Multiple System Atrophies

The MSA nomenclature subsumes several different diseases, including olivoponto-cerebellar atrophy (OPCA), striatonigral degeneration (SND), and Shy-Drager syndrome (SDS). Cognitive deficits are relatively mild in most forms of MSA, and dementia is not a common feature of these conditions (183), except perhaps in OPCA, in which 40% to 60% of patients may develop dementia, which is more prevalent in familial forms of the disease (184). Mild executive and memory deficits have been reported in MSA (SND and SDS) (185), but are considered to be of similar severity to those observed in nondemented patients with PD (176,186). Patients with MSA may show more pronounced attentional impairments and longer reaction times relative to patients with PD (186,187).

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