Multiple System Atrophy: Multimodal Biomarkers and Clinical Phenotypes

This review article explores Multiple system atrophy (MSA), a rare and aggressive neurodegenerative disease defined by the buildup of α-synuclein protein. The authors examine the shift toward a two-compartment model of the illness, which suggests that while protein aggregates in glia are a hallmark, neuronal damage is the primary driver of decline. Diagnosis remains a significant hurdle because definitive confirmation currently requires postmortem analysis, prompting a search for reliable living indicators. The text evaluates the effectiveness of multimodal biomarkers, including structural and functional neuroimaging, fluid-based assays, and skin biopsies, to identify the disease in its earliest stages. Finally, the source details emerging disease-modifying therapies that target protein aggregation and neuroinflammation to improve patient outcomes.