“…The pathogenic cascade leading to αSyn aggregation and the neurodegeneration of this oligodendroglioneuronal proteinopathy is poorly understood [ 10 , 11 ], but recent studies elucidated the early cellular dysfunction in MSA indicating both increased susceptibility to oxidative stress and disease-related translocation of αSyn to the cell nucleus [ 12 ], while others demonstrated mislocalization of myelin-associated oligodendrocyte basic protein (MOBP) and huntingtin protein 1 (HIP1) due to DNA methylation interacting with αSyn in the oligodendrocyte as a pathogenic way of MSA [ 13 ]. Converging evidence suggests a “prion-like” spreading of misfolded αSyn “strains” as a pathogenic key event [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ], while others suggested that MSA is a prion disease [ 26 , 27 , 28 , 29 ]. The prion hypothesis of human synucleinopathies and the question of whether αSyn is a prion or prion-like are a matter of continuous discussion [ 15 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ].…”