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Updated: Feb 6, 2026

Whole-brain Segmentation and Change-point Analysis of Anatomical Brain MRI—Application in Premanifest Huntington's Disease
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Abnormalities on structural MRI associate with faster disease progression in multiple system atrophy.

Florian Krismer1, Klaus Seppi2, Gregor K Wenning1

  • 1Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.

Parkinsonism & Related Disorders
|August 27, 2018
PubMed
Summary

Structural MRI abnormalities predict faster disease progression in early Parkinsonian Multiple System Atrophy (MSA-P). Patients with MRI-positive findings showed worse outcomes, suggesting a more aggressive disease variant.

Keywords:
BiomarkerMagnetic resonance imagingMultiple system atrophyRasagiline

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Area of Science:

  • Neurology
  • Radiology
  • Neurodegenerative Diseases

Background:

  • Predicting clinical progression in Multiple System Atrophy (MSA) is challenging.
  • A previous study found no difference in progression with rasagiline treatment but included a valuable MRI substudy.
  • This analysis leverages that MRI substudy to investigate early disease progression predictors.

Purpose of the Study:

  • To determine if baseline structural MRI abnormalities predict clinical progression in early Parkinsonian MSA (MSA-P).
  • To compare the rate of clinical progression between MRI-positive and MRI-negative patients.

Main Methods:

  • Post-hoc analysis of a prospective MRI substudy in early MSA patients.
  • Comparison of clinical progression using the Unified MSA Rating Scale (UMSARS) between MRI-positive and MRI-negative groups.
  • Statistical analysis using repeated measures ANCOVA.

Main Results:

  • MRI-positive patients (n=13) showed significantly faster progression on UMSARS total and motor scales compared to MRI-negative patients (n=15).
  • At 48 weeks, MRI-positive patients reported significantly worse health status.
  • The study included 28 early MSA-P patients with complete UMSARS data.

Conclusions:

  • Baseline MSA-specific structural MRI abnormalities identify a subgroup of MSA-P with more rapid clinical progression.
  • These findings suggest MRI-detectable abnormalities indicate a more severe variant of MSA-P.
  • Structural MRI may serve as a prognostic biomarker in early MSA.