Multiple System Atrophy Epidemiology

• In 2025, the total diagnosed prevalent cases of MSA across the 7MM was nearly ~70,000. MSA is a rare, progressive neurodegenerative disorder with no clearly defined environmental cause, and its prevalence is projected to grow at 0.7% CAGR across the 7MM, primarily driven by an aging population, improved survival, and enhanced diagnostic awareness.
• The United States continues to hold the largest diagnosed prevalent base of approximately 40,000 cases in 2025, with males representing nearly 47% of the affected population.
• In the US, Stage 3 accounted for the largest share of MSA cases in 2025 (~36%), followed by Stage 4 (~32%) and Stage 5 (~24%), highlighting the predominance of advanced-stage disease. Disease stage is a key factor in determining the patient population and treatment needs, with the number of cases across all stages expected to increase by 2036.
• In Japan, around 80% of MSA cases in 2025 were attributed to MSA-C, while 20% were linked to MSA-P.
• The epidemiology of MSA reflects a significant disease burden, driven by its aggressive nature, poor prognosis, and limited availability of curative options. Additionally, challenges in early diagnosis and non-specific symptom presentation often lead to delayed detection, further influencing reported prevalence patterns and contributing to underestimation in certain regions.

Multiple System Atrophy Epidemiology forecast

• 2025 Multiple System Atrophy Diagnosed Prevalent Cases in the 7MM: ~70,000 
• Multiple System Atrophy Growth Rate (2026–2036) in the 7MM: 0.7% CAGR

DelveInsight’s ‘Multiple System Atrophy–Epidemiology Forecast – 2036’ report delivers an in-depth understanding of MSA, historical and forecasted epidemiology trends in the United States, EU4 (Germany, Spain, Italy, and France), the United Kingdom, and Japan.

The MSA epidemiology report provides a comprehensive analysis of prevalent cases, capturing the number of diagnosed patients across the 7MM. It includes detailed segmentation by histological type, disease stage, age, and gender, along with regional distribution. The report evaluates historical and forecasted prevalence trends (2026–2036), highlighting variations in disease occurrence and diagnosis patterns, and offering insights into the evolving burden of newly diagnosed MSA cases.

Geography Covered 

North America: The United States

Europe: Germany, France, Italy, and Spain and the UK

Asia-Pacific: Japan 

Multiple System Atrophy Understanding and Algorithm

MSA Overview and Diagnosis

MSA is a rare, progressive neurodegenerative disorder characterized by a combination of autonomic dysfunction, Parkinsonism, and cerebellar ataxia. It results from widespread neuronal degeneration and accumulation of α-synuclein in the central nervous system. The disease presents heterogeneously, primarily as MSA-P (parkinsonian subtype) or MSA-C (cerebellar subtype), with patients experiencing varying degrees of motor impairment, balance disturbances, and severe autonomic symptoms such as orthostatic hypotension, urinary dysfunction, and impaired thermoregulation. The condition is progressive and ultimately leads to significant disability.

Effective management of MSA requires a comprehensive and multidisciplinary approach focused on symptom control and quality of life improvement. Diagnosis is based on a combination of clinical evaluation and supportive investigations, as there is no single definitive diagnostic test. It involves identifying key features such as autonomic dysfunction (e.g., orthostatic hypotension, urinary incontinence) along with parkinsonian or cerebellar symptoms. Neuroimaging, particularly MRI, may reveal characteristic findings such as cerebellar or brainstem atrophy (e.g., “hot cross bun” sign), supporting the diagnosis. Additional assessments, including autonomic function testing and urodynamic studies, are often used to evaluate the severity of autonomic impairment. Despite these tools, early diagnosis remains challenging due to symptom overlap with other neurodegenerative disorders, and confirmation is often achieved through disease progression over time.

Further details are provided in the report.

Multiple System Atrophy Unmet Needs

The section “unmet needs of MSA epidemiology” outlines the key gaps in understanding the true disease burden and prevalence patterns. It highlights challenges faced in accurate case identification, reporting, and surveillance, and identifies areas for improvement in epidemiological assessment and data generation. 

1. Need for improved epidemiological characterization and tracking of disease progression
2. Challenges in early and accurate diagnosis leading to underestimation of true prevalence
3. Limited data on type-specific epidemiology and distribution of disease burden
4. Need for better population-based studies to capture real-world disease burden and trends

and others…..

Note: Comprehensive unmet needs insights in MSA and their strategic implications are provided in the full report.

Multiple System Atrophy Epidemiology

Key Findings from MSA Epidemiological Analysis and Forecast 

• According to DelveInsight’s analysis, in 2025, the US had the highest number of diagnosed prevalent cases of MSA among the 7MM, with more than 40,000 cases in the US, followed by Japan with nearly 17,000 cases in 2025.
• In 2025, males accounted for 47% of MSA cases in the US, while females represented 53%. These gender-specific patterns are expected to persist, with prevalent cases projected to grow further by 2036.
• MSA is divided into six stages: Stage 0, Stage 1, Stage 2, Stage 3, Stage 4, and Stage 5. In 2025, Stage 3 had the highest diagnosed prevalent, with around 4,000 cases reported in EU4 and the UK.
• According to DelveInsight’s analysis, in 2025, Germany recorded the highest number of nOH symptomatic MSA with approximately 2,000 cases, followed closely by the UK. Spain recorded the least number of cases in this segment with about 1,200 cases in EU4 and the UK.  
• In the UK, the 70 years and above age group reported the highest number of MSA around 1,200 cases in 2025, surpassing other age groups such as 50–59 and 60–69, with projections indicating an increase by 2036.

Further details are provided in the report.

Total Diagnosed Prevalent Cases of MSA in the 7MM in 2025

Industry Experts and Physician Views for Multiple System Atrophy (MSA)

To keep up with MSA market trends, we take Key Opinion Leaders (KOLs) and Subject Matter Experts (SMEs) opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry Experts were contacted for insights on the MSA epidemiology, prevalence trends, regional distribution, patient demographics, diagnostic rates, and real-world disease burden patterns in MSA, including MD, PhD, Instructor, Postdoctoral Researcher, Professor, Researcher, and others.

DelveInsight’s analysts connected with 8+ KOLs to gather insights at country level. Centers such as the University of California San Francisco, Johannes-Gutenberg-University, Germany, Hyogo College of Medicine, Japan, etc. were contacted. 

Their opinion helps understand and validate MSA epidemiological trends, highlight key gaps in diagnosis and disease burden, provide deeper epidemiological context, and support strategic decisions for patient identification and disease monitoring in MSA.

Scope of the Report

• The report covers a segment of key epidemiological highlights, an executive summary, and a descriptive overview of MSA, including its causes, risk factors, and factors influencing disease occurrence.
• Comprehensive insights are provided into prevalence trends and forecasts, along with the future growth potential of diagnosis rates and evolving patterns of disease detection across the 7MM.
• Additionally, the report includes detailed segmentation of prevalent cases by histological subtype, age, gender, and region, offering a granular view of the epidemiological landscape.
• A thorough assessment of historical and forecasted prevalence data, along with underlying assumptions and methodology, is included, providing a clear understanding of disease burden across the 7MM.
• The report provides strategic insights by highlighting trends in prevalence, diagnostic gaps, and regional variations, supported by expert opinions and epidemiological analysis to better understand and project the MSA disease burden. 

Report Insights

• MSA prevalence forecast, epidemiological burden, segmentation, trends, and opportunity assessment.

Report Key Strengths

• Epidemiology‑based (EPI ‑ based) bottom‑up forecasting
• Artificial Intelligence (AI) - enabled epidemiology research report 
• 11-year forecast 
• MSA epidemiological outlook (North America, Europe, Asia-Pacific) 
• MSA Burden trends (by geography)

Report Assessment

• MSA diagnostic trends
• MSA epidemiological gaps
• MSA development trends
• MSA emerging research focus
• MSA disease burden attractiveness
• MSA qualitative epidemiological insights

FAQs

• What was the MSA prevalent patient population and distribution (%) in 2025, and how will it evolve by 2036? What factors are driving these trends?
• What are the anticipated variations in prevalence and diagnosis rates across different geographies?
• What will be the future diagnosis and epidemiological trends of MSA?
• What are the disease risks, burden, and key epidemiological gaps in MSA? What are the growth opportunities based on the patient population across the 7MM?
• How will changes in prevalence and diagnosis impact the overall epidemiological landscape?
• What are the current diagnosis practices and epidemiology trends of MSA in the US, Europe, UK, and Japan?

Reasons to Buy

• The report will help in developing strategies by understanding the latest trends and changing epidemiology of MSA.
• Bottom-up forecasting builds from the prevalent patient population, delivering a robust, data-driven epidemiological approach.
• Insights on patient burden/prevalence, evolution in diagnosis, and factors contributing to changes in disease epidemiology during the forecast years.
• Understand the epidemiological opportunities across varying geographies and growth potential over the coming years.
• Identifying key trends in disease prevalence will help anticipate shifts in the epidemiological landscape.
• Detailed analysis and segmentation of prevalent cases to provide visibility around high-burden patient groups.
• To understand KOLs’ perspectives on diagnosis challenges and gaps in disease identification.
• Detailed insights on epidemiological unmet needs to support improved disease tracking and diagnosis strategies.
• This Artificial Intelligence (AI)-enabled report summarizes complex epidemiological datasets into clear, actionable insights for stakeholders, investors, and healthcare providers.