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Summary -> 

This paper explored parkinsonism in more depth and talked about the vast differences it can share with MSA with evidence gathered from various research methods. This paper had both strong points and some that might need to be revised. 

PROS

Abstract:

• Clear statements of purpose, tools utilized to measure data, and background knowledge of Multiple system atrophy vs Parkinson’s Disorders

Introduction:

• The authors clearly defined and explained subdivisions of Multiple System Atrophy (MSA)

• They clearly described the geographical prevalence of the parkinsonian and cerebellar variants of MSA (MSA-P and MSA-C), displaying how certain groups of individuals could be more predisposed to a variant of MSA

Defining Parkinsonism in MSA: 

• Clearly discussed the various symptoms and prognoses between MSA-P and Parkinson’s Disease

Emerging Clinical Trials 

• Good incorporation of different clinical treatments of TSA, with emphasis on synuclein targeting

Modeling MSA and PD Using iPSCs

• Showcased application of the iPSC model to their research to show differences between MSA and Parkinson’s disease

Divergent Therapeutic Strategies in MSA‐P, MSA‐C, and Parkinson’s Disease

• Excellent attention to autonomic dysfunction and some medications (droxidopa, midodrine, and fludrocortisone)

• Makes the comparison simple by using specific drug classes (levodopa, MAO-B inhibitors, COMT inhibitors, DBS).

Genomic Variability

• Explains the main PD genes (SNCA, LRRK2, PARK7, PINK1, and GBA1) in detail and mentions a genetic influence of about 15%

Summary

• Clear clinical differences between MSA and Parkinsonism

• Connects clinical and imaging data with biomarker evidence

• Acknowledges limitations in findings

Conclusion

• Ties back well to abstract in the sense of presenting differences between MSA and PD

CONS

Abstract:

• Specify on tailored therapeutic strategies -> is it a derivation of previous methods that have been utilized or something else entirely?

Conclusion

• Lacks a Future Research Section

• Lacks Keywords list

Emerging Clinical Trials 

• Lack of elaboration on Lu AF82422 -> Same concept as TAK-341 and holds clinical significance, more recent

Understanding the Pathogenesis of MSA and PD

• Further explain how serum neurofilament light chain and alpha synuclein seeding assays

Genomic Variability

• Make the reference to Figure 1 more clear by using phrases like "As shown in Figure 1..."

Divergent Therapeutic Strategies in MSA‐P, MSA‐C, and Parkinson’s Disease

• At the beginning, briefly explain that the purpose of this part is to compare the treatment approaches used by MSA-P, MSA-C, and PD.

Summary

• Lack of data to support biomarker elevation or levodopa responsiveness

Competing interests

The authors declare that they have no competing interests.

Use of Artificial Intelligence (AI)

The authors declare that they did not use generative AI to come up with new ideas for their review.