There will be no direct benefit to you from participating in this research study; however, you will undergo medical assessments with a study doctor who specializes in MSA. This study may generate information that can lead to a better understanding of the disease process and may lead to improvement in medical care.

• Risks include:
  Some of the questions you will be answering are personal and about your health condition. This may make you feel uncomfortable, anxious or upset. You do not have to answer questions you do not feel comfortable answering. You may feel tired or frustrated when completing some of the study activities.
• The insertion of the IV may cause pain or a stinging feeling or may leave a bruise. Sometimes people can feel lightheaded or even faint after a blood draw. Rarely, an injury to a blood vessel or nerve could occur. You will need to lie very still under the camera for up to 180 minutes, which may cause back pain, headache, dizziness or feeling tired.
• Risks of blood draw: Blood draws may cause pain and bruising at the site where the blood is taken.
• Risks of [18F] FD4: [18F]FD4 is an investigational imaging agent that contains a small amount of radiation. The amount of radiation you will receive from the [18F]FD4 PET scan is similar to what you would get naturally over 3 years by simply living on the earth

Risks of Lumbar Puncture (LP):

• The lumbar puncture may cause pain at the site where the needle goes in, and the spinal fluid is taken. There is a risk of infection or bleeding. Sometimes people can feel lightheaded or even faint during or after a procedure. After the lumbar puncture, you may get a headache. To minimize the risk of a headache, the doctor will use a thin needle and may prescribe bedrest for one or more hours after the procedure. If a headache occurs, it is usually mild and can be controlled by bedrest, drinking lots of fluids, caffeinated drinks, or a pain pill, such as Tylenol.