Stridor-related gray matter alterations in multiple system atrophy: A pilot study

Area of Science:

• Neuroscience
• Neurology
• Radiology

Background:

• Stridor, a high-pitched breathing sound, is a known complication of Multiple System Atrophy (MSA), but its underlying neuroanatomical basis is not well understood.
• Understanding the brain changes associated with stridor in MSA is crucial for developing targeted therapies and improving patient outcomes.

Purpose of the Study:

• To investigate the gray matter (GM) density differences in the brains of MSA patients with and without stridor.
• To identify specific neuroanatomical regions associated with stridor in MSA.

Main Methods:

• 36 patients diagnosed with MSA underwent nocturnal video-polysomnography to confirm stridor and brain MRI scans.
• Voxel-Based Morphometry (VBM) with the Specific Unbiased Infratentorial Template (SUIT) tool was used to analyze GM density differences between MSA patients with stridor, MSA patients without stridor, and healthy controls.

Main Results:

• MSA patients experiencing stridor exhibited significantly higher GM density in the cerebellum compared to those without stridor.
• Conversely, MSA patients with stridor showed lower GM density in the striatum compared to MSA patients without stridor.
• These GM density changes were observed in specific cerebellar and striatal regions.

Conclusions:

• This study provides the first evidence of stridor-related GM changes in the striatal and cerebellar regions of MSA patients.
• The findings suggest a potential link between stridor pathophysiology in MSA and dystonic disorders affecting laryngeal muscles.
• Further research with larger patient cohorts is warranted to confirm these preliminary results and elucidate the precise mechanisms involved.