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Magnetic resonance imaging markers predict disease progression in early-stage multiple system atrophy: a 2-year
Lingyu Zhang1,2, Junyu Lin1, Chunyu Li1
1Department of Neurology, Laboratory of Neurodegenerative Disorders, Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China.
Background:
Magnetic resonance imaging (MRI) markers are identified as important indicators for the diagnosis of multiple system atrophy (MSA). However, whether these MRI markers can predict the disease progression of MSA remain undefined. We aimed to investigate the relationship between MRI markers and disease progression in patients with early MSA.
Methods:
The patients were divided into MRI-positive and MRI-negative groups based on MSA-specific MRI markers. Disease progression was evaluated using the Unified MSA Rating Scale (UMSARS), Montreal Cognitive Assessment and Frontal Assessment Battery. A repeated measures ANCOVA was used to compare the rate of disease progression between the two groups. A multiple linear regression model was used to assess the association between MRI subtype and disease progression.
Results:
A total of 144 patients with early MSA were enrolled and 73 patients completed the 2-year follow-up. Patients with MSA and MSA of the parkinsonian subtype (MSA-P) in the MRI-positive group exhibited significantly faster disease progression on the total UMSARS score over a 2-year follow-up compared to those in the MRI-negative group (p = 0.002 and p = 0.020, respectively). Multiple linear regression analysis revealed that MRI-positive status was a significant predictor of more severe disease progression on the UMSARS total score in patients with MSA and MSA-P at the 1- and 2-year follow-up after adjusting for age, sex, and baseline disease duration (all p < 0.05).
Conclusions:
This study highlights that MRI markers are valuable imaging predictors of disease progression in early MSA, in addition to their diagnostic role.
Insights
Magnetic resonance imaging (MRI) markers predict faster disease progression in early multiple system atrophy (MSA). These imaging markers are valuable for predicting MSA progression beyond diagnosis.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Magnetic resonance imaging (MRI) markers are crucial for diagnosing multiple system atrophy (MSA).
- The predictive value of these MRI markers for MSA disease progression remains unclear.
- This study investigates the link between MRI markers and disease progression in early MSA patients.
Purpose of the Study:
- To determine if specific MRI markers can predict the rate of disease progression in early multiple system atrophy (MSA).
- To assess the association between MRI-positive status and clinical outcomes over a 2-year period.
Main Methods:
- Patients were categorized into MRI-positive and MRI-negative groups based on MSA-specific markers.
- Disease progression was assessed using the Unified MSA Rating Scale (UMSARS), Montreal Cognitive Assessment, and Frontal Assessment Battery.
- Repeated measures ANCOVA and multiple linear regression models were employed to analyze disease progression rates and predictor associations.
Main Results:
- MRI-positive patients with MSA and MSA-parkinsonian subtype (MSA-P) showed significantly faster progression on UMSARS scores over 2 years.
- MRI-positive status independently predicted more severe UMSARS progression at 1 and 2 years.
- These findings were significant after adjusting for age, sex, and baseline disease duration.
Conclusions:
- MRI markers serve as valuable imaging predictors for disease progression in early MSA.
- Beyond their diagnostic utility, MRI markers offer prognostic insights into MSA.
- This research underscores the importance of MRI in managing and understanding MSA progression.
