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FOR MSA PATIENTS, REMEDIES ARE ELUSIVE

Author: JUDY FOREMAN

Boston Globe, The (MA) January 1, 2002 Edition: THIRD Section: Health Science Page: E4 Index Terms: SCI Estimated printed pages: 2 Article Text:

Despite the promise of deep brain stimulation for a number of neurologic problems, there are some conditions for which it doesn't seem to help, including a baffling - and devastating - condition called multiple system atrophy, or MSA, one of several diseases loosely termed "Parkinson's Plus." MSA, a neurodegenerative disease that is often misdiagnosed as Parkinson's, affects an estimated 25,000 to 100,000 people. "It's like a thief in the night," said Tony Swartz-Lloyd, 65, a longtime vice president at Beth Israel Deaconess Medical Center who is now retired and coping with MSA. "It's a weird and elusive disease. . . . It takes a little piece of you here, a little piece there. You don't realize what's missing at first." MSA, for which there is no long-term effective treatment, often starts, like Parkinson's, with a loss of dopamine-producing cells in the brain. But unlike Parkinson's, dopamine-boosting drugs don't seem to help for more than a couple of years. Early symptoms of MSA include loss of balance and coordination, difficulty speaking, a drop in blood pressure upon standing up but high blood pressure while lying down, stiffness and slowness of movement. Patients often develop other problems, such as impotence and difficulty urinating, that are triggered by degeneration in the autonomic nervous system, which controls involuntary bodily functions. Despite the gloomy prognosis that many MSA patients face - gradual loss of many bodily functions and death within six to eight years - there are some bright spots, notably research suggesting that an underlying problem appears to be abnormal deposits (on brain cells) of a protein called alpha-synuclein. Researchers are also studying neuroprotective drugs to keep brain cells from dying in diseases such as MSA and Parkinson's, and other agents to help new brain cells grow.