Progression of subcortical atrophy and iron deposition in multiple system atrophy: a comparison between clinical subtypes

J Neurol. 2015 Aug;262(8):1876-82. doi: 10.1007/s00415-015-7785-5. Epub 2015 May 28.

Abstract

Magnetic resonance imaging (MRI) can be useful not only for the diagnosis of multiple system atrophy (MSA) itself, but also to distinguish between different clinical subtypes. This study aimed to investigate whether there are differences in the progression of subcortical atrophy and iron deposition between two variants of MSA. Two serial MRIs at baseline and follow-up were analyzed in eight patients with the parkinsonian variant MSA (MSA-P), nine patients with cerebellar variant MSA (MSA-C), and fifteen patients with Parkinson's disease (PD). The R2* values and volumes were calculated for the selected subcortical structures (caudate nucleus, putamen, globus pallidus, and thalamus) using an automated region-based analysis. In both volume and R2*, a higher rate of progression was identified in MSA-P patients. Volumetric analysis showed significantly more rapid progression of putamen and caudate nucleus in MSA-P than in MSA-C. With regard to R2* changes, a significant increase at follow-up and a higher rate of progression were identified in the putamen of MSA-P group compared to MSA-C and PD groups. This longitudinal study revealed different progression rates of MRI markers between MSA-P and MSA-C. Iron-related degeneration in the putamen may be more specific for MSA-P.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Corpus Striatum / metabolism
  • Corpus Striatum / pathology*
  • Disease Progression*
  • Female
  • Follow-Up Studies
  • Humans
  • Iron / metabolism*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple System Atrophy / metabolism
  • Multiple System Atrophy / pathology*
  • Olivopontocerebellar Atrophies / metabolism
  • Olivopontocerebellar Atrophies / pathology
  • Parkinson Disease / metabolism
  • Parkinson Disease / pathology*
  • Striatonigral Degeneration / metabolism
  • Striatonigral Degeneration / pathology
  • Thalamus / metabolism
  • Thalamus / pathology*

Substances

  • Iron