A New Technique to Differentiate Multiple System Atrophy

Parkinson's disease and Multiple System Atrophy have similar symptoms. It's very difficult for physicians to make the differential diagnosis between one and the other, but a new discovery seems to be able to improve this process. Learn all about it in this article!
A New Technique to Differentiate Multiple System Atrophy

Last update: 15 June, 2021

Parkinson’s disease and multiple system atrophy are conditions that coincide in many aspects. For example, their symptoms are similar, and research on their origin points in a similar direction.

What’s more, both are neurodegenerative diseases that inexorably progress to more severe forms. So, the search for effective treatment also involves finding ways to diagnose the disorders in time to address them.

The potentially good news is that the journal Nature published some advances in this regard in February of this year. Perhaps the most relevant is the one led by the University of Texas, which proposes a technique that could differentiate between Parkinson’s disease and multiple system atrophy.

Considering the difficulty that physicians have in diagnosing one or the other in their early stages, the advance could be relevant. An accurate and timely diagnosis would make it possible to establish appropriate treatments without delaying the approach.

However, let’s bear in mind that, so far, the only way to know whether it’s one disorder or the other is to wait for the evolution.

Clinically, multiple system atrophy evolves faster than Parkinson’s disease, so a delay is a worse prognosis. And, certainly, when symptoms are too evident, it’s because the evolution was accelerated. In a biological sense, the delay translates into more neurons with irreversible damage.

Let’s take a closer look.

What is Parkinson’s disease?

Parkinson’s disease is a progressive neurodegenerative disease. The major sign of Parkinson’s disease is impaired movement. Parkinson’s patients present with obvious tremors and shaking, mostly in the hands and legs.

As the disease continues to evolve, the movement difficulty extends to other parts of the body, adding rigidity. This leads to imbalances, lack of coordination, and slower completion of actions.

The chemical alteration that’s known to be the immediate cause is the lack of dopamine. Dopamine is a substance that functions as a neurotransmitter in the nervous system. Its deficiency causes the symptoms of the disease.

It’s more common in those over 60 years of age and, therefore, age is considered to be a risk factor. However, some juvenile clinical presentations are possible. The most symbolic case in the world is that of the actor Michael J. Fox, who was diagnosed at the age of 29.

A woman holding the hand of another woman who has Parkinson's disease.
Tremors are a characteristic sign of Parkinson’s disease.

Continue reading: Ear Acupuncture Treatment for Parkinson’s

What is Multiple System Atrophy?

Multiple system atrophy is also a neurodegenerative disorder. Like Parkinson’s disease, it has its highest incidence in older individuals, in this case, above the age of 50.

Its symptoms are very similar to Parkinson’s disease, including motor disturbances. However, there’s a significant fact regarding this pathology, which is its capacity to affect the autonomous functions of the body. As a result, patients suffer from arterial hypotension, constipation, urinary incontinence, arrhythmias, and abnormal breathing.

There’s no defined cause of multiple system atrophy. Research has yet to uncover the underlying problem that would give rise to the disease. However, we do know that brain neurons atrophy and fill with a protein called alpha-synuclein.

Alpha-synuclein and new research on Multiple System Atrophy

The protein that the diseases share, and that would open the door to differential diagnosis, is alpha-synuclein. Known by the acronym aSyn, it’s a substance that folds on itself incorrectly, causing it to accumulate excessively and damage neurons. When the accumulation of the error exceeds the limits of normality, motor effects appear.

In both Parkinson’s disease and multiple system atrophy, alpha-synuclein accumulates for years until it limits neuronal functionality. The problem was that, although the protein was detectable, it wasn’t possible to distinguish with certainty whether the accumulation would progress to Parkinson’s disease or multiple system atrophy.

This new research published in Nature, along with others, proposes a biochemical method – called cyclic protein folding amplification – that would differentiate folds. So, if further progress is made, the method could distinguish between misfolding in Parkinson’s disease and misfolding in multiple system atrophy.

The sensitivity reported in the article is 95.4 %, which is promising. It would be a diagnostic test with a high success rate in arriving at a timely diagnosis. In addition, it would accelerate treatment plans, without having to wait for differentiation to address one or the other pathology.

A doctor looking at an MRI of the brain.
Neurodegenerative diseases are difficult to diagnose.

A hopeful advance for those suffering from Parkinson’s disease or Multiple System Atrophy

Overall, neurodegenerative diseases are a major problem in society. What’s more, an aging population has brought new aspects of these conditions and science is investigating daily how to diagnose and treat them.

However, this new advance published in Nature could improve early diagnosis, and this could lead to progress in early-onset therapeutics to slow down the progression. For the time being, it’s still important to consult a professional right away when strange symptoms appear.

It might interest you...
The Benefits of Music for Neurological Illnesses
Step To Health
Read it in Step To Health
The Benefits of Music for Neurological Illnesses

Music is an essential tool in the process of neurological rehabilitation. Discover the benefits of music for neurological illnesses!



  • Gerez, Juan Atilio, and Roland Riek. “Neurodegenerative diseases distinguished through protein-structure analysis.” (2020).
  • Singleton, A. B., et al. “α-Synuclein locus triplication causes Parkinson’s disease.” Science 302.5646 (2003): 841-841.
  • Chartier-Harlin, Marie-Christine, et al. “α-synuclein locus duplication as a cause of familial Parkinson’s disease.” The Lancet 364.9440 (2004): 1167-1169.
  • Stefanis, Leonidas. “α-Synuclein in Parkinson’s disease.” Cold Spring Harbor perspectives in medicine 2.2 (2012): a009399.
  • Lotharius, Julie, and Patrik Brundin. “Pathogenesis of Parkinson’s disease: dopamine, vesicles and α-synuclein.” Nature Reviews Neuroscience 3.12 (2002): 932-942.
  • Shahnawaz, M., Mukherjee, A., Pritzkow, S. et al. Discriminating α-synuclein strains in Parkinson’s disease and multiple system atrophy. Nature 578, 273–277 (2020). https://doi.org/10.1038/s41586-020-1984-7