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Imaging biomarkers for early multiple system atrophy.

Prashanthi Vemuri1, Anna M Castillo1, Kaely B Thostenson1

  • 1Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN, 55905, USA.

Parkinsonism & Related Disorders
|September 5, 2022
PubMed
Summary
This summary is machine-generated.

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Structural MRI and diffusion MRI can identify early multiple system atrophy (MSA) progression. Brainstem and cerebellar pathway changes are key biomarkers for diagnosis and clinical trials in MSA patients.

Area of Science:

  • Neuroimaging
  • Neurology
  • Biomarker Discovery

Background:

  • Multiple system atrophy (MSA) is a progressive neurodegenerative disorder.
  • Early diagnosis and tracking disease progression are crucial for effective management and clinical trials.
  • Structural and diffusion magnetic resonance imaging (MRI) offer potential for objective disease assessment.

Purpose of the Study:

  • To systematically evaluate structural and diffusion MRI features for distinguishing early multiple system atrophy (MSA) patients from controls.
  • To assess the utility of these MRI features in tracking longitudinal disease progression in MSA.
  • To identify potential imaging biomarkers for early MSA diagnosis and clinical trial development.

Main Methods:

  • A prospective, longitudinal study involving 14 controls and 29 early-stage MSA patients (MSA-C and MSA-P subtypes).
Keywords:
Imaging biomarkersMRIMultiple system atrophy

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  • Regional morphometric and diffusion MRI features were computed and ranked for discriminative ability.
  • Top-performing regions were evaluated for longitudinal tracking of disease progression over 12 months.
  • Features were validated in an independent dataset.

    • Main Results:

    • Morphometric changes in cerebellar white matter, brainstem, and pons distinguished early MSA-C patients from controls cross-sectionally and longitudinally (p < 0.01).
    • Putamen and striatum changes differentiated early MSA-P patients at baseline but not for longitudinal tracking.
    • Diffusion changes in cerebellar white matter aided in detecting early neurodegeneration in MSA.

    Conclusions:

    • Brainstem and cerebellar pathways show progressive deterioration in MSA, irrespective of clinical subtype.
    • Quantitative MRI measurements in these regions are promising biomarkers for early MSA diagnosis.
    • These imaging markers hold potential as surrogate endpoints for future clinical trials in MSA.