Multiple system atrophy is a rare condition of the nervous system that causes gradual damage to nerve cells in the brain and spinal cord and progressive loss of associated functions. It is a member of a class of neurodegenerative diseases known as synucleinopathies that have in common an abnormal accumulation of the alpha-synuclein protein in various parts of the brain. The hallmark of the disease is the widespread inclusions of misfolded alpha-synuclein protein - the same protein involved in Parkinson's disease. This book will describe the clinical presentations of the disease, types and variants, diagnostic tests used, drugs employed, and therapies administered. The tests can only help determine whether the diagnosis is 'probable' or 'possible' since no laboratory or imaging studies are able to definitively confirm the diagnosis and there are no useful biomarkers. No test can provide a definitive diagnosis, which remains challenging and difficult in part because of many confounding diseases. Because of this difficulty, some people are actually never properly diagnosed or may not ever be diagnosed. The portfolio of the majority of the developed therapeutic approaches is presented. It includes the panoply of drugs, clinical trials, and the newer modalities of immunotherapy, gene therapy, and mesenchymal stem cell therapy. Unfortunately, there is no cure as the alpha-synuclein processes are only symptoms, not the root cause(s), of the disease so the proximal trigger remains unknown. Regardless, while prognosis and future outlook are poor, there is valuable support from numerous advocating and supporting organizations. There is also hope for the future as research has made excellent progress, especially in the development of new treatment options. A shift in thinking about the disease is still needed with greater consideration given to the potential underlying degenerative etiology that will eventually unravel the mystery and provide a cure.
DR. ALAIN L. FYMAT is a medical-physical scientist and an educator. He is the current President/ CEO and Institute Professor at the International Institute of Medicine & Science with a previous appointment as Executive Vice President/Chief Operating Officer and Professor at the Weil Institute of Critical Care Medicine, California, U.S.A. He was formerly Professor of Radiology, Radiological Sciences, Radiation Oncology, Critical Care Medicine, and Physics at several U.S. and European Universities. Earlier, he was Deputy Director (Western Region) of the U.S. Department of Veterans Affairs (Office of Research Oversight). At the Loma Linda Veterans Affairs Medical Center, he was Scientific Director of Radiology, Director of the Magnetic Resonance Imaging Center and, for a time, Acting Chair of Radiology. Previously, he was Director of the Division of Biomedical and Biobehavioral Research at the University of California at Los Angeles/Drew University of Medicine and Science. He was also Scientific Advisor to the U.S. National Academy of Sciences, National Research Council, for its postdoctoral programs tenable at the California Institute of Technology and Member of the Advisory Group for Research & Development, North Atlantic Treaty Organization (NATO). He is Health Advisor to the American Heart & Stroke Association, Coachella Valley Division, California. He is a frequent Keynote Speaker and Organizing Committee member at several international scientific/medical conferences. He has lectured extensively in the U.S.A, Canada, Europe, Asia, and Africa. He has published in excess of 545 scholarly scientific publications and books. He is also Editor-in-Chief, Honorable Editor or Editor of numerous medical/scientific Journals to which he regularly contributes. He is a member of the New York Academy of Sciences and the European Union Academy of Sciences, a Board member of several institutions, and a reviewer for the prestigious UNESCO Newton Prize, United Kingdom National Commission for UNESCO.
