# The Emotional Landscape of Multiple System Atrophy: A Preliminary Personality-Based Perspective

## TL;DR

This study explores personality traits in Multiple System Atrophy patients, finding elevated emotional vulnerability and suicidal ideation.

## Contribution

The study identifies a distinct personality profile in MSA patients, emphasizing emotional and somatic traits not previously well-documented.

## Key findings

- MSA patients showed elevated scores in somatic complaints and internalizing emotional traits.
- Strong correlations were found between somatic and emotional traits, and between neurological complaints and disease duration.
- Externalizing behavioral traits were rare, with no significant aggression or behavioral dysfunction observed.

## Abstract

Background: Multiple System Atrophy (MSA) is a rapidly progressing neurodegenerative movement disorder characterized by autonomic failure, parkinsonism, and cerebellar ataxia. While its non-motor symptoms are well-documented, personality features in MSA remain underexplored. This study characterizes the personality traits of non-demented patients with MSA and explores their association with clinical variables. Methods: Twenty-six patients with MSA were assessed using the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Dementia was excluded by Montreal Cognitive Assessment. Descriptive statistics and non-parametric analyses were conducted to examine clinical, demographic, and MMPI-2-RF variables. Results: Patients commonly showed elevated scores in somatic domains: Somatic Complaints (39%), Malaise (58%), and Neurological Complaints (85%), as well as in internalizing emotional traits: Low Positive Emotions (39%), Introversion (46%), Suicidal Ideation (46%), and Hopelessness (54%). Externalizing behavioral traits were absent, with only 4–8% of patients showing elevations in aggression or behavioral dysfunction. Strong correlations were found between somatic and emotional traits (r = 0.656, p < 0.001), and between Neurological Complaints and disease duration (r = 0.662, p < 0.001). Conclusions: This exploratory study reveals a distinct personality pattern in MSA, characterized by marked suicidal ideation, emotional vulnerability with internalizing coping, and absence of externalizing behaviors. These features highlight the need for suicide risk screening, interventions to alleviate psychological suffering, and tailored multidisciplinary care. Larger, longitudinal studies are warranted to confirm these preliminary results and clarify whether these traits reflect premorbid personality, early disease manifestations, or secondary responses, as well as their prognostic and clinical relevance.