Parkinson’s disease and multiple system atrophy are progressive neurological illnesses that impair daily motions. Atrophy of many systems is less common and usually advances faster.

Two disorders of the neurological system include Parkinson’s disease (PD) and multiple system atrophy (MSA). Both belong to the group of illnesses known as Parkinsonism, which has specific effects on mobility. MSA is uncommon in this group, but PD is the most prevalent condition.

If left untreated, PD and MSA both worsen over time. Some of the symptoms of the two illnesses may be similar, depending on the MSA subtype.

Despite their similarities, it’s critical to recognize that MSA and PD are two different illnesses with unique effects on the brain.

What is Parkinson’s disease?

Parkinson’s disease (PD) is a neurological condition that impacts movement. Uncontrollable stiffness, tremors, and balance issues are its main symptoms. When combined, these symptoms may make it challenging to do daily tasks including eating, walking, and conversing.

What is multiple system atrophy?

Many of the symptoms of PD are also present in MSA, a condition of the neurological system. It is referred to as an atypical Parkinsonian condition because of this. The cause of this uncommon ailment is yet unknown.

Physicians distinguish between two subtypes of MSA: cerebellar type (MSA-C) and parkinsonian type (MSA-P).

Parkinsonian type MSA (MSA-P)

The symptoms of MSA-P are similar to those of PD. Additionally, it may result in problems with digestion, perspiration, urination, and other involuntary bodily processes that are normally regulated by your autonomic nervous system.

Cerebellar type MSA (MSA-C)

Certain brain regions shrink as a result of MSA-C, which can alter speech and vision and cause problems with coordination.

How do the symptoms of multiple system atrophy and Parkinson’s disease differ?

Since MSA and PD can both induce the following symptoms, it may initially be challenging to distinguish between the two conditions:

• speech changes
• bladder control problems
• lightheadedness
• dizziness
• tremors
• stiffness
• lack of coordination
• clumsiness
• slower movements
• anxiety or depression
• sleep problems
• rapid eye movement sleep behaviour disorder

PD and MSA progress at different rates, though. While PD symptoms are more gradual, MSA tends to grow more quickly.

MSA may also result in:

• joint stiffness
• Pisa syndrome (sideways leaning)
• anterocollis (a forward tilt of your head)
• sleep apnea
• autonomic dysfunction, such as problems with your heart rate and digestion

Additional symptoms that may be present in both illnesses include:

• oily skin and scalp
• dementia
• difficulty thinking
• muscle cramps
• dystonia (involuntary muscle contractions)
• orthostatic hypotension (a sudden decrease in blood pressure when standing up)

What causes multiple system atrophy vs. Parkinson’s disease?

The precise cause of MSA is currently being investigated. In addition to genetic and environmental variables, they believe it might be caused by the accumulation of alpha-synuclein protein (Lewy bodies) in brain cells that produce myelin.

Damage to the neurons (nerve cells) in the substantia nigra, which is located close to the base of the brain, is what causes Parkinson’s disease. Dopamine, a crucial brain neurotransmitter that facilitates movement, is produced in part by these cells.

The brain’s ability to produce norepinephrine is likewise compromised in people with Parkinson’s disease. Norepinephrine is in charge of uncontrollable behaviours like controlling your heart rate and blood pressure, whilst dopamine aids in controlled movement.

Lewy body accumulation in brain nerve cells is another effect of Parkinson’s disease (PD) that may exacerbate nerve cell death.

Who is most likely to get multiple system atrophy vs. Parkinson’s?

The majority of MSA cases occur in adults in their 50s. An estimated 15,000 to 50,000 Americans suffer from this uncommon ailment. According to experts, MSA affects both men and women equally and most cases occur at random.

PD primarily affects men and typically begins to develop in elderly persons beyond the age of 60. Given that having a close relative with Parkinson’s disease (PD) can raise your risk of getting the disease yourself, it may also have a genetic component.

How do doctors diagnose multiple system atrophy vs. Parkinson’s?

To diagnose or differentiate between MSA and PD, doctors usually employ the same tests. Among these tests are:

• blood tests
• a neurological exam
• neuroimaging scans to look at your brain, such as an MRI
• bladder function tests
• autonomic nervous system tests

When diagnosing you, a doctor will also take into account your family’s medical history.

If doctors initially administer PD drugs and discover that they don’t alleviate your symptoms, they may then diagnose MSA.

What is the treatment for multiple system atrophy vs. Parkinson’s?

Neither PD nor MSA have a cure at this time.

Both illnesses may benefit from certain therapies that enhance quality of life. No treatment can delay the advancement of MSA, although several drugs can assist decrease the progression of PD.

The following approaches may be used in tandem to treat PD:

• duopa and Rytary contain carbidopa-levodopa, which may raise dopamine levels in the brain.
• dopamine agonists, like ropinirole (Requip) or apomorphine (Apokyn)
• amantadine is an antiviral drug that may raise dopamine levels.
• inhibitors of catechol-o-methyltransferase (COMT), like tolcapone (Tasmar) or entacapone (Comtan)
• monoamine oxidase B (MAO-B) inhibitors, like selegiline (Eldepryl, Emsam, Zelapar) or rasagiline (Azilect)
• trihexyphenidyl and benztropine (Cogentin) are examples of anticholinergics used to treat bladder issues.
• deep stimulation of the brain
• brain lesion removal surgery (only when all other therapies have failed)

However, MSA may not respond to the same medicines that are usually provided for PD. To address particular movement problems, a doctor could suggest alternative treatments such as Botulinum toxin (Botox) injections for dystonia and drugs to enhance sleep and bladder control.

Furthermore, a physician might suggest the following treatments to help with movement in both PD and MSA:

• speech therapy
• physical and occupational therapy
• an exercise program
• massage therapy

What is the outlook for people with multiple system atrophy vs. Parkinson’s?

MSA can advance quickly—between five to ten years. Within a few years of receiving a diagnosis, many people lose their mobility and require walking aids.

People with MSA might expect to live for seven to nine years.

By the time symptoms appear, people with Parkinson’s disease may have lost between 60% and 80% of their dopamine in the substantia nigra. To help slow down additional damage in this progressive illness, prompt therapy is crucial.

The life expectancy for those with PD is almost usual, in contrast to those with MSA, however, this might change based on when they are diagnosed and the severity of their symptoms.

Takeaway

Consider discussing the main parallels and differences between MSA and PD with a physician if you or a loved one has been diagnosed with either illness or if either ailment runs in your family: