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White Matter Abnormalities Track Disease Progression in Multiple System Atrophy.
Sheelakumari Raghavan1, Timothy G Lesnick2, Anna M Castillo2
1Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Movement Disorders Clinical Practice
|June 26, 2024
Summary
White matter abnormalities are central to multiple system atrophy (MSA) progression, affecting both subtypes similarly. Longitudinal MRI can track these brain changes in clinical trials.
Area of Science:
- Neuroimaging
- Neurology
- Neurodegeneration
Background:
- White matter (WM) abnormalities are linked to functional decline in multiple system atrophy (MSA).
- Understanding these changes is crucial for tracking disease progression.
Purpose of the Study:
- Identify white matter (WM) and gray matter (GM) abnormalities in MSA.
- Assess longitudinal structural and diffusion MRI changes as surrogate markers for disease progression.
Main Methods:
- Prospective, longitudinal study of 27 early MSA patients (MSA-C and MSA-P) and 14 controls.
- Utilized structural and diffusion MRI (DT-MRI, NODDI) to analyze brain changes.
- Evaluated temporal imaging trajectories with up to three annual follow-up scans.
Main Results:
- MSA patients showed more widespread WM than GM changes, especially in the cerebellum and brainstem.
- Cerebellum WM and brainstem structural and diffusion measures worsened with disease progression.
- Progression rates were similar across MSA subtypes, indicating clinical feature overlap.
Conclusions:
- WM abnormalities are key features of MSA progression, advancing at similar rates in subtypes.
- Multimodal MRI provides insights into MSA brain abnormalities and their progression.
- Selected MRI measures show potential for tracking MSA progression in clinical trials.
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