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Hypothalamic involvement in multiple system atrophy: A structural MRI study.

Jacopo Pasquini1, Michael J Firbank2, Laura Best3

  • 1Clinical Ageing Research Unit, Newcastle University, Newcastle upon Tyne NE4 5PL, United Kingdom; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Journal of the Neurological Sciences
|April 6, 2024
PubMed
Summary
This summary is machine-generated.

Multiple system atrophy (MSA) shows reduced posterior hypothalamus volume, linked to poorer cognitive function. Further research is needed to understand hypothalamic changes in MSA.

Keywords:
DysautonomiaHypothalamusMemoryMultiple system atrophy

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Area of Science:

  • Neuroimaging
  • Neurodegenerative diseases
  • Human physiology

Background:

  • Multiple system atrophy (MSA) presents with autonomic dysfunction and parkinsonian or cerebellar symptoms.
  • The hypothalamus is crucial for regulating autonomic functions, homeostasis, and cognitive processes.

Purpose of the Study:

  • To investigate in-vivo hypothalamic atrophy in multiple system atrophy (MSA).
  • To explore the clinical correlates of hypothalamic volume changes in MSA.

Main Methods:

  • Utilized a validated automated hypothalamic segmentation tool on 3T MRI 3D-T1-weighted images.
  • Compared hypothalamic volumes in 11 MSA patients against 18 Parkinson's Disease (PD) patients and 18 Healthy Controls (HC).
  • Assessed associations between hypothalamic volumes and autonomic, depressive, sleep, and cognitive scores.

Main Results:

  • Posterior hypothalamus volume was significantly reduced in MSA compared to both HC (p=0.041) and PD (p=0.046) groups.
  • A trend towards reduced total hypothalamus volume was observed in MSA versus HC (p=0.101).
  • Reduced posterior hypothalamus volume correlated with lower Montreal Cognitive Assessment (MoCA) scores in the combined MSA and PD group and in each group individually.

Conclusions:

  • In-vivo evidence suggests structural hypothalamic involvement in MSA.
  • Smaller posterior hypothalamus volume, encompassing the mammillary bodies and lateral hypothalamus, is associated with impaired cognitive function.
  • Larger-scale studies are warranted to further elucidate hypothalamic involvement and its clinical implications in MSA.