizio M; Burger D; Bol JGJM; Huisman E; Rozemuller AJM; van de Berg WDJ; Stahlberg H; Lewis AJ, Distinct ultrastructural phenotypes of glial and neuronal alpha-synuclein inclusions in multiple system atrophy. Brain : a journal of neurology [Brain], ISSN: 1460-2156, 2024 May 02;
Wakabayashi K, et al. “Neuropathology of Multiple System Atrophy, a Glioneuronal Degenerative Disease.” Cerebellum (London, England), vol. 23, no. 1, Feb. 2024, pp. 2–12. EBSCOhost, https://doi.org/10.1007/s12311-022-01407-2.
Stefanova, Nadia, and Gregor K. Wenning. “Multiple System Atrophy: At the Crossroads of Cellular, Molecular and Genetic Mechanisms.” Nature Reviews. Neuroscience, vol. 24, no. 6, June 2023, pp. 334–46. EBSCOhost, https://doi.org/10.1038/s41583-023-00697-7.
Nandanwal D; Truong D Multiple System Atrophy: Diagnostic challenges and a proposed diagnostic algorithm. Clinical Parkinsonism and Related Disorders 2024 Vol11. https://doi.org/10.1016/j.prdoa.2024.100271
MSA-C
Azibte, Gebeyehu Tessema, et al. “Multiple System Atrophy-Cerebellar Type: Diagnostic Challenge in Resource-Limited Settings Case Report.” Clinical Case Reports, vol. 12, no. 7, July 2024, p. e9142. EBSCOhost, https://doi.org/10.1002/ccr3.9142.
Hamid, Mohamed, et al. “Cerebellar Form of Multiple System Atrophy: A Case Report.” Radiology Case Reports, vol. 19, no. 9, June 2024, pp. 3724–28. EBSCOhost, https://doi.org/10.1016/j.radcr.2024.05.044.
Stephen, Christopher D., et al. “Rates of Change of Pons and Middle Cerebellar Peduncle Diameters Are Diagnostic of Multiple System Atrophy of the Cerebellar Type.” Brain Communications, vol. 6, no. 1, Feb. 2024, p. fcae019. EBSCOhost, https://doi.org/10.1093/braincomms/fcae019.
Young onset
Batla A, De Pablo-Fernandez E, Erro R, et al. Young-onset multiple system atrophy: Clinical and pathological features. Mov Disord 2018; 33: 1099-1107. https://www.ncbi.nlm.nih.gov/pubmed/30153390
Badihian, Negin, et al. “Clinical Characteristics and Outcomes in Young-Onset Multiple System Atrophy.” Movement Disorders Clinical Practice, vol. 11, no. 3, Mar. 2024, pp. 220–26. EBSCOhost, https://doi.org/10.1002/mdc3.13925.
Jellinger KA. “Young-Onset Multiple System Atrophy.” Movement Disorders : Official Journal of the Movement Disorder Society, vol. 33, no. 12, Dec. 2018, pp. 1974–75. EBSCOhost, https://doi.org/10.1002/mds.27
Kim HJ, and Jeon B. “Young-Onset Multiple System Atrophy: Its Rarity and Heterogeneity.” Movement Disorders : Official Journal of the Movement Disorder Society, vol. 34, no. 7, July 2019, pp. 1085–86. EBSCOhost, https://doi.org/10.1002/mds.27716.
Late Onset
Oxawe M; Santo R; et al. Late onset Multiple System Atrophy: Neuropathological features associated with slow disease progression. Brain Pathology 2025, 35, 5:e70016. https://doi.org/10.1111/bpa.70016
Imaging and Investigations
Chelban V, Bocchetta M, Hassanein S, et al. An update on advances in magnetic resonance imaging of multiple system atrophy. J Neurol 2019; 266: 1036-1045. https://www.ncbi.nlm.nih.gov/pubmed/30460448
Free PMC article
Chelban, Viorica, et al. “Neurofilament Light Levels Predict Clinical Progression and Death in Multiple System Atrophy.” Brain : A Journal of Neurology, vol. 145, no. 12, Dec. 2022, pp. 4398–408. EBSCOhost, https://doi.org/10.1093/brain/awac253.
Alonso-Canovas A, Tembl Ferrairo JI, Martinez-Torres I, et al. Transcranial sonography in atypical parkinsonism: How reliable is it in real clinical practice? A multicentre comprehensive study. Parkinsonism Relat Disord 2019; 68: 40-45 https://www.ncbi.nlm.nih.gov/pubmed/31621617
Way C, Pettersson D, Hiller A. The ‘Hot Cross Bun’ Sign Is Not Always Multiple System Atrophy: Etiologies of 11 Cases. Journal of Movement Disorders 2019; 12: 27-30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369380/
Takaya S, Sawamoto N, Okada T, et al. Differential diagnosis of parkinsonian syndromes using dopamine transporter and perfusion SPECT. Parkinsonism & Related Disorders 2018; 47: 15-21. https://www.ncbi.nlm.nih.gov/pubmed/29157745
Jensen I; Heine J; Ruf VC; Compta Y; Porcel LM; Troakes C; Vamanu A; Downes S; Irwin D; Cohen J; Lee EB; Nilsson C; Englund E; Nemati M; Katzdobler S; Levin J; Pantelyat A; Seemiller J; Berger S; van Swieten J; Dopper E; Rozenmuller A; Kovacs GG; Bendahan N; Lang AE; Herms J; Höglinger G; Hopfner F, Impact of Magnetic Resonance Imaging Markers on the Diagnostic Performance of the International Parkinson and Movement Disorder Society Multiple System Atrophy Criteria. ISSN: 1531-8257, 2024 Jun 07; Publisher: Wiley-Liss; PMID: 38847384,
Pasquini, Jacopo, et al. “Hypothalamic Involvement in Multiple System Atrophy: A Structural MRI Study.” Journal of the Neurological Sciences, vol. 460, May 2024, p. 122985. EBSCOhost, https://doi.org/10.1016/j.jns.2024.122985
Villena-Salinas, Javier, et al. “Comparative Study between the Diagnostic Effectiveness of Brain SPECT with [ 123 I]Ioflupane and [ 123 I]MIBG Scintigraphy in Multiple System Atrophy.” Biomedicines, vol. 12, no. 1, Jan. 2024. EBSCOhost, https://doi.org/10.3390/biomedicines12010102.
Krismer, Florian, et al. “Progressive Brain Atrophy in Multiple System Atrophy: A Longitudinal, Multicenter, Magnetic Resonance Imaging Study.” Movement Disorders : Official Journal of the Movement Disorder Society, vol. 39, no. 1, Jan. 2024, pp. 119–29. EBSCOhost, https://doi.org/10.1002/mds.29633.
Jensen, Ida, et al. “Impact of Magnetic Resonance Imaging Markers on the Diagnostic Performance of the International Parkinson and Movement Disorder Society Multiple System Atrophy Criteria.” Movement Disorders : Official Journal of the Movement Disorder Society, June 2024. EBSCOhost, https://doi.org/10.1002/mds.29879.
Shiina, Kenta, et al. “Cerebellar Blood Perfusion Is a Diagnostic, but Not a Prognostic, Marker for Parkinsonian-Dominant Type Multiple System Atrophy.” Parkinsonism & Related Disorders, vol. 123, June 2024, p. 106975. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2024.106975.
Meyer M, et al. “Brain 5-HT1A Receptor Binding in Multiple System Atrophy: An [ 18 F]-MPPF PET Study.” Movement Disorders : Official Journal of the Movement Disorder Society, vol. 36, no. 1, Jan. 2021, pp. 246–51. EBSCOhost https://doi.org/10.1002/mds.28295.
Donadio, Vincenzo, et al. “Phosphorylated α-Synuclein in Skin Schwann Cells: A New Biomarker for Multiple System Atrophy.” Brain : A Journal of Neurology, vol. 146, no. 3, Mar. 2023, pp. 1065–74. EBSCOhost, https://doi.org/10.1093/brain/awac124.
Lee S; Martinez-Valbuenal I; Long A; KovacsG Cellular iron deposition patterns predict clincal subtypes of Multiple System Atrophy 2024 Neurobiol.Dis https://doi.org/10.1016/j.nbd.2024.10635
Wiseman J; Halliday G; Dieriks B Neuronal alphasynuclien toxicity is the key driver of neurodegeneration in Multiple Sytem Atrophy Brain 2025 Jul 7; 143,7,2306-2319
Krismer F; Seppi k; Pewe W The role of neuroimaging in Multiple Sytem Atrophy. Journal of neural transmission 2025, Jul, 12.
Genetics
Scholz SW, Houlden H, Schulte C, et al. SNCA variants are associated with increased risk for multiple system atrophy. Ann Neurol 2019; 5: 610-4. https://europepmc.org/article/pmc/pmc4727743
Wernick AI, Walton RL, Soto-Beasley, et al. Frequency of spinocerebellar ataxia mutations in patients with multiple system atrophy. Clin Auton Res. 2021; 31:117-125.PMID: 33502644 https://pubmed.ncbi.nlm.nih.gov/33502644/
Sullivan R, Yau WY, Chelban V, et al.
RFC1-related ataxia is a mimic of early multiple system atrophy.
J Neurol Neurosurg Psychiatry. 2021; 92: 444-6. PMID: 33563805 Free PMC article. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958109/
Fyfe, Ian. “Genes Associated with Multiple System Atrophy.” Nature Reviews. Neurology, vol. 20, no. 7, July 2024, p. 379. EBSCOhost, https://doi.org/10.1038/s41582-024-00986-4.
Chia, Ruth, et al. “Genome Sequence Analyses Identify Novel Risk Loci for Multiple System Atrophy.” Neuron, vol. 112, no. 13, July 2024, p. 2142. EBSCOhost, https://doi.org/10.1016/j.neuron.2024.04.002.
Matsukawa T, et al. “Clinical and Genetic Features of Multiplex Families with Multiple System Atrophy and Parkinson’s Disease.” Cerebellum (London, England), vol. 23, no. 1, Feb. 2024, pp. 22–30. EBSCOhost, https://doi.org/10.1007/s12311-022-01426-z.
Autonomic features and testing
General
Giannini G, Calandra-Buonaura G, Asioli GM, et al. The natural history of idiopathic autonomic failure: The IAF-BO cohort study. Neurology 2018; 91: 1245-1254. https://www.ncbi.nlm.nih.gov/pubmed/30135257
Coon EA, Mandrekar JN, Berini SE, et al.
Predicting phenoconversion in pure autonomic failure.
Neurology. 2020; 18: 95PMID: 32546656. https://pubmed.ncbi.nlm.nih.gov/32546656/
Vichayanrat E, Valerio F, Koay S et al. Diagnosing Premotor Multiple System Atrophy: Natural History and Autonomic Testing in an Autopsy-Confirmed Cohort. Neurology. 2022 Sep 13;99(11):e1168-e1177. doi: 10.1212/WNL.0000000000200861. Epub 2022 Jul 5. https://pubmed.ncbi.nlm.nih.gov/35790426/
Millar Vernetti, Patricio, et al. “Phenoconversion in Pure Autonomic Failure: A Multicentre Prospective Longitudinal Cohort Study.” Brain : A Journal of Neurology, vol. 147, no. 7, July 2024, pp. 2440–48. EBSCOhost, https://doi.org/10.1093/brain/awae033.
Pavy-Le Traon, A., et al. “An Overview on Pure Autonomic Failure.” Revue Neurologique, vol. 180, no. 1–2, Jan. 2024, pp. 94–100. EBSCOhost, https://doi.org/10.1016/j.neurol.2023.11.003.
Luo Y; Wang n; Wang W et al Autonomic Dysfunction in Multiple System Atrophy: From pathophysiology to clinical manifestations. Ann. Med 2025 Dec, 57,1, 2488 PMID 40719373
Blood Pressure and Cardiovascular
Fanciulli A, Leys F, Falup-Pecurariu, et al. Management of orthostatic hypotension in Parkinson’s disease. J Parkinson’s Dis 2020; 10: no.s1, pp S57-S64.
https://pubmed.ncbi.nlm.nih.gov/32716319 Free PMC article
Pavy-Le Traon A, Foubert-Samier A, Ory-Magne F, et al. Ambulatory blood pressure and drug treatment for orthostatic hypotension as predictors of mortality in patients with multiple system atrophy. Eur J Neurol. 2022 Apr;29(4):1025-1034. doi: 10.1111/ene.15232. Epub 2022 Jan 27. https://pubmed.ncbi.nlm.nih.gov/34971021/
Fanciulli A, Leys F, Falup-Pecurariu C, et al. Cardiovascular autonomic function testing in multiple system atrophy and Parkinson’s disease: an expert-based blinded evaluation. Clin Auton Res 2020; 30: 255-263. PMC Full Text https://pubmed.ncbi.nlm.nih.gov/32415621/ Free PMC Article
Wang X; Mei S; Lin Z; Huang Z; Mao W; Chan P, Impaired vestibular function associated with orthostatic hypotension in patients with multiple system atrophy.Journal of neurology [J Neurol], ISSN: 1432-1459, 2024 Jun; Vol. 271 (6), pp. 3486-3495
McCarter, Stuart J., et al. “Nocturnal Pulse Event Frequency Is Reduced in Multiple System Atrophy.” Annals of Neurology, vol. 93, no. 1, Jan. 2023, pp. 205–12. EBSCOhost, https://doi.org/10.1002/ana.26533.
Wang, Xue, et al. “Impaired Vestibular Function Associated with Orthostatic Hypotension in Patients with Multiple System Atrophy.” Journal of Neurology, vol. 271, no. 6, June 2024, pp. 3486–95. EBSCOhost, https://doi.org/10.1007/s00415-024-12324-1.
Claassen DO, et al. “Characterization of the Symptoms of Neurogenic Orthostatic Hypotension and Their Impact from a Survey of Patients and Caregivers.” BMC Neurology, vol. 18, no. 1, Aug. 2018, p. 125. EBSCOhost https://doi.org/10.1186/s12883-018-1129-x.
Lenka, Abhishek, et al. “Asymptomatic Orthostatic Hypotension in Synucleinopathies: To Treat or Not to Treat?” Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society, vol. 34, no. 1, Feb. 2024, pp. 25–29. EBSCOhost, https://doi.org/10.1007/s10286-023-01006-z.
Koag S; Provitera V et al . Cardiovascular autonomic failure correlates with cutaneous denervation in Parkisnon’s Disease and Multiple System Atrophy. Clinical Autonomic Research. 2025. https://doi.org10.1007/s10286-025-01154-L
Urology and Bowel
Fanciulli A, Goebel G, Lazzeri G, et al. Urinary retention discriminates multiple system atrophy from Parkinson’s disease. Mov Disord 2019; 34: 1926-1927. https://pubmed.ncbi.nlm.nih.gov/31710392/
Panicker JN, Simeoni S, Miki Y, et al. Early presentation of urinary retention in multiple system atrophy: can the disease begin in the sacral spinal cord? J Neurol 2020; 267: 659-664 PMID: 31720822 https://www.ncbi.nlm.nih.gov/pubmed/31720822 Free PMC article
Sakakibara R, Panicker J, Simeoni S, et al. Bladder dysfunction as the initial presentation of multiple system atrophy: a prospective cohort study. Clin Auton Res 2019; 29: 627-631. https://www.ncbi.nlm.nih.gov/pubmed/30043182
Yamamoto T, et al. The Utility of Post-Void Residual Volume versus Sphincter Electromyography to Distinguish between Multiple System Atrophy and Parkinson’s Disease. PLoS One 2017; 12, e0169405. https://www.ncbi.nlm.nih.gov/pubmed/28060892 Free PMC article
Todisco M, Cosentino G, Scardina S. Diagnostic and Prognostic Value of External Anal Sphincter EMG Patterns in Multiple System Atrophy. Mov Disord. 2022 May;37(5):1069-1074. doi: 10.1002/mds.28938. Epub 2022 Feb 4. https://pubmed.ncbi.nlm.nih.gov/35122320/
Roy, Holly Ann, and Alexander L. Green. “The Central Autonomic Network and Regulation of Bladder Function.” Frontiers in Neuroscience, vol. 13, June 2019, p. 535. https://doi.org/10.3389/fnins.2019.00535.
Ha, U. N. L., et al. “Low Urinary Tract Dysfunction and Motor Severity in Patients with Multiple System Atrophy.” Parkinsonism & Related Disorders, vol. 122, May 2024, p. N.PAG. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2024.106852.
Craig, Colin F., et al. “Understanding the Potential Causes of Gastrointestinal Dysfunctions in Multiple System Atrophy.” Neurobiology of Disease, vol. 187, Oct. 2023, p. 106296. EBSCOhost, https://doi.org/10.1016/j.nbd.2023.106296.
Yoon H; Jeon S; Kim H; Oh S. Video urodynamics Study in patients with Parkinson’s Disease and Multiple Sytem Atrophy. Mov Dis. Cl. Practice 2025, Jul 23
Che K; Lin K; Li S Refining video urodynamics study based differentiation of Parkinson’s Disease and Multiple System Atrophy: Mehodlological gaps and Interdisciplinary Directions. Mov. Dis Cl Pract. 2025 Spet 23 PMID 40988457
Reitz A; Aaferkamp A; Gilfrich C; Buse S . Sacral Neurostimulation in Neurogenic Lower urinary Tract and Bowel Dysfunction Caused by Multiple System Atrophy. Neurology and Urodynamics 2025 Aug, 44,6,1296-1301
Respiratory and Sleep
Cortelli P, Calandra-Buonaura G, Benarroch EE, et al. Stridor in multiple system atrophy: Consensus statement on diagnosis, prognosis, and treatment. Neurology 2019; 93: 630-639 PMID: 31570638 https://www.ncbi.nlm.nih.gov/pubmed/31570638 Free PMC article
Nishida K, Sakashita K, Yamasaki H, Futamura N. Impact of tracheostomy invasive ventilation on survival in Japanese patients with multiple system atrophy. Parkinsonism Relat Disord. 2022 Apr;97:107-111. doi: 10.1016/j.parkreldis.2022.01.008. Epub 2022 Jan 14. https://pubmed.ncbi.nlm.nih.gov/35063370/
Giannini G, Provini F, Cani I, Cecere A, Mignani F, Guaraldi P, Di Mirto CVF, Cortelli P, Calandra-Buonaura G. Tracheostomy is associated with increased survival in Multiple System Atrophy patients with stridor. Eur J Neurol. 2022 Aug;29(8):2232-2240. doi: 10.1111/ene.15347. Epub 2022 Apr 15. https://pubmed.ncbi.nlm.nih.gov/35384153/
Lajoie, Annie C., et al. “Adherence to Continuous Positive Airway Pressure for the Treatment of Obstructive Sleep Apnea in Neurodegenerative Diseases: A Systematic Review.” Sleep Medicine Reviews, vol. 71, Oct. 2023, p. 101836. EBSCOhost, https://doi.org/10.1016/j.smrv.2023.101836.
Ohshima, Yasuyoshi, et al. “Variation of Respiratory and Pulse Events in Multiple System Atrophy.” Parkinsonism & Related Disorders, vol. 115, Oct. 2023, p. 105817. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2023.105817.
Giannini G, Mastrangelo V, Provini F, Droghini A, Cecere A, Barletta G, Mignani F, Guaraldi P, Cortelli P, Calandra-Buonaura G. Progression and prognosis in multiple system atrophy presenting 9
with REM behavior disorder. Neurology. 2020 Apr 28;94(17):e1828-e1834. doi: 10.1212/WNL.0000000000009372. Epub 2020 Mar 31. https://pubmed.ncbi.nlm.nih.gov/32234825/
Jo, Sungyang; 1Kim, Tae-Young; 1Lee, Yong Seok; 1Lee, Eun-Jae; 1Lee, Sangjin; 1Lee, Jihyun; 1Chung, Sun Ju; 1Lee, Sang-Ahm1 Severity of sleep apnea as a prognostic factor for mortality in patients with multiple system atrophy. Parkinsonism & Related Disorders (PARKINSONISM RELAT DISORD), Jul2024; 124: N.PAG-N.PAG. (1p)
Cao B, et al. “Impact of Sleep-Related Breathing Disorder on Motor and Non-Motor Symptoms in Multiple System Atrophy.” Sleep & Breathing = Schlaf & Atmung, vol. 22, no. 4, Dec. 2018, pp. 981–87. EBSCOhost, https://doi.org/10.1007/s11325-018-1632-8.
Silvani, Alessandro, et al. “Pervasive and Diffuse Muscle Activity during REM Sleep and Non-REM Sleep Characterises Multiple System Atrophy in Comparison with Parkinson’s Disease.” Journal of Sleep Research, vol. 32, no. 2, Apr. 2023, p. e13721. EBSCOhost, https://doi.org/10.1111/jsr.13721
Asakawa, Takashi, et al. “Effects of Rehabilitative Intervention for Augmenting Cough Function in Patients with Multiple System Atrophy.” Progress in Rehabilitation Medicine, vol. 8, Oct. 2023, p. 20230035. EBSCOhost, https://doi.org/10.2490/prm.20230035.
Tipton, Philip W., et al. “Vocal Fold ‘Paralysis’: An Early Sign in Multiple System Atrophy.” Journal of Voice : Official Journal of the Voice Foundation, vol. 34, no. 6, Nov. 2020, pp. 940–44. EBSCOhost, https://doi.org/10.1016/j.jvoice.2019.06.008.
Sweating
Coon EA, et al. Anhidrosis in multiple system atrophy involves pre- and postganglionic sudomotor dysfunction. Mov Disord 2017; 32: 397-404. https://www.ncbi.nlm.nih.gov/pubmed/27859565 Free PMC article
Georges, Claire, et al. “Alterations in Electrochemical Skin Conductance as a Marker of Autonomic Dysfunction in Multiple System Atrophy.” Parkinsonism & Related Disorders, vol. 103, Oct. 2022, pp. 56–59. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2022.08.026.
Provitera, Vincenzo, et al. “Postganglionic Sudomotor Assessment in Early Stage of Multiple System Atrophy and Parkinson Disease: A Morpho-Functional Study.” Neurology, vol. 98, no. 12, Mar. 2022, pp. e1282–91. EBSCOhost, https://doi.org/10.1212/WNL.0000000000013300.
Pavy-LeTraon, Anne, et al. “Combined Cardiovascular and Sweating Autonomic Testing to Differentiate Multiple System Atrophy from Parkinson’s Disease.” Neurophysiologie Clinique = Clinical Neurophysiology, vol. 48, no. 2, Apr. 2018, pp. 103–10. EBSCOhost, https://doi.org/10.1016/j.neucli.2017.11.003.
Other Specific Symptoms
Fatigue
Xu F, et al. “Fatigue Prevalence and Associated Factors in Patients with Multiple System Atrophy.” Acta Neurologica Scandinavica, vol. 144, no. 5, Nov. 2021, pp. 553–58. https://doi.org/10.1111/ane.13488.
Pan, Jing, et al. “High-Frequency Repetitive Transcranial Magnetic Stimulation Over the Left Dorsolateral Prefrontal Cortex Shortly Alleviates Fatigue in Patients With Multiple System Atrophy: A Randomized Controlled Trial.” Frontiers in Neurology, vol. 12, Jan. 2022, p. 755352. EBSCOhost, https://doi.org/10.3389/fneur.2021.755352.
Zhang, Lingyu, et al. “Fatigue in Patients With Multiple System Atrophy: A Prospective Cohort Study.” Neurology, vol. 98, no. 1, Jan. 2022, pp. e73–82. EBSCOhost, https://doi.org/10.1212/WNL.0000000000012968.
Pain
Campese, Nicole, et al. “Pain in Multiple System Atrophy a Systematic Review and Meta-Analysis.” Movement Disorders Clinical Practice, vol. 10, no. 12, Oct. 2023, pp. 1738–49. EBSCOhost, https://doi.org/10.1002/mdc3.13897.
Ali, Nabila, et al. “Factors Impacting Quality of Life in Multiple System Atrophy.” Frontiers in Neurology, vol. 14, Mar. 2023, p. 1111605. EBSCOhost, https://doi.org/10.3389/fneur.2023.1111605.
Rana AQ, et al. “Prevalence of Pain in Atypical Parkinsonism: A Systematic Review and Meta-Analysis.” Journal of Neurology, vol. 266, no. 9, Sept. 2019, pp. 2093–102. EBSCOhost, https://doi.org/10.1007/s00415-018-9049-7.
Yang C; Schmidt M; Smith T; Pantelyat A . Scrambler Therapy of the treatment of Chronic Neuropathic Pain in Atypical Parkinson’s Disorders. Pain Medicine Case Reports 2025, Aug 9,4,211-216
Dystonia / postural
Natalie Anne Watson · Zohaib Siddiqui · Benjamin John Miller · Yakubu Karagam a · Nicholas Gibbins Non‑aesthetic uses of botulinum toxin in the head and neck European Archives of Oto-Rhino-Laryngology (2021) 278:4147–4154 https://doi.org/10.1007/s00405-021-06750-4
Murphy, Kate T., and Gordon S. Lynch. “Impaired Skeletal Muscle Health in Parkinsonian Syndromes: Clinical Implications, Mechanisms and Potential Treatments.” Journal of Cachexia, Sarcopenia and Muscle, vol. 14, no. 5, Oct. 2023, pp. 1987–2002. EBSCOhost, https://doi.org/10.1002/jcsm.13312.
Artusi, Carlo Alberto, et al. “Predictors and Pathophysiology of Axial Postural Abnormalities in Parkinsonism: A Scoping Review.” Movement Disorders Clinical Practice, vol. 10, no. 11, Sept. 2023, pp. 1585–96. EBSCOhost, https://doi.org/10.1002/mdc3.13879.
Thongchuam, Yuwadee, et al. “Orofacial Dystonia and Asssociated Bulbar Symptoms in Multiple System Atrophy: A Blinded Video Analysis.” Journal of the Neurological Sciences, vol. 417, Oct. 2020, p. 116992. EBSCOhost, https://doi.org/10.1016/j.jns.2020.116992.
Todisco, Massimiliano, et al. “Vocal Cord Electromyographic Correlates of Stridor in Multiple System Atrophy Phenotypes.” Parkinsonism & Related Disorders, vol. 70, Jan. 2020, pp. 31–35. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2019.11.025.
Marsili, Luca, et al. “Dystonia in Atypical Parkinsonian Disorders.” Parkinsonism & Related Disorders, vol. 66, Sept. 2019, pp. 25–33. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2019.07.030.
Cognition
Lazzeri, G., et al. “Cognition in Multiple System Atrophy Patients: The Impact of Sex and Motor Phenotype.” Parkinsonism & Related Disorders, vol. 122, May 2024, p. N.PAG. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2024.106765.
Shi, Zhihong, et al. “Characteristics of Mild Cognitive Impairment and Associated Factors in MSA Patients.” Brain Sciences, vol. 13, no. 4, Mar. 2023. EBSCOhost, https://doi.org/10.3390/brainsci13040582.
Kübler, Dorothee, et al. “Structural and Metabolic Correlates of Neuropsychological Profiles in Multiple System Atrophy and Parkinson’s Disease.” Parkinsonism & Related Disorders, vol. 107, Feb. 2023, p. 105277. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2022.105277
Yang, Xiao-Li, et al. “Cerebral Small Vessel Disease Is Associated with Motor, Cognitive, and Emotional Dysfunction in Multiple System Atrophy.” Journal of Parkinson’s Disease, vol. 13, no. 7, 2023, pp. 1239–52. EBSCOhost, https://doi.org/10.3233/JPD-230166.
Bäckström, David, et al. “Prediction and Early Biomarkers of Cognitive Decline in Parkinson Disease and Atypical Parkinsonism: A Population-Based Study.” Brain Communications, vol. 4, no. 2, Mar. 2022, p. fcac040. EBSCOhost, https://doi.org/10.1093/braincomms/fcac040.
Dash, Santosh, et al. “Cognition in Patients With Multiple System Atrophy (MSA) and Its Neuroimaging Correlation: A Prospective Case-Control Study.” Cureus, vol. 14, no. 1, Jan. 2022, p. e21717. EBSCOhost, https://doi.org/10.7759/cureus.21717.
Cuoco, Sofia, et al. “Relationship Between Orthostatic Hypotension and Cognitive Functions in Multiple System Atrophy: A Longitudinal Study.” Frontiers in Neurology, vol. 12, Sept. 2021, p. 711358. EBSCOhost, https://doi.org/10.3389/fneur.2021.711358.
Miki, Yasuo, et al. “Hippocampal α-Synuclein Pathology Correlates with Memory Impairment in Multiple System Atrophy.” Brain : A Journal of Neurology, vol. 143, no. 6, June 2020, pp. 1798–810. EBSCOhost, https://doi.org/10.1093/brain/awaa126.
Hu m; Coma A; Rowe J et al Cognitive and neuropsychiatric profiles distinguish Atypical Parkinsonism Syndromes. Brain 2025, 148, 3239-3251. https://doi.org/10.1093/brain/awaf132
Emotions / Anxiety
Santangelo G, et al. “Theory of Mind in Multiple System Atrophy: Comparison with Parkinson’s Disease and Healthy Subjects.” Journal of Neural Transmission (Vienna, Austria : 1996), vol. 127, no. 6, June 2020, pp. 915–23. EBSCOhost, https://doi.org/10.1007/s00702-020-02181-3.
Jellinger, Kurt A. “The Pathobiology of Behavioral Changes in Multiple System Atrophy: An Update.” International Journal of Molecular Sciences, vol. 25, no. 13, July 2024. EBSCOhost, https://doi.org/10.3390/ijms25137464.
Lai, Thuy Thi, et al. “Anxiety in Synucleinopathies: Neuronal Circuitry, Underlying Pathomechanisms and Current Therapeutic Strategies.” NPJ Parkinson’s Disease, vol. 9, no. 1, June 2023, p. 97. EBSCOhost, https://doi.org/10.1038/s41531-023-00547-4.
Ophthalmic
Ungureanu, Larisa, et al. “Diplopia in Movement Disorders: A Systematic Review of the Literature.” Journal of Personalized Medicine, vol. 14, no. 3, Feb. 2024. EBSCOhost, https://doi.org/10.3390/jpm14030270.
Sidoroff, Victoria, et al. “Emotion Recognition in Multiple System Atrophy: An Exploratory Eye-Tracking Study.” Journal of Movement Disorders, vol. 17, no. 1, Jan. 2024, pp. 38–46. EBSCOhost, https://doi.org/10.14802/jmd.23090.
Garcia, Maria D., et al. “Ocular Features of Multiple System Atrophy.” Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 47, Jan. 2018, pp. 234–39. EBSCOhost, https://doi.org/10.1016/j.jocn.2017.10.028.
Speech
Cuoco S, et al. “The Language Profile in Multiple System Atrophy: An Exploratory Study.” Journal of Neural Transmission (Vienna, Austria : 1996), vol. 128, no. 8, Aug. 2021, pp. 1195–203. EBSCOhost, https://doi.org/10.1007/s00702-021-02372-6.
Atkinson-Clement C, et al. “Psychosocial Impact of Dysarthria: The Patient-Reported Outcome as Part of the Clinical Management.” Neuro-Degenerative Diseases, vol. 19, no. 1, 2019, pp. 12–21. EBSCOhost, https://doi.org/10.1159/000499627.
Swallow
Calandra-Buonaura G, Alfonsi E, Vignatelli L, et al.
Dysphagia in multiple system atrophy consensus statement on diagnosis, prognosis and treatment.
Parkinsonism Relat Disord 2021; Mar 30 S1353-8020 Online ahead of print.
PMID: 33839029 Review. https://pubmed.ncbi.nlm.nih.gov/33839029/ Free article
Mozzanica F; Pizzorni N; Eplite A; Ginocchio D; Colombo A; Mora G; Ambrogi F; Warnecke T; Schindler A, Swallowing Characteristics in Patients with Multiple System Atrophy Analyzed Using FEES Examination.
Dysphagia [Dysphagia], ISSN: 1432-0460, 2024 Jun; Vol. 39 (3), pp. 387-397; Publisher: Springer-Verlag; PMID: 37733099, https://doi.org/10.1007/s00455-023-10619-5?
Kobylecki C; Chelban V; Goh YY; Michou E; Fumi R; Theilmann Jensen M; Mohammad R; Costantini A; Vijiaratnam N; Pavey S; Pavese N; Leigh PN; Rowe JB; Hu MT; Church A; Morris HR; Houlden H, Frequency and outcomes of gastrostomy insertion in a longitudinal cohort study of atypical parkinsonism. Eur J Neurol, ISSN: 1468-1331, 2024 Jun; Vol. 31 (6), pp. e16258; Publisher: Wiley; PMID: 38407533, https://doi.org/10.1111/ene.16258
Wada A; Kawakami M; Yamada Y; Kaji K; Hijikata N; Liu F; Otsuka T; Tsuji T,
Relationship Between Pneumonia and Dysphagia in Patients With Multiple System Atrophy. Frontiers in neurology [Front Neurol], ISSN: 1664-2295, 2022 Jul 04; Vol. 13, pp. 904852; https://doi.org/10.3389/fneur.2022.904852?
Giovanna Calandra-Buonauraa,b,1, Enrico Alfonsic,1, Luca Vignatellia, Eduardo E. Benarrochd, Giulia Gianninia,b, Alex Iranzoe, Phillip A. Lowd, Paolo Martinellib, Federica Provinia,b, Niall Quinnf, Eduardo Tolosag, Gregor K. Wenningh, Giovanni Abbruzzesei, Pamela Bowerj, Angelo Antoninik, Kailash P. Bhatial, Jacopo Bonavitam, Maria Teresa Pellecchian, Nicole Pizzornio, François Tisonp,q, Imad Ghorayebr,s,t, Wassilios G. Meissnerp,q,u, Tetsutaro Ozawav, Claudio Pacchettiw, Nicol` o Gabriele Pozziw, Claudio Vicinix,y, Antonio Schindlero, Pietro Cortellia,b,*,1, Horacio Kaufmannz,1 Dysphagia in multiple system atrophy consensus statement on diagnosis, prognosis and treatment Parkinsonism and Related Disorders 86 (2021) 124-132 https://doi.org/10.1016/j.parkreldis.2021.03.027?
Hui Jae Do1 · Han Gil Seo · Hyun Haeng Lee · Byung‑Mo Oh · Yoon Kim · Aryun Kim · Han‑Joon Kim · Beomseok Jeon · Tai Ryoon Han Progression of Oropharyngeal Dysphagia in Patients with Multiple System Atrophy Dysphagia (2020) 35:24–31 https://doi.org/10.1007/s00455-019-09990-z
El Fassi, Nadia, et al. “UMSARS Versus Laryngoscopy-Based Assessment of Dysphagia.” Movement Disorders Clinical Practice, vol. 10, no. 6, Apr. 2023, pp. 974–79. EBSCOhost, https://doi.org/10.1002/mdc3.13734.
Gandor F; Berger L; Jager V; etal. Is Dysphagia in Multiple System Atrophy responsive to Levodopa? Results from a retrospective study. Mov Dis Cl Prac 2025, Sept 12 PMID 40940632
Nagao r; Mizutani Y et al. Correlations between Dysphagia Severity Scale Scores and Clinical Indices in Individuals with Multiple System Atrophy. Mov Dis Cl Prac 2025, Aug 12,8,1085-1096
Treatment and management
Coon EA, Ahlskog JE. My Treatment Approach to Multiple System Atrophy. Mayo Clin Proc. 2021 Mar;96(3):708-719. doi: 10.1016/j.mayocp.2020.10.005. https://pubmed.ncbi.nlm.nih.gov/33673922/
Krismer F, Poewe W, Seppi K. Comment: Autologous mesenchymal stem cells: Hope for patients with multiple system atrophy? Neurology 2019; 93: 25. https://www.ncbi.nlm.nih.gov/pubmed/31152012
Rohrer G, Höglinger GU, Levin J. Symptomatic therapy of multiple system atrophy. Autonomic Neuroscience: Basic and Clinical 2018; 211: 26-30. https://www.autonomicneuroscience.com/article/S1566-0702(17)30163-7/pdf
Singer W, Dietz AB, Zeller AD et al. Intrathecal administration of autologous mesenchymal stem cells in multiple system atrophy. Neurology 2019; 93: 77-87. https://www.ncbi.nlm.nih.gov/pubmed/31152011 Free PMC article
Raccagni, C., et al. “Physiotherapy Improves Motor Function in Patients with the Parkinson Variant of Multiple System Atrophy: A Prospective Trial.” Parkinsonism & Related Disorders, vol. 67, Oct. 2019, pp. 60–65. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2019.09.026.
Ye, Lan, et al. “The Comorbidity Profiles and Medication Issues of Patients with Multiple System Atrophy: A Systematic Cross-Sectional Analysis.” Journal of Neurology, vol. 271, no. 5, May 2024, pp. 2639–48. EBSCOhost, https://doi.org/10.1007/s00415-024-12207-5.
Saulnier, Tiphaine, et al. “Patient-Perceived Progression in Multiple System Atrophy: Natural History of Quality of Life.” Journal of Neurology, Neurosurgery, and Psychiatry, Mar. 2024. EBSCOhost, https://doi.org/10.1136/jnnp-2023-332733.
Palma, Jose-Alberto, and Roland D. Thijs. “Non-Pharmacological Treatment of Autonomic Dysfunction in Parkinson’s Disease and Other Synucleinopathies.” Journal of Parkinson’s Disease, Sept. 2023. EBSCOhost, https://doi.org/10.3233/JPD-230173.
Cheong, Julia Ly, et al. “Support Needs of People with Multiple System Atrophy.” Parkinsonism & Related Disorders, vol. 120, Mar. 2024, p. 106019. EBSCOhost, https://doi.org/10.1016/j.parkreldis.2024.106019.
Grossauer A, et al. “Symptomatic Care in Multiple System Atrophy: State of the Art.” Cerebellum (London, England), vol. 22, no. 3, June 2023, pp. 433–46. EBSCOhost, https://doi.org/10.1007/s12311-022-01411-6.
Tarisawa M; Matsushima M; Kudo A et al. Trends in Invasive Interventions and Risk Factors for early Critical Events in Multiple System Atrophy. Cerbellum 2025, Spet 06, 24,5,152
Research
Walsh RR, Krismer F, Galpern WR, et al. Recommendations of the Global Multiple System
Atrophy Research Roadmap Meeting. Neurology. 2018; 90: 74-82 Review.
https://www.ncbi.nlm.nih.gov/pubmed/29237794 Free PMC article
Pellecchia MT, Stankovic I, Fanciulli A, et al.
Mov Disord Clin Pract. 2020; 7: 750-762 PMID: 33043073. Review. https://pubmed.ncbi.nlm.nih.gov/33043073/
Bendetowicz, David, et al. “Recent Advances in Clinical Trials in Multiple System Atrophy.” Current Neurology and Neuroscience Reports, vol. 24, no. 4, Apr. 2024, pp. 95–112. EBSCOhost, https://doi.org/10.1007/s11910-024-01335-0.
Meissner WG, Fernagut PO, Dehay B, et al. Multiple System Atrophy: Recent Developments and Future Perspectives. Mov Disord. 2019; 34: 1629-1642 Review. https://www.ncbi.nlm.nih.gov/pubmed/31692132
Stankovic I, Fanciulli A, Kostic VS, et al.
Mov Disord Clin Pract. 2021; 10: 322-340PMID: 33816659. Review. https://pubmed.ncbi.nlm.nih.gov/33816659/
Tsuji, Shoji, and Gregor Wenning. “New Horizon of Multiple System Atrophy Research.” Cerebellum (London, England), vol. 23, no. 1, Feb. 2024, p. 1. EBSCOhost, https://doi.org/10.1007/s12311-024-01667-0.
Street, Duncan, et al. “Progression of Atypical Parkinsonian Syndromes: PROSPECT-M-UK Study Implications for Clinical Trials.” Brain : A Journal of Neurology, vol. 146, no. 8, Aug. 2023, pp. 3232–42. EBSCOhost, https://doi.org/10.1093/brain/awad105.
Gibbons CH, et al. “Skin Biopsy Detection of Phosphorylated α-Synuclein in Patients With Synucleinopathies.” JAMA, vol. 331, no. 15, Apr. 2024, pp. 1298–306. EBSCOhost, https://doi.org/10.1001/jama.2024.0792.
Ando T, et al. “Degeneration of Olivospinal Tract in the Upper Cervical Spinal Cord of Multiple System Atrophy Patients: Reappraisal of Helweg’s Triangular Tract.” Brain Pathology (Zurich, Switzerland), vol. 34, no. 3, May 2024, p. e13226. EBSCOhost, https://doi.org/10.1111/bpa.13226.
Mwesigwa, Naome, and Cyndya A. Shibao. “Norepinephrine Reuptake Inhibition, an Emergent Treatment for Neurogenic Orthostatic Hypotension.” Hypertension (Dallas, Tex. : 1979), vol. 81, no. 7, July 2024, pp. 1460–66. EBSCOhost, https://doi.org/10.1161/HYPERTENSIONAHA.124.22069.
Liu M; Wang Z Shang H Multiple System Atrophy@an update and emerging directions of biomarkers and clinical trials. Journal of Neurology 2024 271, 2324-2344