Multiple system atrophy and Parkinson’s disease are progressive nervous system disorders that affect everyday movements. Multiple system atrophy is rarer and tends to progress more quickly.

Multiple system atrophy (MSA) and Parkinson’s disease (PD) are two nervous system disorders. Both fall under the umbrella of parkinsonism, a group of disorders that affect movement in certain ways. PD is the most common disorder in this group, while MSA is rare.

Both MSA and PD progress over time if they are not treated. Depending on the MSA subtype, the two conditions can have some of the same symptoms.

Despite their similarities, it’s important to understand that PD and MSA are distinct conditions that affect the brain differently.

PD is a nervous system disorder that affects movement. It’s primarily known for causing uncontrollable stiffness, tremors, and balance problems. Collectively, these symptoms can make it difficult to engage in routine activities such as eating, walking, and talking.

MSA is a nervous system disorder that causes many of the same symptoms as PD. For this reason, it’s known as an atypical parkinsonian disorder. Researchers don’t yet know what causes this rare condition.

Doctors divide MSA into two subtypes: parkinsonian type (MSA-P) and cerebellar type (MSA-C).

Parkinsonian type MSA (MSA-P)

MSA-P has the same symptoms as PD. It can also cause issues with digestion, sweating, urination, and other involuntary body functions that your autonomic nervous system typically controls.

Cerebellar type MSA (MSA-C)

MSA-C causes shrinkage in certain areas of the brain, which can cause coordination issues and changes to speech and vision.

At first, it may be difficult to tell the difference between MSA and PD, as they can both cause the following symptoms:

However, MSA and PD differ in their progression rate. MSA tends to progress quickly, while PD symptoms are more gradual.

MSA can also cause:

  • 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

Other possible symptoms seen in both conditions include:

Researchers are still studying the exact cause of MSA. They think it may be due to alpha-synuclein protein buildup (Lewy bodies) in brain cells that create myelin, as well as genetic and environmental factors.

PD is caused by damage to neurons (nerve cells) in the substantia nigra, near the base of your brain. These cells are responsible for helping to produce dopamine, a key brain chemical that helps with movement.

People who develop PD also have problems with norepinephrine production in the brain. While dopamine helps with controlled movement, norepinephrine is responsible for uncontrolled actions, such as regulation of your blood pressure and heart rate.

PD can also cause the buildup of Lewy bodies in nerve cells in the brain, which could further contribute to nerve cell destruction.

MSA most often develops in adults in their 50s. It’s a rare condition, affecting an estimated 15,000 to 50,000 people in the United States. Experts believe that most cases of MSA develop randomly and that MSA affects females and males equally.

PD generally starts developing in older adults after 60 years of age and mostly affects males. This condition may also have a hereditary component, as having a close relative with PD can increase your risk of developing it.

Doctors typically use the same tests to diagnose MSA and PD or to distinguish between them. These tests include:

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

A doctor will also factor in your personal and family health history when making a diagnosis.

Doctors may diagnose MSA if they first prescribe PD medications and find that these medications do not improve your symptoms.

There’s currently no cure for MSA or PD.

Certain therapies may help improve quality of life in both conditions. While some medications are available to help slow the progression of PD, no treatments can slow MSA progression.

PD treatment may involve a combination of the following methods:

However, treatments typically prescribed for PD may not work for MSA. Instead, a doctor may recommend other options to treat specific movement issues, such as botulinum toxin (Botox) injections for dystonia and medications to improve sleep and bladder control.

Additionally, a doctor may recommend the following therapies to support movement in both MSA and PD:

MSA can progress rapidly, within 5 to 10 years. Many people need walking aids within a few years of diagnosis, and many lose the ability to move around.

Life expectancy for people with MSA is 7 to 9 years.

People with PD may have lost 60% to 80% of dopamine in the substantia nigra by the time symptoms start. Prompt treatment is essential to help slow down further damage in this progressive condition.

Unlike people with MSA, those with PD have a nearly typical life expectancy, although this can vary depending on when they receive a diagnosis and how severe their symptoms are.

If you or a loved one has received a diagnosis of MSA or PD or if you have a family history of either condition, consider talking with a doctor about the key similarities and differences:

Parkinson’s diseaseMultiple system atrophy
Age of onsetafter age 60after age 50
Hallmark symptoms• tremors
• stiffness
• movement difficulties		• same symptoms as PD
• more rapid progression
• autonomic dysfunction
Causesdamage to neurons in the brain that make dopamineunknown
Treatment options• medications to increase dopamine
• surgery if these do not work		• dopamine medications do not work
• may consider off-label medications
Outlook• gradual symptom progression
• average life expectancy		• rapid progression
• life expectancy of 7 to 9 years