HCRT and multiple system atrophy: EDS was considered as the result of inadequate sleep or sleep-related breathing disorder (SRBD) in MSA (2–4), but the most relevant cause might be the neural systems pathophysiological impairment, including cholinergic neurons in the mesopontine tegmentum, hypocretin/orexin neurons of the lateral hypothalamus, serotonergic neurons of the rostral raphe, and dopaminergic neurons in the ventral periaquapular gray matter (5–7).