How Is SDS Different From Parkinson’s Disease?
Although Parkinson’s disease may affect the autonomic nervous system, the autonomic symptoms are usually relatively mild as compared to SDS sometimes call Parkinson’s Plus. However, in some cases the distinction between Parkinson’s disease and SDS cannot be made until post mortem examination. While in Parkinson’s disease the brunt of damage is primarily in one system, the nigrostristal pathway, in SDS multiple neuronal systems are damaged. Similar to Parkinson’s disease, there is a loss of nerve cells and pigment in the part of the brainstem called the substantia nigra, which normally contains the highest concentration of dopamine producing cells. However, in SDS there is additional damage in other nerve cells of the brainstem (inferior olive, dorsal motor nucleus of vagus, locus cervievs, oculomotor nuclei, Edinger-Westphal nucievs and the periaqueductal gray matter), basal ganglia cerebellum and spinal cord. Because of these wide spread pathological changes in multiple areas of the central nervous system, SDS is often referred to as ‘multiple system atrophy’ (MSA). In addition to SDS, there is other multiple system atrophies which are clinically and pathologically similar to SDS but have less damage to the autonomic nervous system.