Multiple System Atrophy
Several prodromal symptoms in REM sleep behavior disorder are highly associated with conversion to neurodegenerative diseases.
Although evidence of cognitive impairment in MSA is admittedly more limited than in Parkinson disease, it is now substantial enough to address modification of diagnostic criteria to include the potential for cognitive impairment at any stage of the disease.
While parkinsonian disorders share a common mechanism of protein aggregation, manifestations are quite varied.
Patients with multiple system atrophy with parkinsonism face the greatest risk for death among synucleinopathies.
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