Multiple System Atrophy (MSA) is a brain disorder that gets worse over time. The study aims to see if a new drug called MSA-01 can help slow down this process. MSA-01 is a form of CoQ10, a nutrient some people with MSA might lack. In this study, 140 participants will either receive MSA-01 or a placebo (a harmless pill) for one year. The main focus is to check if MSA-01 can help with motor impairment (trouble moving) by using a test called the Unified Multiple System Atrophy Rating Scale (UMSARS).

• Duration: 12-month study with regular clinic visits.
• Participation: Takes about 52 weeks, with medication diaries and check-ups.
• Eligibility: Must have MSA and be able to walk with or without help. Cannot use CoQ10 supplements during the study.

You cannot join if you have other severe brain disorders, liver disease, or are pregnant. The study will look at the safety of MSA-01 and collect data to see if it works better than a placebo.